The impact of extended shifts on strain‐based work–life conflict: A qualitative analysis of the role of context on temporal processes of retroactive and anticipatory spillover

• Published date: 01 April 2021
• Author: Jane Suter,Tina Kowalski
• Date: 01 April 2021
• DOI: http://doi.org/10.1111/1748-8583.12321

Received: 30 October 2019

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Revised: 14 August 2020

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Accepted: 1 September 2020

DOI: 10.1111/1748-8583.12321

ORIGINAL ARTICLE

The impact of extended shifts on strain‐based

work–life conflict: A qualitative analysis of the

role of context on temporal processes of

retroactive and anticipatory spillover

Jane Suter |Tina Kowalski

The University of York Management School,

University of York, York, UK

Correspondence

Jane Suter, The University of York

Management School, University of York,

Freboys Lane, Heslington, York YO10 5GD,

UK.

Email: jane.suter@york.ac.uk

Abstract

Twelve‐h shifts can facilitate 24‐h service provision and are

often implemented in pursuit of financial goals. Existing

evidence on the benefits of extended shifts is mixed. This

study examines the impact of extended shifts on employee

strain in a large mental healthcare organisation in England.

Semi‐structured interviews were conducted with nurses

and healthcare assistants at 6 and 12 months intervals

(n¼70). Findings illustrate how extended shift patterns

have a profound negative effect on high demands already

confronting mental health staff, shaping spillover of strain.

Analysis contributes to development of strain‐based work–

life conflict theory by conceptualising spillover as temporal

and iterative. We argue theory should differentiate

between retroactive (backward facing) and anticipatory

(forward facing) spillover processes. Using context as a lens

and identification of new dimensions to strain‐based spill-

over aids interpretation of differential effects of extended

shifts across settings. The study discusses implications for

organisations, recovery and scheduling of shift work.

Abbreviations: CWW, compressed work week; HCA, healthcare assistant; NHS, National Health Service;RMN, registered mental health nurse; WLC,

work–life conflict.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and

reproduction in any medium, provided the original work is properly cited.

© 2020 The Authors. Human Resource Management Journal published by John Wiley & Sons Ltd.

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Hum Resour Manag J. 2021;31:514–531. wileyonlinelibrary.com/journal/hrmj

KEYWORDS

12‐h shifts, compressed work week, context, spillover, well‐being,

work–home interference, work–life conflict

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INTRODUCTION

Universal pressures for cost reduction alongside the need for high‐quality care emphasise the importance of

effective workforce management within the healthcare sector (Cooke & Bartram, 2015; Khatri, Gupta, & Varma,

2017). Healthcare organisations are reliant on shift workers, however considerable evidence suggests shift work

exposes employees to physical and psychological harm (Angrave & Charlwood, 2015; Raediker, Janssen, Schomann,

& Nachreiner, 2006) and can cause conflict between work and home (Jacobsen & Fjeldbraaten, 2018). Designing

cost‐efficient shift patterns whilst minimising strain and potential conflicts between work and non‐work domains

are a central concern for human resource management (HRM). Work schedules organised around 12‐h shifts are

often assumed a cost‐efficient way of delivering 24 h nursing, with wage savings arising from fewer handover

periods and less overtime (Dall'Ora, Ball, Recio‐Saucedo, & Griffiths, 2016). These shifts are increasingly popular

amongst healthcare employers to address staffing and financial pressures, particularly in North America and the

United Kingdom (Harris, Sims, Parr, & Davies, 2015). Whilst a tempting model for controlling labour costs, this

needs to be reconciled with ensuring high‐quality care via a high performing and healthy workforce.

12‐h shift patterns lend themselves to a compressed working week (CWW), where standard working hours are

limited to 3–4 days. Employers might assume employees prefer extended shifts as they are compensated by

additional days off (Hyatt & Coslor, 2018), offering a win–win solution. However, mixed evidence of the impact of

extended shift patterns on workers reveals variability across study findings (for a review, see Dall'Ora et al., 2016;

Knauth, 2007). We propose the role of context could explain differential outcomes. It is increasingly recognised

that context is an important shaper of employee experience (Cooke, 2018; Fletcher, Bailey, Alfes, & Madden, 2020;

Johns, 2006,2017), but is often overlooked. Extant work–life conflict (WLC) research has paid limited attention to

context, as studies often recruit participants outside of their employing organisation and so do not account for

situational influences shaping spillover processes (Casper et al., 2007; Eby et al., 2005; Gisler et al., 2018; Pop-

pleton, Briner, & Kiefer, 2008; Williams, Berdahl, & Verdello, 2016).

In this study, we examine how employees respond to the introduction of a 12‐h shift pattern in a context

characterised by a tight labour market, high demands and limited resources, namely acute wards in a large National

Health Service (NHS) mental health trust in England. A high and increasing demand for mental health services with an

estimated increase of 2million service users in the United Kingdom by 2030 (Mental Health Foundation, 2013) has led

to severe financial pressures resulting in staff shortages, increased workloads and work‐related stress (UNISON,

2017). Burnout is a problem for the mental health workforce, as acute mental health wards are inherently stressful

workplacescharacterised byhigh emotional labourof caring for mentally unwell patients, a high risk of physical assault

and continuous monitoring of patients at risk of self‐harm (Johnson et al., 2018). Our analysis focuses on interrogating

how context shapes employee experience of extended shift patterns and how this influences strain. With the intro-

duction of 12‐h shift patterns, and subsequent CWW, one might expect a reduction of WLC. Conversely, our analysis

exposed how longer shifts and extended periodsaway from the workplace amplified demands in this context, and how

this has a powerful influence on the temporal nature and processes of strain‐based spillover.

Cross‐sectional quantitative studies predicting relationships between work and family variables dominate

management research on the work–life intersection, with qualitative research under‐utilised, limiting our under-

standing (Beigi & Shirmohammadi, 2017). Studies on the relationship between shift work and WLC tend to focus on

time‐based conflicts, for example, examining how unsocial hours interfere with family responsibilities (e.g.,

Arlinghaus & Nachreiner, 2016; Karhula et al., 2018). We contribute to the work–life interference literature by

demonstrating how the context in which a work schedule is introduced shapes the process of spillover, creating

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