Cortisol, known as a stress hormone, normally follows a well-defined circadian rhythm: high in the morning to wake the body and low at night to promote rest. However, new research published on Nursing Open raises an alarm for those who work double shifts. The Turkish study conducted on 52 shift nurses showed that these professionals have significantly higher cortisol levels than those who work a single shift, with particularly high peaks during the night.
High voltage midnight
The data reveal that at midnight, when the hormone should reach its physiological minimum, cortisol levels in double shift workers almost doubled. This alteration is not just a number: it indicates a body constantly on alert, unable to recover adequately and subjected to chronic physiological stress. The authors underline how this imbalance can have consequences on both the health of nurses and the safety of patients, given the effects on attention and reactivity.
The burden of long shifts
According to Professor Fadime Ulupınar, lead author of the study at Erzurum Technical University, extended shifts alter the circadian rhythm of cortisol, exposing the body to a higher than natural stress load. Working beyond biological limits means putting a strain not only on the endocrine system, but also on psychological well-being and work performance. Experts therefore recommend rethinking shift planning, providing for longer rest periods and a balanced distribution of night loads.
Implications for healthcare and the future
This research highlights how shift management is not just an organizational issue, but a public health issue. Nurses working double shifts risk burnout, sleep disturbances and a compromised immune response, all of which can also affect the quality of care provided. Rethinking working hours could reduce exposure to chronic stress, improve patient safety and preserve the health of healthcare workers, making shifts sustainable in the long term.
A problem too often ignored
Too often nurses and doctors are exploited with double shifts and exhausting shifts, without adequate generational turnover or sufficient resources. The Covid-19 pandemic has highlighted this fragility, showing how healthcare personnel are essential but often subjected to unsustainable pressure. Yet, despite the emergency that followed and the understanding of their importance, very little has changed. We cannot continue like this: investing in larger staff, guaranteeing balanced shifts and valorising those who dedicate their lives to the care of others can no longer be postponed.
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