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Objective <p>To explore neonatal nurse practitioners’ (NNPs) perspectives on prolonged shift-length, fatigue, and strategies to support well-being and workforce sustainability.</p> Study design <p>This qualitative study examined open-ended responses from a national mixed-methods survey of U.S. NNPs conducted between November 2024 and January 2025. Participants were board-certified NNPs practicing in neonatal intensive care units nationwide.</p> Results <p>Among 396 respondents, two themes emerged: individual-level and system-level strategies. Individual-level strategies included work-life balance, self-care, and adaptability. Prolonged shifts were viewed positively or neutrally when voluntary and associated with fewer workdays, continuity of care, and reduced commuting. System-level strategies included protected downtime, fatigue monitoring, and scheduling flexibility. Negative perceptions arose when extended shifts were inflexible or imposed, contributing to fatigue and decreased morale.</p> Conclusion <p>Prolonged shifts present benefits and risks. Findings suggest that practitioner choice, protected rest, and organizational recognition of fatigue are essential to supporting NNP well-being, workforce sustainability, and safe neonatal care.</p>

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Neonatal nurse practitioners’ perspective on fatigue, safety, and collaboration during 24-hour shifts in the neonatal intensive care unit

  • 期刊论文

  • 发表日期：

    2026年6月3日

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  • Meredith L. Farmer,
  • Jacqueline Hoffman,
  • Jessica Gomez,
  • Christopher C. Imes,
  • Tracey R. Bell

摘要

Objective

To explore neonatal nurse practitioners’ (NNPs) perspectives on prolonged shift-length, fatigue, and strategies to support well-being and workforce sustainability.

Study design

This qualitative study examined open-ended responses from a national mixed-methods survey of U.S. NNPs conducted between November 2024 and January 2025. Participants were board-certified NNPs practicing in neonatal intensive care units nationwide.

Results

Among 396 respondents, two themes emerged: individual-level and system-level strategies. Individual-level strategies included work-life balance, self-care, and adaptability. Prolonged shifts were viewed positively or neutrally when voluntary and associated with fewer workdays, continuity of care, and reduced commuting. System-level strategies included protected downtime, fatigue monitoring, and scheduling flexibility. Negative perceptions arose when extended shifts were inflexible or imposed, contributing to fatigue and decreased morale.

Conclusion

Prolonged shifts present benefits and risks. Findings suggest that practitioner choice, protected rest, and organizational recognition of fatigue are essential to supporting NNP well-being, workforce sustainability, and safe neonatal care.