Pregnant nurses' experiences of working shifts: a qualitative systematic review.

Abstract

Objective: The objective of this systematic review was to synthesize the experiences of nurses who work shifts during pregnancy.

Introduction: Pregnancy is a process of rapid physical change that requires adaptation both mentally and physically. Many women continue to work during pregnancy, including in the nursing profession, but there are various risks associated with working while pregnant.

Inclusion criteria: This review included studies that focused on the experiences of pregnant registered nurses, regardless of their level of qualification, working shifts in any workplace, including hospitals, nursing home facilities, or clinics, in any country. Nurses not involved in direct care (eg, advanced practice nurses, administrators, educators) were excluded.

Methods: The review followed the JBI methodology for qualitative systematic reviews. Published and gray literature were searched for via CINAHL (EBSCOhost), MEDLINE (EBSCOhost), PsycINFO (EBSCOhost), and Igaku Chuo Zasshi (Japan Medical Abstracts Society). No language restrictions were imposed, and the date limit was set for 2013 to 2021. Two independent reviewers performed data collection, extraction, critical appraisal, and analysis. Unequivocal and credible findings were used to develop categories, which were then synthesized to provide a set of comprehensive findings that were graded according to ConQual.

Results: Five qualitative studies were included (2 from the USA, 2 from Japan, and 1 from Korea), from which 23 findings with narrative illustrations were extracted. Of these findings, 22 were assessed as unequivocal and 1 as credible. The studies were low to moderate quality based on the JBI critical appraisal checklist for qualitative research. All studies used qualitative methodologies, including phenomenology, qualitative description, and the grounded theory approach. Results were integrated into 8 categories and 3 synthesized findings. The first synthesized finding was that nurses struggle with the physical burden of pregnancy and work environments that threaten continued pregnancy. The second was that nurses achieve work-pregnancy compatibility by disclosing their pregnancy and obtaining support. The third was that development as a nurse results from continuing to work during pregnancy.

Conclusions: Pregnant nurses face a harsh work environment; the support they receive after disclosing their pregnancy allows them to balance work and pregnancy; and they feel that they grow as professionals by continuing to work even if they are pregnant. More research is needed to inform support systems for pregnant nurses.

Review registration: PROSPERO CRD42022309674.

Supplemental digital content: A Japanese-language version of the abstract of this review is available: http://links.lww.com/SRX/A31.