Night shift and occupational fatigue among nurses who work 12 hours in Jeddah

Abstract

The ever-demanding job of nurses necessitates night shift work for 12 hours at various healthcare facilities to improve continuity of care. Working at night is associated with physical and mental stress as it disturbs circadian rhythm, affects sleep, influences dietary and eating routine, and impairs cognitive function. Nursing is a high-demand profession that requires working for longer hours, due to which, nurses are at increased risk of occupational fatigue. This occupational fatigue involves various components of one’s life including poor physical performance, poor mental health, impaired cognition, and sensory overload on account of high work demand but low energy restoration. The current scope review aimed to assess the effect of night shift and occupational fatigue on nurses who work 12 hours. A systemic search of PubMed, EBSCO, CINAHL, MEDLINE, and Google Scholar was conducted. A total of 245 full-text articles underwent eligibility evaluation. In the end, 17 full-text articles were included in this scoping review. This scoping review found that there is a significance positive association of occupational fatigue with 12 hours nightshift work and that chronic fatigue leads to negative emotions, lack of concentration, and decreased motivation and subsequent reduced physical performance. In addition, nurses’ 12 hours nightshift work results in psychological, physical issues including anxiety, depression, burnout, exhaustion, and professional performance as well as affects nurses’ social and quality of life. Therefore, policymakers need to work on circadian rhythm-based interventions considering the work duration, speed of shift change, number of consecutive shifts, and social support.

Introduction

Night shift work, defined by the International Agency for Research on Cancer (IARC) as working ≥3 hours between 23:00 and 06:00, is essential yet associated with significant physical and mental stress due to circadian rhythm disruption, sleep disturbances, dietary changes, and cognitive impairment.[1,2]

Nurses, comprising approximately 59% of the global healthcare workforce, play a vital role in providing continuous patient care.[3] However, night shifts negatively impact their well-being, leading to fatigue, mental health issues, absenteeism, and reduced work performance.[4] Nurses working night shifts face increased risks of anxiety, depression, substance abuse, cognitive decline, and cardiovascular and metabolic disorders, ultimately affecting their job performance.[5] Moreover, the ever-demanding job of nurses necessitates nigh sift work for 12 hours at various healthcare facilities to improve continuity of care which adds more burden on nurses.

Nurses working night shifts often experience reduced social support and personal time, increasing feelings of loneliness and stress.[5] Work-related stress can lead to burnout and suicidal thoughts.[6] To mitigate these effects, maintaining a consistent sleep schedule—even on days off—along with good sleep hygiene, such as avoiding caffeine, alcohol, and nicotine, is recommended.[5]

Beyond mental health concerns, night shift work is linked to cardiovascular and metabolic diseases, increasing risks of obesity, hypertension, type 2 diabetes, dyslipidemia, and metabolic syndrome.[7,8] A population-based study found night shifts associated with higher cardiometabolic multimorbidity,[9] while research on healthcare workers linked circadian disruption to obesity and metabolic disorders.[10] Thus, night shift nurses face significant physical and mental health challenges.

Circadian rhythm disruption due to night work contributes to stress, irritability, and mood disorders,[11] while also limiting social and leisure activities, making work-life balance difficult.[12] Misalignment between the body’s internal clock and work demands increases emotional strain and stress, often leading to substance use as a coping mechanism.[13,14] Social isolation further exacerbates these risks,[15] highlighting the urgent need to address the adverse effects of night shift work on nurses’ well-being.

However, Occupational fatigue refers to work-related tiredness due to excessive workload, though no single definition exists. It is a multifactorial syndrome characterized by exhaustion that impairs one’s ability to complete tasks.[16] Nursing, a high-demand profession with long hours, puts nurses at increased risk of occupational fatigue, affecting physical performance, mental health, cognition, and sensory processing due to high work demands and inadequate recovery.[17]

Frequently observed among shift workers, including nurses and paramedics, occupational fatigue manifests as physical discomfort (e.g., numbness, body aches), lack of motivation, burnout, and drowsiness.[18,19] Occupational fatigue is a major concern in nursing, particularly for night shift workers, as it contributes to burnout, anxiety, depression, cognitive decline, and increased medical errors.[20] Chronic fatigue is also linked to absenteeism, reduced job satisfaction, and compromised patient safety.[16] Given nurses’ critical role in patient care, addressing fatigue is essential to maintaining healthcare quality and workforce well-being.

Although studies have examined the effects of night shifts and occupational fatigue in various countries,[20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35] a gap remains in reviewing the specific impact of extended night shifts (≥12 hours) on nurses’ well-being and performance. Prior research[4] links fatigue to absenteeism and reduced job performance, yet few studies explore how shift duration, consecutive shifts, and recovery periods influence fatigue development. Addressing this gap requires a deeper analysis of the physiological, psychological, and professional effects of long night shifts on nurses.

Thus, this review aims to identify gaps in literature regarding the effect of night shift and occupational fatigue on nurses who work 12-hour and its physiological, psychological, and social impact on nurses who work 12-hour night shift.

Materials and Methods

Study selection process

The review followed the preferred reporting items for systemic review and meta-analyses (PRISMA) guidelines. Inclusion and exclusion criteria were set to include studies in the review. Inclusion criteria included studies published in the English language from 2020 to 2024, involving occupational fatigue among nurses who worked during the night shift for 12 hours or less. The systematic review, meta-analyses, general communication, case studies, editorials, and studies that involved nurses who worked only day or afternoon shifts were excluded from the study.

Review questions

The Population-Intervention-Comparison-Outcome-Time (PICOT) framework was used to develop the scoping review’s questions. The review questions were: What is the impact of night shifts on nurses who work 12-hours? and what is occupational fatigue level among who work 12-hours?

Search strategy

The researcher used keywords in the English language to identify studies and extract data. An online search was conducted on Google Scholar and PubMed using a keyword such as “nightshift”, “impact of nightshift”, “occupational fatigue”, “workload”, “nurses”, “12 hours”, and “nightshift nurses” and their different combinations applying filters like studied published from 2020 to 2024 and English language. The articles with free full-text versions or PDF files were included in the study. The articles published outside of the given period, with abstracts only, or those published in other languages were excluded. This scoping review was conducted in year 2024. A thematic analysis was used in retrieving and categorizing the studies. A systematic purposive sampling method was employed to identify and select relevant studies that assess the impact of night shifts and occupational fatigue among nurses who work 12-hour.

Charting of data

A total of one figure and four tables were created from the selected studies. Figure 1 illustrates the PRISMA flow diagram of the selection process of the studies. Table 1 demonstrates the basic information of the selected studies including author names, country of publication, year of publication, aim of the study, study design, total sample, age of the participants, sampling method, study tool, duration of study, and outcomes. It demonstrates night shifts and related outcomes including anxiety, depression, burnout, exhaustion, elevated stress hormones, sleep disturbance, and safety issues such as lane deviation or near-miss accidents while driving after performing 12 12-hour night shifts In addition, it demonstrates the level of occupational fatigue and related outcomes of chronic fatigue, acute fatigue and inter-shift recovery.

Figure 1.

PRISMA flow diagram of the selection process of the studies

Table 1.

Basic description of the included studies

Table 2 addresses the demographic characteristics of the participants in the reviewed study including author names, country of publication, year of publication, average age of the participants, gender, nationality, marital status, education level, work experience, nursing position, and work department.

Table 2.

Demographic characteristics of the participants in the studied included in the review

Authors, year of publication (Country)	Age (Years)	Gender	Nationality	Marital status	Education	Work experience	Nursing position	Work department
Crincoli et al.,[21] 2024 (USA)	34	89.9% F	Hispanic or Latino=11.8% Not Hispanic or Latino=86.0%	S=46.5% M=38.2% Divorced=4.4%	Associate degree=15.4% Baccalaureate degree=71.9% Master’s=5.7% Doctorate degree=0.4% In Master’s=4.8% In Doctorates=1.3%	3.2 years	Charge Nurse	Medical Surgical
Cockerham, et al.,[22] 2023 (USA)	≥20	78% F	Asians=38% Caucasians=32% African Americans=16% Hispanics=10% Others=4%	M=78%	ADN=7.5% BSN=85% Graduate degree=7.5%	0–5 years=25% 6–10 years=25% 11–15 years=30%	–	Medical Surgical
James and James[24] 2023 (USA)	35.93	89.4% F	–	–	Bachelor’s degree=73.4%	–	–	Neonatal Pediatric Adult Geriatric
Dall’Ora, et al.,[23] 2023 (UK)	42	86% F	–	–	–	–	Registered nurses Nursing associates Healthcare support workers	Inpatient ward Surgery OPD Outreach Community Primary care Care home
Zhang et al.,[36] 2023 (China)	31.8	100% F	Chinese	M=61.2% S=38.8%	Associate’s degree=19.7% Bachelor’s degree and above=80.3%	In the hospital=10 years In the ICU=7 years	–	ICU
Alshammari et al.,[25] 2022 (KSA)	20–>50	79.2% F	Saudi	M=48% Single, divorced, widowed, separated=52%	Diploma=12% Bachelor’s degree=79.2% Master’s degree=8.8%	1–5 years=68.42% 6–10 years=12.28% 11–15 years=8.77% 16–20 years=10.53%	Head nurse=12% In-charge nurse=7.2% Staff nurse=80.8%	Emergency department
Min et al.,[29] 2022 (South Korea)	26.40	94.5% F	Koreans	S=91.3% M=8.7%	Diploma=11.9% Baccalaureate=80.1% Master’s or Higher=8.0%	3.07 years	–	Medical Surgical ER ICU
Benzo, et al.,[26] 2022 (USA)	30.8	91% F	–	M=48%	–	5.8 years	–	Medical Surgical ICU Pediatrics Mother and Baby Others
Kida and Takemura,[27] 2022 (Japan)	36.5	90% F	Japanese	M=43.8% S=49.5% O=6.7%	–	13.1 years	–	–
Tang et al.,[30] 2022 (Taiwan)	23 – 39.3	96.8% F	Taiwanese	M=32.6% S=67.4%	Five-year junior college=27.4% Two-year college of technology=17.9% University or above=54.7%	In the same unit: <0.5 years=37.9% 7 months to one year=9.5% > Year=52.6%	–	General ward MICU SICU ER
Li et al.,[28] 2022 (China)	33.24	94.8% F	Chinese	M=74.7% S=23.2% O=2.1%	Associate’s degree=10.7% Bachelor’s degree=88.7% Master’s degree=0.6%	0–5 years=32.02% 6–10 years=36.49% 11–15 years=23.13% 16–20 years=6.32% >20 years=2.04%	Primary=57.1% Intermediate=37.8% Senior=5.1%	Internal Medicine Surgery ER Gynecology and Obstetrics Pediatrics OR ICU OPD Others
Hong et al.,[31] 2021 (Korea)	28.42 for 2-shift, 42.49 for 3-shift	92.9% F	Koreans	S=77.9% M=22.1%	–	5.23 years=2-shoft 5.39 years=3-hift	–	General wards ICU
Alsharari et al., 2021 (KSA)	≥21	50.7% M 49.3% F	Saudi=94.3% Philippines=3.0% Indian=1.3% Others=1.4%	M=64.8% S=32.1% Divorced=2.1% Separated=1.0%	Diploma=58.4% Bachelor’s degree=33.9% Postgraduate degree=7.7%	1–3 years=26.5% 4–6 years=26.5% 7–10 years=24.8% >10 years=22.2%	Staff nurse=75.0% In-Charge nurse=12.2% Nursing supervisor=12.8%	ER ICU Surgical Medical
Westwell et al.,[32] 2021 (UK)	20–>50	92% F	–	–	–	0–5 years=39% 6–15 years=28% >15 years=33%	Nurses Midwives	Pediatrics and Neonates Anesthetics and Critical Care Surgical Medical Gynecology and Obstetrics
James et al.,[33] 2020 (USA)	36.26	92.2% F	Non-Hispanic White/Caucasian=88.9% Black=3.3% Hispanic White/Caucasian=1.1% Hispanic Native American=1.1% East/Southeast Asian=1.1% Native Hawaiian or Other Pacific Islander=3.3%	–	–	–	–	–
Ruiz-Fernández et al.,[35] 2020 (Spain)	≥20	75.5% F	Spanish	M=69.8% S=15.8% Divorced=6.5% O=7.8%	–	275.36 months	–	Hospital care=55% Primary care=45%
McElroy et al.,[34] 2020 (USA)	40	88% F	–	–	–	–	–	Nursing=23% Laboratory=22% Radiology=26% Pharmacy=29% Respiratory Therapy=24%

ADN=Associate Degree in Nursing, BSN=Bachelor of Science in Nursing, ER=Emergency Room, ICU=Intensive Care unit, MICU=Medical Intensive Care Unit, M=Male or Married, O=Others, OPD=Outdoor Patient Department, OR=Operating Room, S=Single, SICU=Surgical Intensive Care Unit

Quality assessment

The methodological quality of the 17 studies that the search found out, and the degree to which each study addressed the possibility of bias in its design, conduct, and analysis were evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tool. Each of the listed studies was assessed using the eight-question cross-sectional study appraisal checklist.

Results

Search results

A total of 245 articles were identified via Google Scholar, CINAHL, PubMed and ProQuest health-related large data bases. A total of 225 articles were excluded as they were duplicates or not fulfilling the criteria in the three data bases i.e., Google Scholar, CINAHL, PubMed and ProQuest. Three more studies were excluded based on missing data. Finally, 17 articles were included in this review. The Figure 1 illustrates the PRISMA flow diagram of the selection process of the studies.

Characteristics of included studies

The basic description of the all the 17 included studies is given in the Table 1. All the studies were published in English language between 2020 to 2024. Six studies were published from United States.[21,22,24,26,33,34] Two studied were published from each of the countries including China,[28,36] UK,[23,32] Saudi Arabia,[20,25] and South Korea.[29,31] Similarly, one study was published from each of the countries including Japan,[27] Taiwan[30], and Spain.[35] Most common study design was cross-sectional while other designs included nonrandomized control trial, prospective cohort study, retrospective study, online survey, and quasi experimental design. All the included studies were quantitative. The data collection or study period varied from two weeks[26] to one year and three months.[28] Out of 17 studies, three studies[24,30,33] did not mention about the study period.

The most common sampling method used was purposive sampling used in 10 studies.[21,22,23,24,25,26,30,31,32,35,36] Six studies used convenience sampling.[20,27,29,33,34] One of the included studies used a subsample from a large multicenter sample from the Nurses’ Health Cohort Study of Shandong.[28]

Out of 17 studies, 14 studies included nurses as their participants while two studies by Westwell et al.[32] and McElroy et al.[34] included nurses and other health professionals as well e.g., midwives and other employees. The age of the participants in all the included studies ranged from 20 to >50 years.

The findings from 17 studies were discussed in terms of occupational fatigue or fatigue, burnout, exhaustion, cortisol level, lane deviation, anxiety, depression, sleep, and fatigue-related outcomes. The 12-hour nightshift work has physiological, psychological, and social impact. Table 1 presents the impact of 12 hours night shift work on the nurses’ quality of life in the form of fatigue, burnout, exhaustion, hormonal levels (i.e., cortisol), anxiety, depression, and sleep disturbance. Occupational fatigue is a significant challenge for nurses and hospital administration as it impacts negatively on nurses themselves and patients. Especially, Crincoli et al.,[21] Alshammari et al.,[25] Min et al.,[29] and Hong et al.[31] emphasized the occupational fatigue among 12-hour nightshift nurses and reported statistically significant fatigue among them.[21]

Results based on themes obtained

The results of this scope review were categorized into two main themes: Night Shifts and Occupational Fatigue.

Theme 1: Effects of night shifts on nurses

Review results showed that nurses working night shifts encounter considerable disturbances in their circadian rhythms, which adversely affect their sleep quality and lead to heightened fatigue. Cockerham et al.[22] indicated that night shift nurses exhibited significantly elevated postshift cortisol levels in comparison to their day shift counterparts, as well as increased fatigue. Furthermore, Tang et al.[30] discovered that night shift nurses experienced more frequent sleep disruptions than those on day or evening shifts, resulting in greater mental health challenges. In addition, the review showed that extended night shifts are associated with heightened psychological distress, manifesting as anxiety, depression, and emotional fatigue. Li et al.[28] reported that the prevalence of depression (58.82%) and anxiety (62.08%) was markedly higher among night shift nurses than among nonshift nurses. In addition, Alshammari et al.[25] found a strong correlation between burnout, stress, and workplace commitment with chronic fatigue in night shift nurses.

Moreover, the review highlighted that nurses on night shifts are at an increased risk of safety-related incidents, including near-miss accidents while driving after their shifts. James and James.[24] noted that lane deviation incidents were significantly more common among night shift nurses compared with those working during the day. Similarly, Westwell et al.[32] reported that 44% of nurses experienced a near-miss car accident in the previous year due to sleepiness, with an abnormal score on the Epworth Sleepiness Scale (ESS) correlating with a higher likelihood of accidents. In addition, results showed that nurses working night shifts often report diminished job performance as a result of fatigue and exhaustion. Dall’Ora et al.[23] found that burnout rates were most pronounced among nurses working shifts exceeding eight hours, with 70% of those on 8–12-hour shifts experiencing significant exhaustion. Furthermore,[20] emphasized that 85.7% of nurses reported patient safety concerns stemming from errors related to fatigue.

Theme 2: Occupational fatigue and its implications

Results of the review indicated that nurses engaged in extended shifts, especially during nighttime, encounter significant levels of both acute and chronic fatigue. Research by Crincoli et al.[21] highlighted that chronic fatigue is a strong predictor of missed care during night shifts. In addition, Min et al.[29] established that the frequency of night shifts is a critical factor influencing both acute and chronic fatigue, with an increased number of night shifts correlating with heightened fatigue levels. Moreover, it was noticed that inadequate recovery periods between shifts intensify occupational fatigue. A study by Hong et al.[31] revealed that nurses operating within a two-shift framework reported lower fatigue levels than those in a three-shift system. Furthermore, Alshammari et al.[25] found that Saudi nurses exhibited a moderate-to-high chronic fatigue index, attributing this to elevated patient-to-nurse ratios and insufficient recovery time.

However, the review showed that occupational fatigue adversely impacts cognitive abilities, resulting in diminished decision-making skills and lowered alertness. According to James et al.,[33] nurses on night shifts demonstrated significantly lower predicted cognitive effectiveness scores compared with their day shift counterparts (P < 0.001), which may hinder their capacity to execute complex tasks. Extended working hours and ongoing fatigue detrimentally affect nurses› social and personal lives. McElroy et al.[34] indicated that those working night shifts and long hours experience heightened chronic fatigue, which adversely influences their family and social interactions.

The findings from the scope review emphasize the considerable effects of night shifts on the physical, mental, and professional health of nurses. Disruptions to circadian rhythms contribute to fatigue, burnout, and increased safety hazards. Both acute and chronic occupational fatigue intensify these issues by diminishing cognitive abilities, lowering work performance, and impacting social interactions.

Discussion

The results of this scope review corroborate existing research that emphasizes the detrimental effects of night shift work and occupational fatigue experienced by nurses on 12-hour shifts. The review showed that alteration of circadian rhythms caused by night shift work has been thoroughly examined as a significant contributor to negative health outcomes. Consistent with the conclusions of this review, earlier studies have highlighted that circadian misalignment leads to heightened levels of stress, anxiety, irritability, and mood disorders.[11] Okechukwu et al.[12] further validated that night shift work plays a substantial role in deteriorating mental health, which aligns with the high rates of anxiety (62.08%) and depression (58.82%) reported among night shift nurses in this review.[28]

In addition, nurses engaged in 12-hour night shifts frequently experience diminished cognitive abilities and slower response times, which heightens the risk of errors and jeopardizes patient safety.[33] This review has pointed out lane deviations and near-miss incidents as prevalent occurrences following shifts among night shift nurses.[24,32] These observations reinforce earlier findings by Ishikawa,[6] who noted elevated stress levels, burnout, and suicidal thoughts among healthcare professionals due to prolonged night shifts. In addition, night shifts have been associated not only with psychological and cognitive challenges but also with metabolic and cardiovascular issues.[7] This result is aligned with the research conducted by[9] and,[10] both of which indicated that disrupted circadian rhythms elevate the likelihood of obesity, hypertension, type 2 diabetes, and metabolic syndrome. These health concerns are particularly significant for nurses engaged in continuous 12-hour night shifts, as they face diminished energy recovery and irregular eating habits.

Furthermore, the results indicated demanding workload, inadequate recovery periods, and extended hours render nurses susceptible to occupational fatigue, a phenomenon that has been thoroughly examined in existing literature. This review substantiates that nurses on longer night shifts endure heightened levels of both chronic and acute fatigue.[21,29] Occupational fatigue is a complex issue that impacts physical endurance, emotional well-being, and cognitive capabilities.[17] This finding is consistent with the observations made by Ahmadi et al.[18] which indicates that fatigue presents as exhaustion, drowsiness, diminished motivation, and bodily discomfort. However, Crincoli et al.’s[21] study used quantitative methods, such as Dillman surveys, to evaluate occupational fatigue and instances of missed care. Although these tools yielded clear numerical data regarding fatigue levels, they overlooked the emotional distress and individual coping strategies that nurses may encounter. Qualitative interviews or focus groups could have been employed in conjunction with these quantitative measures, enabling nurses to articulate their personal methods of coping with the physical and emotional challenges associated with 12-hour night shifts.

A significant concern raised in this review is the correlation between occupational fatigue and diminished work performance. Alsharari et al.[20] reported that 85.7% of nurses experienced patient safety concerns stemming from fatigue-related mistakes, a pattern that aligns with the findings of Alsayed et al.[16] In addition, Dall’Ora et al.[23] confirmed that nurses working shifts exceeding 8 hours report heightened levels of burnout, emotional fatigue, and decreased job satisfaction, further supporting the conclusions of this review. Furthermore, Social isolation represents a significant challenge linked to night shift employment and occupational fatigue. The findings from the review suggest that nurses working night shifts experience a reduction in social support, which contributes to feelings of loneliness and heightened stress.[5] Similar observations were made by Cousin et al.[15] who indicated that the social disconnection resulting from shift work exacerbates psychological distress and increases the likelihood of substance use.

Although, the reviewed studies offer significant quantitative insights into the correlation between 12-hour night shifts and occupational fatigue, several qualitative aspects need further exploration. Primarily, many of these studies focused mainly on numerical assessments of fatigue, burnout, and sleep disturbances, frequently using scales and surveys. Although these instruments yield measurable data, they do not adequately reflect the subjective experiences of nurses, including their emotional distress, personal coping mechanisms, and the social interactions within their work environment. This lack of depth in qualitative analysis limits our understanding of how fatigue influences nurses’ daily lives and their ability to provide patient care. In addition, certain studies lacked contextual understanding of the unique challenges encountered by nurses in various countries or healthcare environments. For example, research conducted in countries such as Saudi Arabia, China, United Kingdom and South Korea[23,25,29,31,32,36] may have not looked at the critical cultural and institutional factors that shape the experience of night shift work. By overlooking these elements, the studies might have missed valuable insights into how diverse healthcare systems either support or hinder nurses working night shifts.

Furthermore, while some studies incorporated assessments of mental health, including anxiety, depression, and burnout, there was a notable absence of emphasis on nurses’ personal narratives or qualitative interviews that could have provided a more comprehensive understanding of the emotional impact of night shift work. Qualitative research could have allowed nurses to articulate their individual experiences more thoroughly, providing insight onto the specific fatigue triggers, coping strategies, and the social support networks that influence their resilience. The analysis of results in certain studies appeared to focus primarily on the statistical correlations between night shift work and fatigue, without addressing the broader implications for nurses’ overall well-being. For instance, although research indicated elevated cortisol levels or heightened burnout, there was insufficient exploration of the long-term emotional consequences or the interpersonal difficulties that nurses encounter during extended working hours. This lack of comprehensive interpretation raises unresolved issues regarding how nurses cope with the emotional and cognitive impacts of fatigue in their daily routines. Furthermore, numerous studies offered broad recommendations aimed at enhancing nurse welfare; however, these suggestions often lacked specificity or feasibility for implementation. Recommendations such as “increased support” or “better scheduling” are indeed beneficial but lack actionable strategies that healthcare administrators can implement to make a change. This g the gap highlights the necessity for practical, culturally-sensitive interventions that address nurses’ well-being on a more individualized level.

Limitations

One of the limitations of this scope review is the exclusion of the non-English research documents and not including them in the present review, however, these studies which are in other languages could have yielded to a useful insight about the area of study.

Conclusion

This review highlights strong evidence that 12-hour night shifts contribute to occupational fatigue, psychological distress, and reduced work efficiency. These findings align with previous research on circadian rhythm disruption, stress accumulation, and safety risks among night shift nurses. Healthcare organizations should reconsider shift schedules, ensuring adequate recovery time and favoring rotating shifts over consecutive night shifts. Establishing peer support groups, mental health resources, and regular training on fatigue management, rest, and stress reduction techniques is crucial.

Future research should explore occupational fatigue in diverse cultural and geographic contexts and evaluate the effectiveness of support initiatives such as peer support, counselling, and organizational policies. Integrating qualitative methods and culturally relevant interventions will enhance strategies to mitigate fatigue and improve nurses’ well-being.

Author contributions

Conceptualization, B.A., R.A., and H.A.; Methodology, B.A., R.A., and H.A.; Software, B.A.; Validation, B.A., R.A., and H.A.; Formal Analysis, B.A., R.A., and H.A.; Investigation, B.A., R.A., and H.A.; Resources, B.A., R.A., and H.A.; Data Curation, B.A., R.A., and H.A.; Writing—Original Draft Preparation, B.A.; Writing—Review and Editing, B.A., R.A., and H.A.; Visualization, B.A., R.A., and H.A.; Supervision, R.A., and H.A.; Project Administration, B.A., R.A., and H.A. All authors have read and agreed to the published version of the manuscript.

Ethical consideration

Ethical approval was not required as this manuscript is a scoping review.

Conflicts of interest

The authors declare no conflicts of interest.

Use of Artificial Intelligence

AI or AI-assisted tools were not used in drafting any aspect of this manuscript.

Funding Statement

Nil.