The position statement, "The Effect of Staff Nurses’ Shift Work and Fatigue on Patient Safety and Nurses’ Health," was approved by the NANN Board of Directors in July 2026. Merritt and Elizabeth Spear of Lucile Packard Children’s Hospital at Stanford, California updated the statement, which was first published in 2015.

The statement highlights evidence linking shift work, extended hours and fatigue with increased risks to patient safety and nurses’ well-being. NANN recommends that nurses and employers share responsibility for reducing fatigue-related risks through measures such as evidence-based scheduling, adequate staffing, uninterrupted breaks and fatigue management programs.

Among its recommendations, NANN advises limiting nurses to three consecutive 12-hour shifts, no more than 12 hours of work in a 24-hour period and no more than 40 hours in seven days, while allowing adequate time for recovery between shifts. The statement also emphasizes the importance of sleep health and recognizing fatigue as a workplace safety issue.