Travail de nuit en 12 heures : un « scénario de travail » élaboré par les infirmiers dans un service de réanimation

Abstract

The 2x12 is massively deployed in hospital settings but is not without risks for the quality of care. To take into account their vigilance and the care they must give, the nurses use regulation strategies in their activity. This essentially means studying the quality of care from the nurses’ point of view and looking to understand how regulating their activity might contribute to its stability. The study concerns solely the work of nurses on 12-hour night shifts in a medical reanimation. First, 18 nurses are observed. In exploratory interviews, 12 nurses are then questioned about their personal conceptions of the quality of care given and their regulation strategies. From these talks, we established three questionnaires. At four different times throughout their night shifts, nurses are asked to evaluate their vigilance, the quality of care given and to indicate their regulation strategies. They are also continually observed. After every test period, we asked them to comment on their answers in an individual interview. The results show that the nurses feel less and less vigilant as the night goes on, although their view on the quality of care given remains positive at all times. It is their “work scenario”, developed early in the night that enables them to maintain a satisfactory level of quality. This scenario allows them to enhance the reliability of their care,, increase their work load and organise break times.

Keywords

• hôpital
• travail de nuit
• régulation
• qualité des soins
• ergonomie