Challenges of Long Working Hours for Nurses in Saudi Arabia: A Report

This report examines the critical issue of long working hours faced by nurses in Saudi Arabia's healthcare system. It highlights the government's commitment to healthcare and the central role nurses play in providing services. The report delves into the causes of extended work shifts, including nurse shortages, educational challenges, and system-related issues. It analyzes the impact of long hours on nurses' physical and psychological wellbeing, including sleep deprivation, increased risk of health problems, and reduced job performance. Furthermore, it explores the specific challenges faced by female nurses and the effects on their work-life balance. The report concludes with recommendations for addressing the problem, such as reducing shift lengths and promoting punctuality. This report underscores the need for regulations to improve working conditions and ensure the health and effectiveness of the nursing workforce in Saudi Arabia. This report is a valuable resource for understanding the challenges in the healthcare sector.

Running head: LONG WORKING HOURS IN SAUDI ARABIA
LONG WORKING HOURS IN SAUDI ARABIA
Name of the student:
Name of the university:
Author note:

1LONG WORKING HOURS IN SAUDI ARABIA
Introduction:
The ministry of health (MOH) in Saudi Arabia has full intension and dedication of
providing free healthcare services that is segregated into four levels of care including primary,
secondary and tertiary (Alsaqri 2014). In Saudi Arabia, the government plays a significant role,
for the purpose of providing several health services. Due to the commitment of the government
to the state people, the healthcare industry is constantly ensuring their service is adequate for the
people. It cannot be denied that the healthcare industry is not under the pressure of providing
best services since the ministry of health is determined to provide the best. Several challenges are
faced by the healthcare industry. Various challenges and obstacles constantly make the industry
go through issues such as financial, ethical and certainly the healthcare related. The nursing
workforce is one of the major support that the healthcare industry is built on. It is important that
the nursing workforce is taken vital care in order to ensure smooth function of the industry.
Regardless of the negative factors associated with the nursing working environment, they have
been providing the best of service. One of the current nursing practice issue identified with the
nursing workforce in Saudi Arabia is the long working hours. Long working hours can become a
risk factor in many ways for nurses. The paper aims to discuss the way long working hours is an
issue for nurses in Saudi Arabia. Although providing the best healthcare is a priority of the
nation, it is important that the service providers are looked after by the government as well.
Discussion:
Saudi Arabia and the working hours:
In a healthcare system, nurses are the nucleus, without them it is hard for the cell to
survive. They represent a powerful force that brings about the change required in order to meet

2LONG WORKING HOURS IN SAUDI ARABIA
the needs of health for all the people (You et al. 2013). Although doctors are the primary factors,
it is a universal fact that nurses play the central role in delivering health care. Nurses’ role ranges
from the admission of the patient till the discharge. Advocating for health promotion, educating
patients and the public on the prevention of illness and injury are the roles of nurses
(Kemppainen, Tossavainen and Turunen 2013). Also, they participate in rehabilitation, provide
care and assistance in the process of cure and lastly provide support to the family members and
the relatives. There is no other health care professional with a role such as nurse that consists of
vast and far reaching area of work and knowledge.
Regardless of the fact that there is a major significance of the nurses in the healthcare
setting and it is the largest provider group, healthcare organizers face severe shortage of nurses
who are appropriately qualified (Lamadah and Sayed 2014). Along with several challenges in the
healthcare workforce for nurses, the long hours are one of the crucial system challenge that are
faced by the nurses. It is one of the cause that is cited as major deterrents to uptake nursing by
Saudi Arabia. nurses in Saudi Arabia is contracted to work a 44 hour week in certain hospitals,
however it is the unsaid rule of the working hours is likely to be more than what is mentioned.
Also, if a nurse work in-patient then the nurse may work 22 12 hours shifts in a period of 6 week.
Some hospitals have 3 weeks of days and three weeks of nights. The time mentioned here are
only minimal and it is only expected to be more and not less.
Causes of long working hours:
The major cause of long working hours for the nurses in Saudi Arabia is the shortages of
nurses in the nation. The inadequate numbers of national nurses suddenly increase and then it
loses good number of qualified nurses. Saudi Arabia loses the nurses of its country one they gain
experience. The qualified nurses prefer to move out to the more developed countries in order to

3LONG WORKING HOURS IN SAUDI ARABIA
find greater opportunities. Saudi Arabia is a state that has most of its nurses from the other
nations. Saudi Arabia has majority of male as well as female nurses coming from overseas who
work in the public hospitals (Aboshaiqah 2016). The expatriate nurses tend to be in Saudi Arabia
on a temporary basis. Many expatriate nurses in the nation have been found encountering issues
with the language. Several nurses found themselves lacing the competences in the English
language as well as the familiarity with the Arabic language. Therefore, language and the
communication gap is a major problem that causes the nurses in Saudi Arabia leave the nation
(Almutairi, McCarthy and Gardner 2015).
The reasons for the long shift of the nurses are linked indirectly to the other causes. The
prime cause of increasing working hours of the nurses is the shortage of nurses. Therefore,
looking at the causes for the shortage of nurses are the indirect reasons that causes dragging long
hours for the sustained nurses in the healthcare industry. There are several challenges faced by
the workers in the nursing profession. One of the reason for the lack of sufficient nurses in the
Saudi Arabia is the educational challenges. There is an increased demand for nursing education
and services. According to various researchers, the pattern of education has restricted the process
that lets nurses gain nursing professionalism. The notion that nursing is not a real profession has
created medical students from attempting nursing as a profession. For decades, the nursing
profession in Saudi Arabia has been offering only diploma and associate degree program
managed by the Ministry of health or the BSN programs which is managed by Ministry of
Higher Education (Althubaiti and Alkhazim 2014). There is a need for improvement in the
courses offered by Saudi Arabia. Nursing is a hospital based education and it is the experience of
the interns, trainees, staff nurses or senior nurses that influence the decision of staying or leaving
the profession. Saudi Arabia has a tough work environment compared to the other developed

4LONG WORKING HOURS IN SAUDI ARABIA
countries. Therefore, people seeking the nursing profession often leave the profession once they
experience the on-floor challenges of sustaining in a hospital. The system challenges is a
significant cause of lack of adequate nurses in the nation. Poor working condition involves work
related factors such as rotating shifts and gender mixing. Although these are unavoidable
circumstances, these are often not most preferred type of job that one seeks. For the nurses who
are already in the profession, are faced with different challenges that make it hard for them to
sustain.
Nurses have been heavily imposed with long hour’s duties due to the increase in
population. It is necessary for the nurses to be at the healthcare centers and be available for any
kind of nursing assistance. Tracing the last decades, nursing profession suffers from an
incredible shortage of nurses in the Saudi Arabia. Also, the ministry of health and the health
organization are depended on expatriate nurses. Living the nurse life in Saudi Arabia is not very
comfortable like other developed countries.
The inexperienced nurses are also an additional workload for the experienced nurses. The
job role of nurses is a vast field covering various aspects of the profession. Along with all the
responsibilities and the job role, an additional workload is ensuring nurses, who are in practice,
avoid making critical mistakes.
Impact of long working hours:
It is evident for healthcare organizations to provide patient care around the clock. The
demand of 24 hours patient care has impacted heavily on nursing profession. Shift work and long
working hours are the outcome of increase in workload. However, increase in shift hours are not
appropriate for any profession. There is a high risk associated with the short sleep duration or
sleep disturbances. The major problem of working more than the shift hours is the shortage of

5LONG WORKING HOURS IN SAUDI ARABIA
sleep. Approximately 32 percent of healthcare workers complaints of less sleeping hours
(Alsaggaf et al. 2016). By the very nature of the nursing profession, it is inevitable for nurses to
give their full potential and effort if they work more than their shift timing. The longer they are
exposed to their working environment that involves illness, trauma and other injuries, the greater
the chances for them to become physically and psychologically stressed. Therefore, although for
the short-term when nurses work for more than their shift hours are helpful, it is becoming a
growing concern for the long term. It is universal as well as scientific fact that it is biological
need for a human to have adequate amount of sleep like the biological need of eating and
drinking. The trend of shorter sleep is linked with several factors. The difficulty that is faced by
the nurses is the demand for longer schedules, it leads to difficulty in sleep. Since the
requirement of more sleep at irregular times is increasing for the nurses, it becomes difficult for
them to cope with the normal sleeping hours. Misalignment of sleeping hours has a different set
of side effects that can even cause damage the productivity of the workforce. Even though
nurses take the long working hours willingly due to personal reasons it will lead to insufficient
time between work shifts and the competing demands of work along with personal life. Lack of
knowledge about importance of sleep can push the workers towards taking up more work time
by the nurses and cut down their sleep for other activities. It has been noted that among every
other working industry, the healthcare industry is the second highest sectors where workers feel
the shortage of sleep. For women, it is found that long working hours have more severe impact
on health. female nurses who work more than 60 hours per week nearly 3 times are have the
possibility of developing heart disease, depression, asthma or high blood pressure, arthritis and
diabetes on the basis on work. Also, due to less free time, the nurses fail to engage in the health
behavior such as meditation, exercises and fitness methods (Eldevik et al. 2013). Although both

6LONG WORKING HOURS IN SAUDI ARABIA
genders are faced with problems due to long working hours, it is women who face more sever
issues considering health issues. Even in the contemporary considering the pattern of the society,
women are more stressed as the impact of the working hours are on the work-family conflict and
social support among the doctors. Longer working hours for women leads to more family
conflict which helps in gaining lesser social support. Previous studies have shown negative
impact on health due to long run working hours since it affects personal and social relationship.
Lastly, the major impact of long working hours is the increased risk for reduced performance on
the job (García-Gómez et al. 2013). It also leads to chronic diseases, obesity and ranges of injury.
Instead of less hours of full productivity, the state is moving towards long hours of reduced
productivity. The impact of reduced productivity will not help in providing the best services to
the patients and patients’ lives may fall under danger due to lack of concentration in work of the
nurses.
Recommendation:
Working hours require acute regulation with appropriate time frame. The twelve hours
shifts need to be reduced to eight hours shift for the nurses. It is important that the nurses
understand the significance of working on time. Punctuality is a significant aspect of nursing. A
shift will only be able to go off duty when the next shift arrive on time. Therefore, it is crucial for
the nurses to be accurate with their punctuality. Also, when a nurse works beyond shift time,
they should be compensated for the over-time (Alshmemri 2014). An experienced nursing in-
charge should maintain the schedule in order to ensure each nurse is provided with appropriate
balance. Too long hours at night or in the day will have impact on their social life. Asking for the
nurses on duty before scheduling will make them feel valued. In case, the long working hours
cannot be compromised, the nurses should be allowed to take proper rest in the hospital in the

7LONG WORKING HOURS IN SAUDI ARABIA
rest room with mutual understanding of co-workers. This would be a way of reenergizing and
feeling fresh. Canteens should provide healthy and rich nutrition food for the nurses. Hospitals
should provide higher remuneration for working long hours and any kinds of salary deduction or
discouraging speeches should be avoided. Work environment need to be healthy as well as
friendly in order to make the working environment feel less hectic and stressful. An extra
initiative can be taken by the hospital, that would involve providing counselling and education
regarding the way of balancing home and work life (Khalifa 2014). Education should involve
imparting knowledge about the importance of rest, emotional stability, diet food and ergonomics.
This particular process will help feel satisfied and committed to their work.
Focusing on strategies that would help in improving team work would be the best ways to
initiate cooperative working hours. A supportive environment for the nurses will encourage the
nursing workforce work in better ways. Also, it is important to recruit more healthcare nurses
since the shortage of nurses is the major reason for the long working hours of the nurses. As
discussed before, nursing as a profession is often not considered as a proper job which
discourages many students who aim to get in the nursing field (Miligi and Selim 2014).
Therefore, it is necessary for the hospitals to invest in the endorsement of nursing training and
courses.
Conclusion:
There are several factors that contribute to the working environment of nurse job in Saudi
Arabia. A unique situation is observed in Saudi Arabia, where the main issue is the shortage of
nursing workforce leading to long hours for the remaining nurses. The problem is not merely the
long hours of the nurses that can be reduced. The problem is related to various other aspects of
the healthcare industry. It is important to have a closer look to the problem and understand the

8LONG WORKING HOURS IN SAUDI ARABIA
root cause of the problem. As discussed above, the problems are various from systematic issues
till educational challenges. There is need for the Saudi Arabia government to understand the
details of the problem and take measures accordingly. Since the causes of the problem are deeply
rooted, there is requirement of immediate actions. However, looking at the depth of the problem,
it is uncertain to determine the time frame when Saudi Arabia will be experiencing an
appropriate nursing workforce. As discussed above, due to the commitment of the government to
the state people, the healthcare industry is constantly ensuring their service is adequate for the
people. It cannot be denied that the healthcare industry is not under the pressure of providing
best services since the ministry of health is determined to provide the best services. However it
would only be possible when the problem solving is done from an in-depth aspect.

9LONG WORKING HOURS IN SAUDI ARABIA
References:
Aboshaiqah, A., 2016. Strategies to address the nursing shortage in Saudi Arabia. International
nursing review, 63(3), pp.499-506.
Almutairi, A.F., McCarthy, A. and Gardner, G.E., 2015. Understanding cultural competence in a
multicultural nursing workforce: Registered nurses’ experience in Saudi Arabia. Journal of
Transcultural Nursing, 26(1), pp.16-23.
Alsaggaf, M.A., Wali, S.O., Merdad, R.A. and Merdad, L.A., 2016. Sleep quantity, quality, and
insomnia symptoms of medical students during clinical years: relationship with stress and
academic performance. Saudi medical journal, 37(2), p.173.
Alsaqri, S., 2014. A survey of intention to leave, job stress, burnout and job satisfaction among
nurses employed in the Ha'il region's hospitals in Saudi Arabia.
Alshmemri, M., 2014. Job satisfaction of Saudi nurses working in Saudi Arabian public
hospitals.
Althubaiti, A. and Alkhazim, M., 2014. Medical Colleges in Saudi Arabia: Can We Predict
Graduate Numbers?. Higher Education Studies, 4(3), pp.1-8.
Eldevik, M.F., Flo, E., Moen, B.E., Pallesen, S. and Bjorvatn, B., 2013. Insomnia, excessive
sleepiness, excessive fatigue, anxiety, depression and shift work disorder in nurses having less
than 11 hours in-between shifts. PloS one, 8(8), p.e70882.
García-Gómez, P., Van Kippersluis, H., O’Donnell, O. and Van Doorslaer, E., 2013. Long-term
and spillover effects of health shocks on employment and income. Journal of Human
Resources, 48(4), pp.873-909.

10LONG WORKING HOURS IN SAUDI ARABIA
Kemppainen, V., Tossavainen, K. and Turunen, H., 2013. Nurses' roles in health promotion
practice: an integrative review. Health Promotion International, 28(4), pp.490-501.
Khalifa, M., 2014. Technical and human challenges of implementing hospital information
systems in Saudi Arabia. Journal of Health Informatics in Developing Countries, 8(1).
Lamadah, S.M. and Sayed, H.Y., 2014. Challenges facing nursing profession in Saudi
Arabia. Journal of Biology, Agriculture and Healthcare, 4(7), pp.20-25.
Miligi, E. and Selim, A., 2014. Saudi nursing students’ attitudes towards the nursing
profession. European Journal of Business and Management, 6(29), pp.197-208.
You, L.M., Aiken, L.H., Sloane, D.M., Liu, K., He, G.P., Hu, Y., Jiang, X.L., Li, X.H., Li, X.M.,
Liu, H.P. and Shang, S.M., 2013. Hospital nursing, care quality, and patient satisfaction: cross-
sectional surveys of nurses and patients in hospitals in China and Europe. International journal
of nursing studies, 50(2), pp.154-161.