Latvian Healthcare Workers’ Perspectives on the Abolition of 24-Hour Shifts: A Nationwide Study

Background/Objectives: Prolonged working shifts may adversely affect healthcare workers’ health, wellbeing, cognitive performance, and patient safety. Nevertheless, 24-hour shifts remain widely used in Latvian healthcare. This study aimed to examine healthcare workers’ experiences of 24-hour shift work, their attitudes toward its revi-sion, and the main factors influencing their preferences. Methods: A nationwide cross-sectional survey was conducted in Latvia between October 2025 and February 2026. A structured 64-item questionnaire assessed sociodemographic and professional charac-teristics, workload, shift patterns, health and emotional wellbeing, patient-safety con-cerns, professional motivation, and attitudes toward alternative schedules. Of 1524 submitted questionnaires, 1318 were valid for analysis. Quantitative data were sum-marized using descriptive statistics, while open-ended responses were analyzed using inductive qualitative content analysis. Results: Most respondents regularly worked 24-hour shifts, and 40.5% worked at more than one institution. More than half reported health changes potentially related to 24-hour work, 61.1% experienced emotional ex-haustion, and 49.2% reported persistent fatigue. Fatigue had contributed to an error or perceived decline in care quality for 34.9% of respondents. Nevertheless, 59% opposed replacing 24-hour shifts at their workplace, and approximately half preferred retaining them. The main reasons were schedule convenience, consecutive days off, higher earn-ings, and the ability to combine workplaces. Open-ended responses supported a grad-ual transition toward flexible mixed schedules rather than immediate universal aboli-tion. Conclusions: Latvian healthcare workers perceive substantial health and safety risks associated with 24-hour shifts but also depend on their financial and practical benefits. Sustainable reform requires flexible scheduling, adequate staffing, financial neutrality, protected recovery time, and meaningful employee participation.