Exploring generation Z nurses' experiences of shift work in intensive care units: A qualitative analysis

OBJECTIVES: Generation Z nurses are entering the workforce with distinct expectations regarding work-life balance, professional recognition, and organisational support. Intensive Care Units (ICUs), characterised by rotating and night shifts, are associated with significant psychophysical and organisational demands. This study explored how Generation Z nurses perceive and manage ICU shift work and its impact on well-being, coping strategies, professional integration, and career sustainability. METHODS: A qualitative interpretative descriptive study was conducted in ICUs of a tertiary-care academic hospital in northeastern Italy. Thirty Generation Z nurses working rotating 24-h shifts participated (mean age 25.2 years; mean ICU experience 1.7 years). Semi-structured interviews were conducted between June and September 2025, audio-recorded, and transcribed verbatim. Data were analysed inductively using Braun and Clarke's thematic analysis. Coding was performed independently by two researchers and refined through team-based analytic discussion and consensus. RESULTS: Three themes emerged: (1) Experiencing psychophysical imbalance; (2) Seeking stability in an unstable context; and (3) Navigating professional identity. Participants described fatigue, circadian disruption, sleep disturbances, and anticipatory anxiety related to shift work. Nurses adopted coping strategies including structured routines, emotional regulation, and digital boundary-setting. Peer support facilitated professional adaptation and resilience. However, limited organisational recognition, communication barriers, and perceived undervaluation of competencies contributed to disillusionment and uncertainty about future career development. Participants questioned the long-term sustainability of shift work and considered pursuing further education or alternative career pathways. CONCLUSIONS: Generation Z nurses experience ICU shift work as demanding and potentially unsustainable early in their careers. Organisational recognition, supportive leadership, and structured transition processes appear important to promote well-being, professional integration, and workforce retention. IMPLICATIONS FOR CLINICAL PRACTICE: These findings highlight the need for supportive leadership practices, mentorship programmes, and structured transition pathways to support the well-being, professional development, and retention of Generation Z nurses in ICUs.