For Nurses: Is a 12-Hour Shift Better Than an 8-Hour Work Schedule?
Posted: July 8, 2014 in Nursing Newsroom
In the 1970s and 1980s, the standard work schedule for nurses underwent a monumental change due to hospital staffing difficulties with the then-ongoing shortage of nurses. The standard three shifts per day schedule was eliminated in many institutions and replaced with two twelve-hour shifts, usually running from 7 a.m. to 7 p.m. and from 7 p.m. to 7 a.m.
With this “simple” change, the number of shifts per nursing position was reduced from three nurses per day to two per day. One very noticeable improvement was that of patient “continuity of care.” Patient reports take place now only twice per day as opposed to the usual three, decreasing the potential for errors during the exchange of information.
The current status of the 12-hour shift
Today, the 12-hour shift is, by far, the most common nursing work schedule in inpatient facilities such as nursing homes, acute care hospitals and rehabilitation centers. In some of these facilities, a 12-hour shift is mandatory. Others allow exceptions based on a nurse’s age, tenure, health or unusual family situation.
A minority of acute care hospitals — recognizing that the weekday day shift is by far the most frenzied of work times — sometimes allow a nurse nearing retirement to work an eight-hour shift, from 7 a.m. to 3 p.m. in order to help assist with paperwork, new physician orders and any unexpected tasks. Some nursing homes that find weekends particularly difficult to staff routinely offer two 16-hour shifts for Saturday and Sunday coverage from 7 a.m. to 11 p.m.
Nursing opinions regarding the 12-hour shift
According to a recent research study, “8 Hour Vs. 12 Hour Shifts: Effects on Patient Outcomes,” a survey of 805 nurses from 13 New York hospitals indicated that nurses working 12-hour shifts:
- Expressed more job satisfaction;
- Reported less emotional exhaustion;
- Reported an enormous increase in schedule satisfaction (by a factor of 10);
- Reported the “importance” of a 12-hour shift at twice the rate of other staff;
- Reported nursing units or assignments with 12-hour shifts had a higher staff retention rate;
- Were nearly 60% less likely to call in to cancel a shift.
Other studies have consistently demonstrated that the majority of nurses prefer 12-hour shifts to eight-hour work assignments for a number of reasons:
- Fewer “work” days;
- Decreased commuting expenses;
- More time with family;
- More time for personal interests;
- Increased ability to pick up extra shifts for more money;
- Deceased use of “agency nurses” — more likely to be unfamiliar with the staff, hospital policies and the floor layout — on their units.
The effect of 12-hour shifts on nurses
Unfortunately, the documented effect of 12-hour shifts on nurses and nursing performance is not nearly as positive as nurses’ opinions of the work schedule. Multiple studies have demonstrated the increased fatigue that accompanies a shift at least 50 percent longer than a usual work schedule, resulting in a higher number of accidents and nursing mistakes. For instance, a 2011 Joint Commission report indicated:
Nurses who work more than 12.5 hours have three times the patient care error rate than nurses working shorter shifts. Most nurses who work 12-hour shifts do, in fact, work up to 55 minutes longer than the twelve-hour mark because of patient turnover time and the need to complete ongoing patient care.
- In general, “long shift length increases the risk of errors, close calls and decreases vigilance.”
- Nurses working 12-hour shifts suffer a higher incidence of occupational injury — such as needle sticks — than their peers working shorter shifts.
The effect of 12-hour shifts on patients
Although research indicates a negative impact on patient care resulting from nurses working 12-hour shifts, there is marked controversy on the validity of the research methods. An overwhelming number of studies were disregarded because of poor methodical quality, while other studies mention specific health care provider outcomes were mostly evaluated by single studies, yielding inconclusive data.
edited by Kevin PhangLearn More: Click to view related resources.
- "Nurses’ Long Shifts May Have Downside: Study," HealthDay
- Amy Witkoski Stimpfel, Douglas M. Sloane and Linda H. Aiken, "The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction," Health Affairs, 31, No. 11, (2012):2501-2509
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