[psychnurse1998]

Originally Posted by saali

you're right about continuity of care, but i think it will be better if they make it 3 shifts to avoid or at least to reduce the number of med errors....

But Jedda you are in Saudia Arabia..isnt that where they cut your hand off if you make an error? <smile>

[Woodenpug]

Dwyer, T., Jamieson, L., Moxham, L., Austen, D., & Smith, K. (2007). Evaluation of the 12-hour shift trial in a regional intensive care unit. Journal of nursing management, 15, 711-20.

Richardson, A., Dabner, N., & Curtis, S. Twelve-hour shift on ITU: a nursing evaluation. Nursing in critical care, 8, 103-8.

Stone, P. W., Du, Y., Cowell, R., Amsterdam, N., Helfrich, T. A., Linn, R. W., et al. (2006). Comparison of nurse, system and quality patient care outcomes in 8-hour and 12-hour shifts. Medical care, 44, 1099-106.

Szczurak, T., Kamińska, B., & Szpak, A. (2007). Estimation of the psychological load in the performance of nurses' work based on subjective fatigue symptoms. Advances in medical sciences, 52 Suppl 1, 102-4.

Thomas, F., Hopkins, R. O., Handrahan, D. L., Walker, J., & Carpenter, J. Sleep and cognitive performance of flight nurses after 12-hour evening versus 18-hour shifts. Air medical journal, 25, 216-25.

Weinberg, A. D., Lesesne, A. J., Richards, C. L., & Pals, J. K. Quality care indicators and staffing levels in a nursing facility subacute unit. Journal of the American Medical Directors Association, 3, 1-4.

Wootten, N. Implementing 12-hour shifts on a cardiology nursing development unit. British journal of nursing (Mark Allen Publishing), 9, 2095-9.

[pantheon]

Just like Politics if you look hard enough you'll find what ever information you want. Whether it be true or not everyone has an opinion. The truth is sometimes the truth, but most of the time it is stretched out (false). Look to your resources and even better look at what you are observing first hand. Don't ever forget that! Be your own influence based on visual facts.

[psychnurse1998]

Originally Posted by pantheon

Just like Politics if you look hard enough you'll find what ever information you want. Whether it be true or not everyone has an opinion. The truth is sometimes the truth, but most of the time it is stretched out (false). Look to your resources and even better look at what you are observing first hand. Don't ever forget that! Be your own influence based on visual facts.

i hope I understand what you are saying and that this is related. I once read a book, by Adler..How To Read A Book. One of his suggestions was to read from original thinkers, not from second hand sources. For example read from Aristotle himself instead of by someone else that read Aristotle. That way you can sort out for yourself..one those that may have not understood Aristotle, those that hated his views and want to distort them, and those that are nuts about him and may strecth the truth a bit. How many Americans have ever read from an original thinker? And how many have let politicians, priests, ministers, or educators do their reading for them? And digested what they read.

[pantheon]

I said what I wanted to say and I believe I made my point clear. I have nothing else to add. Have a nice day psych 1998!

[achot chavi]

I think it's a matter of being prepared (mentally and physically) before going into that 12 hour shift and pacing yourself. Some nursing positions lend themselves better for 8 hour shifts and some for 12 hour shifts. I don't think that its a matter of one being better than another. I do agree that as nurses we tend to neglect our own physical needs and the longer the shift the more likely we are to do that. I also wonder what happens after your 12 hour shift, if the next nurse doesn't show- how do you continue till a replacement is found? This would certainly be a point in favor of 8 hour shifts. My lst point is the (long) drive home after a 12 hour shift. I once had a cop pull me over for a routine check (my driving was fine) and I so resented the time "wasted" while he just checked that I had my license and registration that I was curt to him (all he was doing was his job), I also find that I have less patience and get easily irritated after that 12 hours. But many people handle it so.... Good luck anyway!

[lujological]

I agree with all you had to say-achot chavi but would like to add what makes it unsafe is the number of 12 hour shifts you do in a row.some places work you 3 or 4 days in a row.Anything beyond 2 days is unsafe.I just am coming off 2 years of working 12 hour shifts and learned quickly that 2 in a row was my max.Not only is it not safe for your patients but also for your own body.Health reasons is why I am making the change back to 8 hour shifts.I will miss my extra time off between days working but at least will be alive to enjoy time off.my reward for 2 years 12 hour shifts is hypertension,diabetes,and an ulcer!as nurses we need to take care of ourselves so we can take care of others.Bless all nurses no matter how long their shifts are.

[achot chavi]

I agree 2 is my max as well

[jjjoy]

I do think that some people have a lot of stamina and they can handle several 12s. That doesn't necessarily mean that it's something that should be allowed. It depends on what works well for the most and if we can trust that people will recognize and heed their own limits. Some truck drivers might be fine driving more than 24hours straight but for many drivers it would be unsafe. But with the pressure to make more money and to not look less capable than one's professional colleagues and to help out when staffing is short, some people may overestimate their ability to handle several long shifts.

Where to draw the line, though? No more than 7 12-hour days straight? No more than 4 12-hr days straight?

Personally, I'm done after two. To follow that, though, I'd get little day to day patient continuity because I'd never be on more than two shifts in a row. Traditional 8-hr scheduling can be a pain, I admit, though. Three days on. One off. Two days on. One off. Three days on... ugh! Gotta have two days off in a row sometime!!

Though if one's work load actually fit into 8 hours such that you weren't running all shift or having to stay late, then even 5 days/wk wouldn't seem so bad. When it's break-neck pace all day then the idea of just getting it over with in a couple of long, crazy shifts makes more sense. But better staffing and a do-able pace would get my vote any day.

[Morettia2]

I work 12 hour night shifts..I hate it. and we are mandated as night shift to work one weekend night Friday , Sat. or Sunday, 4x's a month, with no weekend diff....no matter how I tweak my schedule It's aways the same,If I don't work 3 -12 hour shifts in a row I know that I won't have a few days in a row off but 3-12 hour night shifts on my floor is more like 3 -14 hour shifts, b/c we are critical care Interventional Cariology/CCU step-down and at 0400 or 0500 as you are about to start gathering AM Meds, and doing 0600 Blood Sugars there is always a pt. or 2 that has a problem that requires a RRT or Code, and it's always at the worst time or there's always a prolem at the start of shift at 1900 that backs you up for the rest of the night. so this schedule It dosent leave us night shift RN's with much time b/t days off. MY hosp. schedule weeks go Sunday to Saturday as being one complete week, yes it's 7 DAYS if you work DAY shift and days are only req. to work 1 weekend day a month with shift diff. which we don't get on nigh shift even tought we are req. to work weekends 4xs a month.With nights you carry over so it's not really 7 DAYS, Ok you work sunday(start of the work week)..have off Monday which is shot b/c you will sleep all day have off tuesday wed thurs (which is nice) BUT, this is the catch..if work friday sat sunday but that sunday starts the next work week so friday and saturday are part of the 3 12's req. in the first week and that sunday,the 3rd 12 in a row, is part of the new work week, yea it's confusing I know and took me a while to get the hang of scheduling. so you have to have a weekday in that sat-sun work week to complete the 3 12 hour shifts/week.. and you never want to schedule one of your shifts on a wed on a tuesday or wed..and if you do you end up with what we call the "devil's schedule" which is so hard to explain it would take forever but it's almost like working every other day on night shift for 2 weeks but complicated and worse. God forbid I have something Important to do on a weekend b/c I have to arrange my schedule to the "devil's schedule" just to have the time, and that creates a ripple effect for the next 2 weeks of work causing me to work in a 12 hour shift pattern that is physically exhausing, with no real time off b/t shifts. The last time this happened I ended up with asthamatic bronchitis steps away from pneumonia and almost ending up as a pt. my self. I notice when I am on the "devils schedule" or if I work 3-12's in a row I find my self forgetting things, irritated with everything, eating poorly, my townhouse looks like a bomb hit it, b/c I know that sleep is my priority for that time being, I loose weight which is great ,right, but when I eventually get back to my regular groove I gain it back, which is terrible on my body, I am so tired some days that driving to and from work is a total blank..days and nights start to mesh together.And when I arrive to work at 1900,get report, and start my rounds the unit is in total chaos 90% of the time,usually we are understaffed with nurses and CNA's, we might have one CNA at night if we are lucky(while days havd 3-4 CNA's) for 36 bed critical care unit this is AWFUL at night, we are the largest unit in the hospital with the least amt. of staffing b/c no one wants to work on our floor b/c they know how horrible it is we have CCU nurses pulled to us when we are LUCKY and they despise our floor, and lately we have had more codes and RRT's then anyother unit in the hosp. This is a LARGE inner-city hosp. with no nurses union to back us.If pt is transfered to us from the CCU most likely the pt. will go right back to the CCU b/c we don't have the staffing we should. And if you see the night shift nurses we are all exhausted with blood shot eyes from running all over the unit with a 6:1 pt. ratio of critical pt's. as where days have a 4:1 or 3:1 ratio and the majority of day RN's tell us how great the unit is during the day and ask why are we so tired at night. I also see the day RN's leave by 1930 on the dot, and it is rare that the night shift RN's leave by 0730, but usually by 0830 or 0900. I know alot of this has to do with my hosp. but working 12hr nights at my hosp is making me feel and look like a train wreck..I don't want to loose my license, so I am interviewing in the ICU next week...wish me luch so so long of a post