That Dreaded 3-11 Shift

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    Many hospitals and other types of healthcare facilities made the conversion from 8-hour shifts to 12-hour shifts many years ago, mostly due to difficulties staffing the 3-11 shift. This article will discuss the 3-11 shift and other random issues surrounding shift work for nurses.

    That Dreaded 3-11 Shift

    One of my patients, a hard-nosed nurse who retired from the profession after more than 30 years of duty, struck up a conversation with me not too long ago about shift work.

    "What hours do you work?" she interrogated. Her New Jersey accent was notable, especially considering the fact that southern drawls are the most common intonation in the geographic region where I live and work.

    I replied, "I work from 6 o'clock in the evening until 6:30 in the morning."

    She chimed, "Those are hard hours, but they seem a hell of a lot better than the 3-11 shift. I worked the 3-11 shift back in the days when all TV programming would cut off at midnight. Once midnight struck, all of the channels would repeatedly play the instrumental version of the Star-Spangled Banner. Nowadays cable TV has shows and movies 24 hours a day."

    "I used to work the 3-11 shift," I added. "In fact, I worked those hours at my very first nursing job after graduating from school. Personally, I wouldn't go back to working that shift unless I was about to become homeless."

    "You crack me up," my patient laughed. "I got off that shift as soon as possible. It took up most of my afternoon, all of my evening, and part of my night. I was glad when the hospitals finally went to the 12-hour shifts."

    This recent conversation got me thinking about shift work. Many hospitals made the conversion from 8-hour shifts to 12-hour shifts many years ago, primarily because of difficulties maintaining adequate staffing on the 3-11 shift. The main issue with going back to 8 hour shifts is keeping the 3-11 shift covered because relatively few nurses like to do it full-time anymore. This shift is simply not conducive with family life, especially if one has school-aged children. In addition, many childless singles (myself included) do not particularly like this shift.

    To be fair, there are people out there who absolutely love working the 3-11 shift. Moreover, some nurses contend that they cannot handle 12-hour shifts due to fatigue during the last four hours. Also, a study or two has implied that 8-hour shifts are actually safer.

    12-hour shifts have their benefits because they eliminate the need for one additional shift change per 24-hour period. This may improve continuity of care since errors due to skipped information are reduced as the result of two nurses receiving report in a day instead of three. Likewise, many nurses prefer 12-hour shifts because they enable one to have up to four days off per week. Besides, 12-hour shifts may help to simplify staffing at healthcare facilities because only two shifts need to be covered instead of three.

    I now work 12-hour shifts because I prefer them since there's no way I'd want to be at the bedside five days per week. Anyhow, I was never able to establish a routine while working the 3-11 shift. If left to my own devices, I awakened at noon, slowly got ready for work, worked the shift, then arrived home sometime before midnight and watched television or did mindless internet browsing until 4am before settling down to go to sleep. I was able to create a solid routine when I worked midnights (11-7am) or days (7-3pm), but my time largely went to waste when I worked evenings.

    In summary, many healthcare facilities went to 12-hour shifts for specific reasons that revolved around their struggles to staff the 3-11 shift. Countless nurses love 8-hour shifts and many others are fond of 12-hour shifts, so it would be ideal if facilities devised a happy medium to satisfy all parties.
    Last edit by Joe V on Dec 8, '14
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  3. by   ThePrincessBride
    I'm in the minority because I adore them. Granted, I am childless and single and a PCA but I like the fact that I still get the same differential as the night shift without wrecking my circadian rhythm (I despise nights). They also are great for my school schedule and I don't have to wake up ridiculously early or deal with baths.I imagine that my opinion will change when I start having children. But as it stands, I would choose a 3-11 shift before a 7p-7a or 11p-7a.
  4. by   ElizaW
    I am married, no kids, and I love, love, love working 3 - 11. You can keep the early mornings. I will spend my days in the park with my dogs and roll into work at 2:30 as long as they let me.
  5. by   TaraAnn91
    Wow just yesterday I was asking my friends why they make nurses in the hospital work 12 hour shifts instead of 8 hour shifts? This article really summed up the question for me! Im soo glad you wrote this article! I didnt realize some nurses get off 4 days if they work 12 hour shifts, that is very appealing to me! Before I read this I was against the thought of working 12 hour shifts, now I think I would not want to work any other shift than the 12 hour shift! I have two small children, a 3 and 1 year old and I was worried about how the 12 hour graveyard shift would work out for my family? I would think I would be really tired around the time I would get off and it would be unsafe to take them to school?! Any advice that would help me, Im only in my nursing pre-reqs right now, it will take me a few years to obtain my nursing degree.
  6. by   I<3Nursing
    TaraAnn91 I have young children and have no problem taking them to school after an overnight. You feel more awake when the sun comes up and get a burst of energy until about 9:30. That's how it was for me. Good luck with nursing.
  7. by   merlee
    I was around when "12's" became the norm - during the staffing crisis of the late 70's. It had less to do with 3-11 shifts, and more to do with the need for fewer nurses over all. The first thing that happened was the 'Baylor Plan', nurses who worked 2 12 hour shifts on weekends only, and got paid for 40 hours, and all the benefits. They were usually required to sign a minimum 6-month contract, which allowed for one weekend off during that time. Then came the stop-gap 12 hour shifts, thought to be a short-term solution to the staffing shortage.

    Facilities realized that this new pattern could save them money. So they stuck with it, regardless of the studies that say that this is dangerous for the patients.

    I never liked working 12's, always felt like I hit a wall after 10 hours. And rarely felt rested. I think 3 consecutive 12's should be banned altogether.

    We are still killing ourselves for admin's sake.
  8. by   nurseaig
    Hard work.
  9. by   nurseprnRN
    I loved 3-11. Get up around 0830 or 0900, run errands, go to the library or the bank, do some laundry, have a nice lunch, see the dentist or get the car serviced, leisurely tool on over to the shop, home by midnight, rinse, repeat. Most of my patients, even in the ICU, weren't going anywhere for testing during the shift, the first and second cases were already back from the OR and tucked in and stable (mostly), only one meal to pass trays for, the visitors left by 2000, no traffic to or from work. The occasional four hours OT at time-and-a-half or double time. What's not to love?

    I hate twelves for many reasons, none of them personal. Sure, I'd be happy to work just three shifts a week for full pay and benefits and call the rest of the week my own. But you know what? The patient care sucks. When everyone works two on, one off, one on, three off, or some variation thereof, there's no continuity of care for the long-term patients that need it the most. That leetle hint that something is about to go wrong gets missed if the patient has six different nurses in three days. Remember that horrific series of chemo overdoses in Boston a few years back? One person, a beloved columnist for the Boston Globe, died after getting a four-fold OD for four days in a row by four different nurses, IIRC, because nobody knew that her reactions were escalating and a few others (not so celebrated) got bad cardiomyopathy, which did a number on their cancer survival.

    When you get asked to work overtime, all of a sudden you're there for sixteen hours (or even more), not just twelve. Coming in early means being awakened and asked to come in at 0300, not 1100, to work to 2300. We all know that error rates rise dramatically at ten hours; I wonder if the increased incidence of patient care errors in the last several years is related to the sheer numbers of people working these long shifts. Work two in a row and your third day is crap; work three in a row and your fourth day is a total loss. How many errors happen in the second half of that third shift?

    Well, I know this is supposed to be about 3-11, and I did enjoy my time doing that. Most of the world works an eight-hour day; there's a reason for that. You couldn't get me to work 11-23 or 15-03 or 07-19 for all the tea in China.
  10. by   RNperdiem
    I wonder if people who want 8-hr shifts have actually worked them.
    I remember 3-11. Day shift discharges the patients, and evenings are spent with admissions.
  11. by   TheCommuter
    Quote from TaraAnn91
    I have two small children, a 3 and 1 year old and I was worried about how the 12 hour graveyard shift would work out for my family? I would think I would be really tired around the time I would get off and it would be unsafe to take them to school?!
    Several mothers of school-aged children work 12-hour night shifts at my place of employment and it works out for them just fine.

    Since the day shifts at my workplace start at 6:00am, there's no way they would be able to get the kids to school and come to work if they worked 12-hour days. However, night shift workers get off at 6:30am, so they can get the kids to school before the start time of 8am.

    Most of my coworkers who work 12-hour nights stay up until 9am or 10am because we take some time to settle into a comfortable sleep. Then again, most of us are nocturnal people. A diurnal person who is forced into working nights will begin to have problems with fatigue, sleepiness, weight issues, and eventual health issues.
  12. by   nursel56
    I loved 3 to 11, too. I was just upset that I never got to chart in green ink. For some reason that really appealed to me. My hospital had already done away with that in the mid-70s. I found that when I worked 7 to 3 I would fall asleep for an hour or two after I got home (this was pre-kids) thus negating all that daylight time to be productive . . .
  13. by   DogWmn
    I LOVE 3-11:30, I can sleep in if I need to, have plenty of daylight hours to do things and then go to work. I can't do nights, I've tried and it's not me, it actually made me physically ill.
  14. by   martymoose
    3-11 works for me. actually is the only shift that works for me. My son's bus gets to house at 620 am. Too late for me to get to work on days( I have 45 minute ride one way).All the day cares in my area open at 6 am- again, too late. I have no neighbors( rural area)Mind you it sucks to get home at 200 am, and try to sleep , then get up at 0530 to get him on the bus, but I do go back to sleep until about 11 am, then get ready for work.Nights wont work either as I get out too late- wouldnt be home til 0830. Hopefully someday my son will be independent , but at 12 , I cant trust him t get on the bus alone at 6 20 am. Then maybe someday I will have a normal life.