When will nurses advocate for themselves?
Ask any bedside nurse what is one of the most challenging parts of his or her job, and I’ll bet you the "12-hour shift" will be one of the top 3 answers. Ask any nurse who has left bedside care and I’ll bet you, “It’s hard on your body,” or “it breaks you down,” will be in the top 3 answer choices.
Ask any bedside nurse what is one of the most challenging parts of his or her job, and I’ll bet you the 12-hour shift will be one of the top 3 answers. Ask any nurse who has left bedside care and I’ll bet you, “It’s hard on your body,” or “it breaks you down,” will be in the top 3 answer choices.
So, my question is, “When will nurses advocate for themselves?” Yes, I know the research among nurses who provide direct care is mixed. Most of the research shows that some nurses like the 12-hour shifts because they have 3 or more days off in a row. Other research shows how nurses are not happy campers when it comes to the professional autonomy they DON’T have and scheduling is one of the reasons. Still, even more research documents the occupational injuries, medical mistakes, and even death to nurses after working 12-hours shifts, including when overtime is factored into the equation.
We can’t have it both ways or can we? The12-hour shift is by and large a function of the reduced or projected shortfall of nurses and/or a function of the employer being able to get the most bang out of its buck of nurses-basically, 2 shifts for the price of 3 shifts. Physically, our bodies know that working 12 hours, often without a reasonable break, is not a good thing for our body functions. Mentally, 12 hours straight is emotionally draining. At the end of the day (or night), nurses are so mentally fatigued they literally can’t think straight. And, professionally, there is a cost, too. Nurses make more mistakes, especially medication errors, not to mention communication errors or missed opportunities for interprofessional communication about patient care. Sadly, nurses have been killed in car accidents when driving home, especially after working a 12-hour night shift.
How much is enough? In our highly technological age, there must be a way to have adequate staffing for inpatients while reducing the physical and mental taxation on professional nurses. What about flexible scheduling, where nurses choose to work either 6, 8, or 12 hours, as they choose if they fulfill X number of hours bi-weekly or per month? What about not admitting everyone that comes to the emergency room with symptoms that are not life-threatening, but, can be managed at home? What about discharging patients at night, if necessary, once their inpatient goals and trends are in the right direction? What about statutory mandates for nurse-patient ratios and do away with the staffing grid games that are common in many hospitals?
Better yet, how about nurses advocating for themselves, their own health, and the healthy lifestyles that we promote for our patients? I understand advocating is a risk and no one wants to be singled out as a rabble-rouser, but, I fear that nothing is going to change until patients and nurses are seriously hurt and/or the risk threshold is too high for the hospital administration to ignore. I still ask how or why prominent nursing organizations allowed this to happen. Where was the professional advocating on behalf of the nurse members of these organizations?
It’s sad to admit, but, the bottom-line seems to be the same as it is in many issues: Follow the money! As a nurse, this makes me angry, but, truth is truth and clarity are what’s important. I encourage nurses everywhere to take a risk, advocate for US, and let’s present a united front for our profession, our own health and welfare. Nurses want to go home to their families at the end of the day, too!.
About Eschell2971, RN
I am an RN and an adjunct instructor. I have an entrepreneurial spirit and I love to travel.
Eschell2971 has '2' year(s) of experience and specializes in 'Acute Care'. From 'Maryland'; Joined Mar '14; Posts: 57; Likes: 227.Mar 7I seem to recall at in my town, the facilities had just changed from 8 hour to 12 hour shifts when graduated in the early 1990's. I was told it was at the request of the nurses to change. I never did well doing 12 hour shifts. Needless to say my current job is 8 hour shifts. I'm baked at the end of each one too.Mar 7I am old enough to remember when hospitals started moving away from 8-hour shifts to 12-hour ones. And I have been involved in many discussions about transitioning back to 8-hour shifts.
In my experience, the staff nurses themselves are often the ones saying they prefer the 12-hour shifts. People have gotten used to the idea of only working fewer (but longer) shifts per week -- and commuting and needing child care for fewer shifts. Even though they are sleeping, miserable and/or not really enjoying their extra day or two "off" per week, they want them -- even at the cost of their physical and mental health.Mar 7Although it is contrary to popular belief, 12 hour shifts actually cost MORE than 8 hour shifts when everything is taken into account, including all the costs for filling unexpected absences (call-ins). The chief attractions? 12 Hour shifts are less complex to schedule and nurses are able to get more days off. So, it's really a convenience thing.
As someone who has worked all types of shifts, I liked 12 hour shifts as a critical care staff nurse but it was much more difficult in terms of childcare & family responsibilities. HATED 3-11 shifts. Had no real problem with 7-3 or 11P-7A. 10 hour shifts were just weird because I had to hand off my patients and change roles for the last 2 hours... usually doing admissions or some sort of department quality stuff.
As a manager... having an all 12-hour shift staff was horrible. Everyone had a 'part time' mentality. It was very difficult to get anyone to participate in any type of shared governance because they were all exhausted by the end of the shift & no one wanted to do anything but relax on days off. No one would come in to attend meetings.Mar 7I've worked an 11a-11:30p ER shift, the heavy traffic hours, and alternated 4-shift and 3-shift weeks for nearly 24 years. We get one 30-minute lunch break in the middle. I workout at a gym for 30 minutes before going in on work days and do an hour of dance fitness on days off. A healthy lifestyle goes way beyond having our work hours bunched together. Some may prefer or need shorter shifts for family reasons. A choice would be good, but I like having whole days off. You are right that we need to advocate for ourselves, but I believe there are far greater challenges to our health and our profession than 12-hour shifts.Mar 8If I was full time I would might force myself back on 12 hour shifts to get the 4 days off, but since I am only 32 hours a week, I much prefer the 8's. Now that I'm in my later 40's I find being gone 14 hours (or more) on a regular basis is just really hard on me. I feel like a million bucks after an 8 hour shift, comparatively. Part of that might be I work 3-11 now, so if I did 12's I'd be on nights, which you generally feel worse on...I haven't had to do 5 days a week in a long time and admittedly thinking about doing that isn't terribly appealing as it feels like all you do is work. But, after working 12 hour nights for many years, I can honestly say I feel 100% less drained on 8 hour afternoon shifts. Unfortunately for me, not a lot of hospitals even have the option to work 8 hour shifts anymore.Mar 8I, also, have been around long enough to recall that 12 hour shifts became the norm because nurses demanded them, not because employers forced them on people. Employers resisted implementing them and nurses around the country organized within their facilities and agitated to get them. So, OP, that is one example (ironically) of nurses doing just what you are asking about, and they got what they wanted.Mar 8Quote from elkparkI remember as well. We used to get OT for the last 4 hrs and if I recall correctly, nurses were behind the alternative 40 hr work week which exempted the employer from paying OT until over a 12 hr day or 40 hr week. You had to go to a SNF for an 8 hr schedule. (California)I, also, have been around long enough to recall that 12 hour shifts became the norm because nurses demanded them, not because employers forced them on people. Employers resisted implementing them and nurses around the country organized within their facilities and agitated to get them. So, OP, that is one example (ironically) of nurses doing just what you are asking about, and they got what they wanted.Mar 9worked 12 hour shifts for 24 years then went to 8 hours shifts for the last 2 can't wait to get back to 12 hour shifts have much more time to do things with the family on 12'sMar 10I used to think... OMG how will I survive 12 hrs shift. Now I am like other nurses... yah, nah, no, I do not want to come 5x a week to this place. I rather suck up 12 hours without break.
But otherwise great, great question!
Advocating for ourselves is UNIONIZATION. And I am assuming we all know how well that goes.Mar 12My 12 hour shifts are a big reason why I stay with my employer. I cram all my hours into one week, work three 12's have a day off and work another three 12's. Yes, that week is pretty brutal by the end but the upside is I then have a week off. It's great for vacations, taking a week off gets me three weeks off so there is plenty of time for a couple of extended vacations a year. I've travelled a lot more since changing to this schedule.Mar 13If my employer required me to work five 8's per week, I would be looking for a new job...STAT. Three-day work weeks is what attracted me to nursing in the first place. It enables me to take long stretches of days off without biting into PTO and have a PRN job on the side.Mar 13My recollection is that nurses wanted the 12 hr shift option. At the time, it was also an effort to attract job-seekers to the hospital. They briefly offered 4 10s as well. Sounds hellish for the poor soul who had to schedule that.
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