Are 12 hour shifts safe?

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.

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.

A quick pub med search showed the above two articles both favoring 12 hour shifts and showing no decrease in patient safety. Full articles were found on CINAHL

I work 3 twelves and would not want to work 4 or 5 days a week ever again. I feel I have more time to complete my tasks. Working 8 hours make me feel like my day is compressed and I feel rushed, after all I have the same amount of patients working an 8 or 12 hour day.

We are the only hospital doing 12 hour shifts in this region.The nurses clearly indicate that they are happy with these shifts for the time off,but they agree that they are bad for quality patient care.Staffing issues also abound and generally they are so demotivated.

While most nurses prefer 12 hr shifts for their convenience, more than one study has shown that the rate of errors increases in the last four hours of a 12 hr shift. But then there have also been studies that show that for every patient over 4 that an RN is responsible for the chances of dying increase by 7 percent. And if your nurse is responsible for 8 or more pts your chance of dying increases by 31 percent, or almost one third. So the rate of deaths, whether influenced by error or not, can be correlated more readily with the number of patients for whom you are responsible than the hours worked.

I listed two recent studies that showed something quite different. Please cite your sources. I realize that a quick pub med search shows only what is popular, so I honestly want your sources.

Thank you in advance.

I HATE the 12 hour shifts. To me, this is something hospital administration has "snowed" nurses into believing is a great benefit when it actually most benefits the hosptial. For example:

- When have your ever really worked a 12 hour shift? Most of the time it is a 13 or 14 hour shift. And yet, do you earn overtime? Nope, because you probably never get to the over 40 hour mark to start earning overtime. Benefit goes to the financial administrator of your hospital.

- When you are off (trying to recover!) how many times have you received desperate calls to work extra shifts because the unit is short? Hospital Admin sees our "4 day off time" as a much expanded potential work force to be drafted PRN. And, sadly, so many nurses cave in and agree to work more, even when tired and still recovering from regularly scheduled shifts.

- When working your 12 hour shifts, do you get expanded times for "breaks" (the Tech's do)? Do you get to leave the floor and take a leisurely lunch break for at least an hour because you never get to take breaks? Nope. You just keep plowing on all day long, jumping everytime the call bells go off, or a doctor calls, or a transportation person needs help moving a patient, etc.... Do you get paid for the time you didn't take a break or lunch?

- How is your nurseatient ratio? If staffing is "short" a 12-hour shift can really be exhausting AND create great potential for error if you are carrying a high patient load. And when counting patient load...don't forget to count all the admissions and discharges during your shift. I once worked at a hospital that promoted the folklore that "we staff a 4:1 ration." The truth was that you never had less than 5 or maybe 6 patients on days. And, during that day it was not unusual to discharge 2 or 3 and get 2 or 3 new patients. By my count, this really means that I had anywhere from 6 to 9 patients that long 12+ hour day.

- Do you like working like a "coal miner" - going in in the dark and comming home in the dark? Are you overweight or nutritionally deficient because you eat main meals at 10 PM after getting home so late and fall into bed to repeat the process the next day?

- Is your family missing you at dinner or other family time events that usually take place prior to your late arrival after a 12-14 hour shift which is almost 50% of your life?

- Think of it this way.... why should you work yourself down so hard for 3 days a week that it takes you a day or two to "recover" from working so hard? Work should fit into your life so that it takes some energy but not enough to where you loose several days trying to rest up so you can go and do it all over again!

These 12+ hour workday situations are now so common that it is quite hard to find a position that offers 8 hour days. But I have found one and I am very happy to be living what I consider a "normal" working life.

Just my opinion. Thanks for letting me sound off!

I happen to work every Friday, Sat & Sunday, 12 hrs sifts in PCU, which is both mentally & phyiscally exhausting. By the 3rd day I'm pooped! However, I have four days to recover, as one person already pointed out. Sundays are usually better because I know my patients & have established a connection with them, which is important to me. The weekenders are usually the same nurses & we get along good.
I think working 8 hrs shifts would be more stressful due to time restraints.

L

OK, I am different from everyone else from what I have read. I hate 12 hour shifts! I have always worked 3pm-11pm and loved it! Think about this. I was working full-time 8 hour shifts and yes it was busy but I loved that. I did the best I could and what was left over was what is called continuation of care. You can't do everything that's face it. This is my point: sure 5 days a week every other weekend seemed to suck! But the pay was great. I made $80,000+ dollars as a staff RN on a med/surg/tele floor in NJ not far from NYC. I hated the commute so I found a job closer to me after 3 years. That unit was 12 hour shifts. I thought WOW, 3 days a week only 36 hours and that is considered full-time! Well, the pay was basically the same but because I was working bi-weekly meaning 6 shifts in a 2 week pay check it reduced my salary significantly. 36 hours is only 72 hours per pay check and if you work more than that your not getting time and a half. You would have to exceed 80 hours in a pay period. When I did 40 hours a week, I got that time in a half no questions asked because it was a busy floor. So most of my pay checks were 84 hours give or take a few hours. They could see by my documentation that I was legitimate. I think more and more hospitals are doing 12 hour shifts because it saves them money. I was so tired after nine hours that all I could think about was going home to sleep. Hey, if you don't mind making less money then go for it. Some hospitals do offer 12 hour shifts with one 8 hour shift which I think is great. For now I'm sticking to my 8 hour shifts.

Hi Pantheon,

I understand your point, however, I work the "Balard" on weekends, so even though I work 72 hours, I still receive an additional 16 hours of pay in a two week period.

That is, you have to "give up" your weekends.

You lost me! What do you mean by Balard? It's not in my Webster dictionary and I haven't heard that used in any hospital I worked in. We had weekend people that were considered per-diem, no medical benefits etc. They made 50 to 60+ dollars an hour doing 12 hour shifts sometimes 16 hour shifts. Are you saying you work during the week and are on call for the weekends? How do you receive an additional 16 hours of pay in a two week period? I'm very interested in what you mean. Thanks.