Are 12 hour shifts safe?

HealthyRN · Feb 4, 2008

I am a young nurse and I hated working 12-hour shifts, days or nights. I disliked how there wasn't any time left to do anything when I got home, except eat leftovers (because I was too tired to cook) and sleep. I couldn't workout, get shopping or errands done, or anything else that I could easily accomplish with an 8-hour shift. That being said, would I have preferred to work five 8-hour shifts/week? NO!!! Maybe I'm not the best person to ask though, because I don't enjoy direct patient care, but being in the hospital 5 days/wk would be my idea of a personal hell.

It would be interesting to see if there are any studies on the acutal safety of 12-hour shifts though. It would seem errors would be more likely to occur when one is tired.

allnurses Guide · Feb 5, 2008

I think they are, especially if you stay busy. =) I've found that when I work a long night shift and things get slow, it's actually harder on me because it's harder to stay awake. =)

I think 16's are pretty unsafe, ESPECIALLY when you work psych. I worked psych for a year, and for three months of that year I did 16's... evening and night shift. Psych can get slow, especially at night... and let's just say, I'd sit at the nurse's station and fight sleep HARD. One morning early, I actually did doze off and awoke to this female patient standing at the counter of the nurse's station staring me down. She proceeded to hand me a note that she had written. On the note she had written, in crayon, in big letters... "I need Dental Floss... when you come out of your DAZE".

:lol2: I actually laugh when I tell that story, though it could have been disasterous had that patient been in a... um, particularly violent mood.

psychnurse1998 · Feb 5, 2008

I think they are, especially if you stay busy. =) I've found that when I work a long night shift and things get slow, it's actually harder on me because it's harder to stay awake. =)
I think 16's are pretty unsafe, ESPECIALLY when you work psych. I worked psych for a year, and for three months of that year I did 16's... evening and night shift. Psych can get slow, especially at night... and let's just say, I'd sit at the nurse's station and fight sleep HARD. One morning early, I actually did doze off and awoke to this female patient standing at the counter of the nurse's station staring me down. She proceeded to hand me a note that she had written. On the note she had written, in crayon, in big letters... "I need Dental Floss... when you come out of your DAZE".
I actually laugh when I tell that story, though it could have been disasterous had that patient been in a... um, particularly violent mood.

Yep your post was funny, but your right..your ghost could be typing your post now. We had about 3 serious injuries from patients attacking staff. For some reason lately its been mostly female staff that get attacked. I ask myself frequently why do I go back for more, even though I havent been attacked, just threatend.

TrickieTam · Feb 5, 2008

Its not safe if you don't get any rest or go in sleepy. I work 12-hour baylor weekends and have no problems. My facility only has 12-hr shifts offered so you get used to itl.

HJS27 · Feb 7, 2008

Depends on the person. Also, nurses look at the floor, or anywhere but family's direction, so they can't be engaged in conversation...easier to stay on track that way. Not sayin it's right, just sayin.

psychnurse1998 · Feb 7, 2008

Depends on the person. Also, nurses look at the floor, or anywhere but family's direction, so they can't be engaged in conversation...easier to stay on track that way. Not sayin it's right, just sayin.

When the nurses on duty seem fatigued, despondent, burned out, its becomes hard to draw a line between who is the nurse and who is the patient. I think it gives clues to a bigger problem. When I graduated from nursing, in 71, this was not the case. Nursing care, has not gotten better, but is getting worse. the outcome of cost effective nursing, has not been high quality nursing, but I am not blaming nurses for that. A hospital is not

an auto assembly line, with patients being the car. I dont think we had as many nurses burning out in the 70,s. I left nursing for a while, in 1980, I was working as an Lvn in an acute care hospital. I remember seeing 2 ro 3 ICU nurses crying after they had lost a patient. I sensed they felt guilty for maybe not being able to do every vS every 15 minuntes as ordered,not really sure if that was the case. I asked my self, do I want to be in this situation? I cancelled my plans to go for my RN and dropped out of nursing for a few years. As I see nurses in california, having good outcomes with getting staffing ratios improved, it gives me hope nurses will overcome, and make nursing more rewarding both for the nurse and the patient.

Woodenpug, BSN · Feb 7, 2008

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

gerry79 · Feb 7, 2008

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.

ssakd · Feb 7, 2008

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.

Kayartea · Feb 7, 2008

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.

Woodenpug, BSN · Feb 7, 2008

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.

JoAnna McNurse · Feb 7, 2008

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 nurse:patient 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!