Debate: 8-hour shifts vs. 12-hour shifts

canesdukegirl, BSN, RN · May 13, 2011

I can only give you examples of what I have experienced in my career as a nurse.

I used to work with an OB resident WAY back in the day (1997) when there were no limits on the number of hours a resident can work. After she had been on for 43 hours, she drove home (it was during the day). The residents had a "buddy system" that they used when they worked a ridiculous number of hours, and the resident traveling home always called their buddy to let them know they had made it home in one piece. The senior resident never received a call, and worry started to set in. After some phone calls were made to law enforcement, the resident's car was found in a ditch a mile from her house. The resident unconscious, but thankfully had no life threatening injuries. After this incident, the hospital and the governing bodies of the residency program finally started to consider cutting back "duty hours" for the residents. It has taken over 10 years for this to finally come into effect, and our residents now have a limit of 16 hours in one 24 hour period that they can work.

I know that this is not relative to nursing hours as you requested. However I believe that generally speaking, ALL health care workers should have limits on how many hours they are allowed to work.

I have come home after working 12 hours and then had to stay for 5 more because there were so many call outs on my unit. Although I had the next day off and didn't mind so much (after a double espresso), I found myself drifting off at the wheel when I was driving home. I had a 45 minute commute at the time, and the lull of the highway was making me so sleepy despite putting all of the windows down and turning up the radio. Scary stuff, huh?

OP, what is your take on the debate?

NurseLoveJoy88, ASN, RN · May 13, 2011

This thread came just in time since I'm scheduled to work a whopping 16 hours tomorrow:banghead:.

I don't know of any specific facts or studies from evidence based practice but speaking from my own experience I don't think 16 hour shifts are the safest. I only do 16 hour shift if the unit is pretty laid back. I have worked busy units and my mind and body would start to shut down after a while which is not safe practice at all. I believe 12 hours should be the max but then there are so many other considerations as well. We have to take in account call offs, some nurses need the extra money ( like me), and etc. Good luck on finding more responses.

mfrench · May 13, 2011

@Canesdukegirl- I am glad they instituted that limit! Even 16 hours seems ridiculous to me. I am sure I will get used to it, but right now being a nursing student, I can barely even do 8 hours without being exhausted. I go home after a partial day and just want to sleep! I know what you mean about the sleepiness on the road-I have felt that way on my way back from clinicals-very scary.

@Nurselovejoy88- That is crazy! I didn't even know that they can schedule you like that. I would definitely not agree to taking that shift! Even if there is a call-off, I don't think they should keep nurses who already worked a long shift. It is unsafe practice and can harm the patients. Ethically, I would refuse because I am taking on a commitment to doing what is best for my patients and avoiding harm to them.

I am very interested in and adamant about patient safety. Without question, I would risk losing my job for standing up and refusing to work overtime when I am unsafe. Working when I am tired is also a risk to my license, because I am responsible for any errors that I make. I could be taken to court for it! Personally, I feel that not having a job is better than not having a license.

I can't say from personal experience, since I have never worked either an 8 or 12-hour shift-even my clinical days are shorter than that. As of right now, I don't think I could do 12-hour shifts unless I get lots of breaks. I am just too exhausted from the work of staying on my feet and taking care of people.

Woodenpug, BSN · May 13, 2011

Here's a link to a well-written article, with citations:

http://www.swbooster.com/Opinion/Letters-to-the-editor/2010-11-03/article-1921236/Nursing-errors-reduced-as-a-result-of-12-hour-shifts/1

This topic has been discussed and plenty of research has shown that 12 hour shifts are no more prone to errors than 8 hour shifts.

The problem is that this is an old topic, which was well researched. More recent evidence will be hard to locate.

Biffbradford · May 13, 2011

In the ICU unit I last worked in, many folks made sure that their last shift of the week was 12 hours. If you 'only' worked 8 hours and staffing was short, guess who got to stay over for an extra 4 to 8 hours to cover the shortage? So much for that weekend getaway! Sorry, but you're 'it'. As everybody else runs away to start their weekend.

SummitRN, BSN, RN · May 13, 2011

The largest source of error in the medical field is poor communication. If you have 3 handoffs a day instead of 2, that is AWFUL.

That said, shifts need to truly be 12 hours. Errors go up massively when people are not given 12 hours off between shifts.

hope3456, ASN, RN · May 13, 2011

Alot of nurses are driven from the profession by the 12hr shifts (that often turn into 14hrs, ect). But i agree the 3 'report offs' per day are a problem also. 1)waste of time 2) things don't get passed on i.e. forgotten.

mskate · May 13, 2011

Having worked both, I will gladly stick to my 12 hour shifts. Albeit, I don't have children to try to wrangle childcare around, etc... for me - work is stressful. The trade off is 4 days off in a week! If I had to show up to the unit 5 days a week, I'd trade in my ICU job for a desk job.

arnie1234 · May 13, 2011

I have a desk job and I work 5-10 hr days. I would gladly go back to 12 on a busy unit. 12 can go by fast and then you have more off days built into your schedule. My current schedule requires me to use PTO if I want a day off- so I will burn through it quicker.

The benefit of 12s is a major attraction for many nurses- I am suprised that any nursing floors besides procedural areas would work 8's anymore.

JaredRN · May 13, 2011

I think you can argue safety both ways on 8-hour vs 12-hour shifts. There can definitely be more mandatory overtime if shift scheduling is not filled in correctly. I think that continuity of care is sacraficed a little because if one shift can stay with a patient for 5 days a week, thats a lot better then assignments changing every day or other day with 12 hour shifts, where a nurse may not return for 4 days or more. There could be less fatigue, possibly fewer errors.

Ultimately everyone I work with prefer's 12 hour shifts. I think that working too many in a row can burn you out where a reprieve of 3 or 4 days after doesn't feel like enough. People still work 16 hour shifts which can be dangerous too, but often times nurses will do it for the double time.

Give or take, nursing is demanding work that takes a lot of skill, and concentration which is hard to keep up for 12 hours. You should probably look in to how often people actually get a break. Some nurses don't get a break at all. Some might get a break short, and don't clock the missed meal or break because they're afraid of getting in trouble. Some places let you put all your breaks into 1 hour, or 2 30 minutes. Those can be just as dangerous sometimes too.

nursestacey62 · May 14, 2011

I only worked as a floor nurse for 7 months but I mostly worked 12-hour shifts. After two in a row, I couldn't move the next day. The shifts do turn into at least 13 hours. I worked a couple of 8 hour shifts and they flew by. I was always asked to stay for the extra four and, if I had an easy group of patients, I would stay for the over-time. I'm 48-years-old and can't do 12 hours on my feet any more. My legs and back just killed me. As far as safety goes, my floor was so busy, I didn't have time to get tired. The worst was getting an admission from the ED at 6pm, right when you're trying to finish up with charting, etc. And then the night nurse would be mad if I didn't do everything on the admission orders before I handed the patient over. I never saw the night nurses staying till 8:30 am finishing up but I stayed late many nights trying to finish everything.