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Effect of 12 Hour Shifts on Patient Care and the Nurse: A Need for Change.

Nurses Article   (11,132 Views | 92 Replies | 918 Words)

LindaGracie is a ADN, BSN and specializes in geriatric, psychiatric/mental illness.

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How can I bring change to 12 hour shifts on patient care?

Many nurses find it difficult to work 12 hour shifts both physically and cognitively. Research has shown working 12 hour shifts often effect nurses’ critical thinking, productivity and job satisfaction which impacts patient care and patient safety. This Article discusses a change theory which can be used to implement changes to the current practice of working 12 hour shifts. You are reading page 5 of Effect of 12 Hour Shifts on Patient Care and the Nurse: A Need for Change.. If you want to start from the beginning Go to First Page.

CKPM2RN has 3 years experience as a ASN, EMT-P and specializes in Emergency/Med-Tele.

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7 hours ago, CGB1 said:

Why would it turn into 14-16 hour shifts?  Nursing is 24/7.  When the next shift comes in, report is given and off I go.  730-8.  

In certain disciplines (I'm looking at you SNF!) once you give report you can find quiet time to do your charting and filing for the shift. That was my experience. 

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kbrn2002 has 25 years experience as a ADN, RN and specializes in Geriatrics.

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20 hours ago, hoiboy said:

12 hour shifts make sense in that you want to minimize the amount of handoffs given. Every handoff potentiates the loss of information --> more errors.

The only trouble though is that night shift is always short staffed/inexperienced, though I don't see how moving to 8 hour shifts or anything else would solve that issue.

The handoff between shifts is much improved when it's just 2 shifts I agree. Less opportunity for things that really should be reported getting lost between shifts.   

Nights has always been a difficult shift to staff, there are those nurses that love it and stay on the shift their entire career but they are few and far between. My personal experience was being a die hard night shifter for 15 years then something in my body chemistry changed and I found I wasn't sleeping during the day as well as I needed to for my health so I changed to days and haven't looked back.  I honestly don't know if an 8 hour night shift would've been better for me health wise but I wasn't willing to give up my 12's to find out. 

Adding to the argument for 12 hour shifts as an option not only do many nurses seem to prefer the 12 hour option it also saves money for the employer.  Sure they are paying for the  same amount of hours but paying 2 nurses instead of 3 cuts out an entire position.  While that makes no significant difference in total hours paid it does reduce the non wage expenses of that 3rd nurse which are a significant cost for an employer. 

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smc5127 is a BSN, CNA, RN and specializes in ER, TNCC.

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I love 12hr shifts. After 3 days, LEAVE ME ALONE!!! Many places are only open during business ghours which means that I would never be able to make my own appts. Also, on my 4 days off, I'm sleep and in the gym, after 8hr shifts and traveling, I'm too tired to go workout. I hate working 5 days a week. 

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Here.I.Stand has 16 years experience as a BSN, RN and specializes in SICU, trauma, neuro.

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On 10/26/2019 at 10:43 PM, 2BS Nurse said:

For those of you advocating for 12's, don't they turn into 14 -16 hour shifts? You would have to find extremely flexible child care in that situation.

They only turn into 16 hours when I agree to stay over, which is rare.  Occasionally if my shift was a 💩show and I don’t have time to chart, it turns into 13 hours.  

That said, I prefer nurses to have the choice. I have actually been with a hospital for 6 years which has both 12’s and 8’s available.... I did 8’s for over 5 years and loved it.  Now at a different place in life and 12’s work better for me.  One perk of having both is because of the overlap, there are all sorts of opportunities to pick up princess shifts lol... which benefit both myself (as I wouldn’t pick up a full shift as easily) and the hospital (they have coverage that they may not have otherwise had.)

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On 10/17/2019 at 9:28 PM, LindaGracie said:

Thank you everyone for your comments. It seems there are a lot of nurses who really enjoy working 12 hour shifts. I wonder how many older (age 50+) nurses prefer working 12 hour shifts. This paper was a paper I wrote for one of my courses when I was working on my BSN. CGB1, this article didn't address acuity and nurse patient ratios because that wasn't the topic addressed for the course. When I worked in hospital settings (and SNF) everyone commented on the increased acuity of the patients. It does seem that people are getting sick with chronic conditions at a younger age and many of us baby boomers do have numerous chronic conditions. It is common for a patient to have diabetes, neuropathy, obesity, hypertension, hyperlipidemia, along with the pneumonia or whatever condition they were admitted for. Unfortunately the hospitals (in my area) only focus on the one condition rather than coordinating care with the patient and the patient's healthcare providers. If these comorbid conditions where also addressed this would increase continuity of care and promote better health. I also strongly believe that nurse patient ratios need to be addressed and have read other articles on allnurses which addressed this. There are nurses advocating for change which I am in agreement with and have read that many nurses do advocate for this change however there are a few nurses who is opposed to this.

I'm not working right now but I last worked 12s in 2013 at age 53-54 and I loved it!  I previously worked 8s and hated it.  I will never work 8s again if I can help it.

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KeepinitrealCCRN has 5 years experience and specializes in SICU,CTICU.

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I would resign if I had to work 8s and Id leave the profession all-together if that was the norm in all hospitals.  

There is no need for change!  We shouldn't even put this out there in the world!

Edited by KeepinitrealCCRN
edit

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myoglobin has 12 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

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The "only" good thing about eight hour shifts is that it would instantly increase demand for nurses by about 30% (an extra shift per day). Also, since about 30% of people would quit nursing it might increase demand even further. Also, about half the people in my hospital work two extra shifts per week for the overtime (they literally depend on it to survive).  These people would  be in grave trouble since getting an extra 24 hours per week with 8 hour shifts would simply not be possible.

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JBudd has 38 years experience as a MSN and specializes in Trauma, Teaching.

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Just turned 60, still doing 12 hour nights in the ER (fortunately, just 2 a week). I briefly tried going back to 8 hour nights when the kids were tweenies, but it didn't work.  I had less time with them than with the 12s.

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For some of us, the 12 hour shift would be 8 a.m to 8 p.m.  Because of HR rules, this would mean losing the 2nd shift differential we get working the later 8 hour (12 -8) shift.

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I left bedside nursing because I could no longer tolerate 12 or should I say 13 plus hour shifts.  Even though I work eights now and have weekends off, the weekends feel really short.  But, at least I can mentally and physically do it.

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myoglobin has 12 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

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I think some people would do better with 8 hour shifts. But the majority (especially those like me with two hour commutes each way) wouldn't even consider it as an option if they had any other choice.  Frankly, as I transition into the NP role the thing that I miss most in my life are "the three 12's per week" that I used to work as an RN. My wife and I (also a former ICU nurse) used to have 4 days off per week together  thanks to working three 12 hour shifts and we worked/ and drove to work together (and had breakfast on the way home). Those four days off were filled with trips to Disney World and the beach. Now we are so stressed and tired with our five day per week routines that the weekend is pretty much a "sleep and watch Netflix" break between the weekly Monday-Friday grind.  I was probably 200% happier then, but thanks to the student loans I've accumulated (plus no 401K and we still rent) "going back" to three 12's isn't an option.

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9 minutes ago, myoglobin said:

I think some people would do better with 8 hour shifts. But the majority (especially those like me with two hour commutes each way) wouldn't even consider it as an option if they had any other choice.  Frankly, as I transition into the NP role the thing that I miss most in my life are "the three 12's per week" that I used to work as an RN. My wife and I (also a former ICU nurse) used to have 4 days off per week together  thanks to working three 12 hour shifts and we worked/ and drove to work together (and had breakfast on the way home). Those four days off were filled with trips to Disney World and the beach. Now we are so stressed and tired with our five day per week routines that the weekend is pretty much a "sleep and watch Netflix" break between the weekly Monday-Friday grind.  I was probably 200% happier then, but thanks to the student loans I've accumulated (plus no 401K and we still rent) "going back" to three 12's isn't an option.

Commuting 2 hrs to work??? You all must be living in big cities! I've watched our NPs work and I couldn't do it no matter the shift. They can't even get a vacation because the doctors in their specialties are in such high demand. I couldn't imagine commuting 2 hours after seeing patients.

Edited by 2BS Nurse

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