Jump to content

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

Nurses Article   (9,063 Views 91 Replies 918 Words)

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

4 Articles; 990 Profile Views; 18 Posts

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 7 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.

booter512 has 22 years experience and specializes in Diabetes, Transplant, CCU, Neurology.

1 Article; 41 Posts; 1,665 Profile Views

Working 8 hour shifts forces the hospital to staff 3-11 and 11-7, which I've always found difficult to fill those positions (3-11 moreso than 11-7).  Of course, you could force people to rotate shifts, which makes daycare even more challenging.  Also, studies have shown that almost twice the error rate for rotating shifts than for night shift (the 2nd highest).  With this knowledge, I would think a hospital would open itself up to liability lawsuits simply by forcing rotating shift on to staff.

Share this post


Link to post
Share on other sites

Jamesdotter has 38 years experience and specializes in Women's health & post-partum.

463 Posts; 8,366 Profile Views

Retired nurse here. I never worked 12 hours (unless it was overtime). The last couple of years before retirement I would have welcomed 6 hours! 12 hours would have been wonderful when I had small children, but I had a very supportive husband whose job allowed him to be with the kids when I was at work and they weren't at school or at childcare. I realize everyone doesn't have that luxury.

Share this post


Link to post
Share on other sites

tachyallday has 10 years experience as a BSN and specializes in ED/ Adult ICU/ PICU/ Acute Peds.

28 Posts; 507 Profile Views

Seriously?

Posting this "article," which is just a poorly-written BSN program paper (that leaves out tons of relevant information), is the last way to gain buy in for change in shift length. 

 

Share this post


Link to post
Share on other sites

SummitRN has 5 years experience as a BSN, RN and specializes in ICU.

2 Articles; 1,511 Posts; 30,488 Profile Views

8-hour shifts mean 50% more patient handoffs in 50% more nurse is providing care. These are huge sources of communication error and impair situational awareness of the patient. 

Edited by SummitRN

Share this post


Link to post
Share on other sites

30 Posts; 820 Profile Views

It would appear that "most nurses" prefer 12 hour shifts and the topic should be left alone...

 

Share this post


Link to post
Share on other sites

131 Posts; 1,079 Profile Views

This topic should be separated by inpatient vs outpatient too.

Share this post


Link to post
Share on other sites

Hoosier_RN has 20 years experience as a MSN and specializes in LTC, home health, hospice, ICU, ER, dialysis.

3 Followers; 1,602 Posts; 3,397 Profile Views

I think it would be nice if acute and sub acute could offer a mix...not everyone wants 8s, not everyone wants 12s, and reasons vary...one area hospital does offer a mix, and they say it works out great for them

Share this post


Link to post
Share on other sites

3 Posts; 28 Profile Views

On 11/9/2019 at 11:43 AM, tachyallday said:

Seriously?

Posting this "article," which is just a poorly-written BSN program paper (that leaves out tons of relevant information), is the last way to gain buy in for change in shift length. 

 

This poorly written BSN paper earned an A along with praise from the professor. The paper met the requirements for the assignment. It wasn't meant to be a doctorate thesis. If I was writing a doctorate thesis on this subject I would have included opinions on all sides of the issue of patient's safety and causes of nurse fatigue and dissatisfaction. I haven't advocated for changing the length of shifts. Just posted some of my writings because some people actually appreciate reading my papers. Not everyone has the same taste for writing styles or subjects. We just need to agree to disagree and respect each other. That makes us all different. You have gifts and talents in one area and I have them in another area. At the end of the day the question is "what difference did we make in someone's life?". Did we help each other in some way or did we do harm or hurt someone's feelings? We as nurses are trusted and are known to be there for our patients. Patients want their nurse to be caring and to be there for them. Anyway that is what I learned from school and from colleagues as well as patients. Just my two cents worth.

Share this post


Link to post
Share on other sites

3 Posts; 28 Profile Views

7 hours ago, Hoosier_RN said:

I think it would be nice if acute and sub acute could offer a mix...not everyone wants 8s, not everyone wants 12s, and reasons vary...one area hospital does offer a mix, and they say it works out great for them

Fantastic. Great comment 👍 Thanks so much for sharing. I hope everyone reads your comments. This is the best solution to the length of shift debate.

Share this post


Link to post
Share on other sites

tachyallday has 10 years experience as a BSN and specializes in ED/ Adult ICU/ PICU/ Acute Peds.

28 Posts; 507 Profile Views

11 hours ago, Linda Ransom said:

This poorly written BSN paper earned an A along with praise from the professor. The paper met the requirements for the assignment. It wasn't meant to be a doctorate thesis. If I was writing a doctorate thesis on this subject I would have included opinions on all sides of the issue of patient's safety and causes of nurse fatigue and dissatisfaction.

 It is obvious your paper was for your BSN program. It is not difficult to get a good grade on those papers when your audience in your professor & fellow students, and we all know this. It indeed was well-written for it's purpose and for your audience. But this forum isn't that audience. 

I haven't advocated for changing the length of shifts.

No? Then what exactly are you advocating for? You did title it "Affect of 12 hour shifts on patients: a Need for Change." and "How can I bring change to 12 hour shifts on patient care?"

What are the alternatives? 

 

11 hours ago, Linda Ransom said:

 

Just posted some of my writings because some people actually appreciate reading my papers. Not everyone has the same taste for writing styles or subjects. We just need to agree to disagree and respect each other.

Ok, that is wonderful that some people appreciate your papers, and it's ok that I didn't appreciate it, and I provided you some feedback in an open forum. I am sorry your feelings got hurt. If you are going to put your article out there, there are going to be people that don't like it. I never did not agree to disagree. Seems like you are the one not agreeing to disagree that I did not like your article because you go on to admonish me & virtue signal about feelings. 

That makes us all different. You have gifts and talents in one area and I have them in another area. At the end of the day the question is "what difference did we make in someone's life?".

Why are you making this so personal?

Did we help each other in some way or did we do harm or hurt someone's feelings?

Sometimes when my feelings are hurt, I have to ask myself: am I being overly sensitive, or am I allowing my feelings to be hurt?

We as nurses are trusted and are known to be there for our patients. Patients want their nurse to be caring and to be there for them. Anyway that is what I learned from school and from colleagues as well as patients. Just my two cents worth.

Of course we are. I am not sure why you are bringing in this comment, other than to somehow make it really personal and insinuate that I don't care about feelings. I care about my patients & if you were my patient, I would give you the very best care. But you are not my patient. You are someone on a forum posting an article that I criticized. 

I stand by, that: it is not well-written for this forum. We all know about change theory if we've been through a BSN program. You provide no compelling evidence whatsoever for improving outcomes, just purport that we should shorten shifts, and nurses and hospitals should look at the evidence. Ok, we all know all of us should be looking at evidence for everything little thing that affects our care of patients from the color of walls, to falls, to readmissions to hospital food etc. If you want buy-in vs burn-out from the average nurse on posted 'articles', make it succinct and convincing and show us some convincing proof instead of saying we need to look at evidence that is not even provided. Otherwise, you're just stirring the pot. 

And for the record: I actually would be interested in looking at compelling evidence on changing 12 hours shifts (or how to make them better). Not only for effects on patient care, but for effects on nurses work-life balance. I spend at least one full day of the week dysfunctional from exhaustion. So right there, my four days off are really three. 

 

 

Share this post


Link to post
Share on other sites

myoglobin has 11 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

613 Posts; 4,303 Profile Views

1 hour ago, tachyallday said:

 

I stand by, that: it is not well-written for this forum. We all know about change theory if we've been through a BSN program. You provide no compelling evidence whatsoever for improving outcomes, just purport that we should shorten shifts, and nurses and hospitals should look at the evidence. Ok, we all know all of us should be looking at evidence for everything little thing that affects our care of patients from the color of walls, to falls, to readmissions to hospital food etc. If you want buy-in vs burn-out from the average nurse on posted 'articles', make it succinct and convincing and show us some convincing proof instead of saying we need to look at evidence that is not even provided. Otherwise, you're just stirring the pot. 

And for the record: I actually would be interested in looking at compelling evidence on changing 12 hours shifts (or how to make them better). Not only for effects on patient care, but for effects on nurses work-life balance. I spend at least one full day of the week dysfunctional from exhaustion. So right there, my four days off are really three. 

 

 

The best way to make 12 hour shifts "better" would first and foremost be to adopt the California "ratio law" (which has teeth) and to adopt the California "lunch break"/break law which also has teeth. In almost ten years at my current job I've been able to take about 10 real lunch breaks, because we do not staff for breaks even though we must clock out (and not get paid) for a 30 minute lunch.  Start with some basics like safe staffing and actual breaks written into law with actual enforcement provisions.  

Share this post


Link to post
Share on other sites

tachyallday has 10 years experience as a BSN and specializes in ED/ Adult ICU/ PICU/ Acute Peds.

28 Posts; 507 Profile Views

5 hours ago, myoglobin said:

The best way to make 12 hour shifts "better" would first and foremost be to adopt the California "ratio law" (which has teeth) and to adopt the California "lunch break"/break law which also has teeth. In almost ten years at my current job I've been able to take about 10 real lunch breaks, because we do not staff for breaks even though we must clock out (and not get paid) for a 30 minute lunch.  Start with some basics like safe staffing and actual breaks written into law with actual enforcement provisions.  

Your employer is breaking the law if they are forcing you to clock out, but not insuring that you are getting 30 uninterrupted minutes, and not paying you if you do not get them. If my break gets interrupted by work, I am not counting it as a break. An anonymous call to your state's labor board could help out with that. 

Share this post


Link to post
Share on other sites
×