How do Hospitals save money changing 12 hr shifts into 8 hrs?

Nurses General Nursing

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I'm a RN in the Bay Area, CA and there is a trend in the past 3 yrs that I've noticed. Hospitals are getting rid of 12 hr shifts and converting them to 8 hrs; can anyone tell me why? Does this save money from the Hospitals in the log end?

A Managers insight would be great!

- ER RN, "You're here for what?"

My former manager tried to create some shifts that were a combination of 8 and 12 hour shifts. It was an absolute disaster. She created several positions where the nurse worked 3 8's and 1 12 hr shift a week to equal 36 hours. Basically, only the day shift nurses who worked this schedule were happy. This is what happened:

It was very hard to get staff who would agree to work the afternoon and night shifts. Only the single people without families would even consider coming in 4 days on an off shift, and even they got very burnt out quickly. With weekends, they often worked too many days in a row and had little control over their schedules. They could not decide what day would be their 12 hour shift, and often ended up working a 12 hour night shift and were expected back the next day for their 8 hour shift, leaving little time to sleep. When they asked to switch to another shift (either 12 hours or the day shift) they were denied. Most of them were so unhappy the ended up quitting or transferring out.

The rest of the staff hated it because the 8 hour shifters often didn't have someone following them, so the rest of the staff had to split up the assignment of the nurse going home for the last four hours. This created a lot of headaches for the 12 hour shifters. Often I would get report at 7 pm that started with "I only picked this patient up at 1500 so I don't know much about them... I was too busy to look through the chart.... they seemed ok....."

The patients didn't like it because they were constantly getting new nurses and couldn't figure out what was going on!

I would say the experiment failed. The (night and afternoon) staff who stuck it out were happy to switch to 12 hour shifts, staffing and retention is better. Oh, and the manager is no longer there...

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My former manager tried to create some shifts that were a combination of 8 and 12 hour shifts. It was an absolute disaster. She created several positions where the nurse worked 3 8's and 1 12 hr shift a week to equal 36 hours. Basically, only the day shift nurses who worked this schedule were happy. This is what happened:

It was very hard to get staff who would agree to work the afternoon and night shifts. Only the single people without families would even consider coming in 4 days on an off shift, and even they got very burnt out quickly. With weekends, they often worked too many days in a row and had little control over their schedules. They could not decide what day would be their 12 hour shift, and often ended up working a 12 hour night shift and were expected back the next day for their 8 hour shift, leaving little time to sleep. When they asked to switch to another shift (either 12 hours or the day shift) they were denied. Most of them were so unhappy the ended up quitting or transferring out.

The rest of the staff hated it because the 8 hour shifters often didn't have someone following them, so the rest of the staff had to split up the assignment of the nurse going home for the last four hours. This created a lot of headaches for the 12 hour shifters. Often I would get report at 7 pm that started with "I only picked this patient up at 1500 so I don't know much about them... I was too busy to look through the chart.... they seemed ok....."

The patients didn't like it because they were constantly getting new nurses and couldn't figure out what was going on!

I would say the experiment failed. The (night and afternoon) staff who stuck it out were happy to switch to 12 hour shifts, staffing and retention is better. Oh, and the manager is no longer there...

Have always wondered if the system of shifts used in French hospitals ( 7am to 3pm, 2pm to 9pm and 9pm to 7am) would work in USA.

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Specializes in Med-Surg, OB, ICU, Public Health Nursing.
In California, unless your an employer with some type of exemption, you pay overtime after eight hours. Working three 12s automatically gives me 12 hours of overtime a week. If I worked five 8s, I wouldn't get it. That's the most significant reason I can think of why an employer might want to change things up.

It depends on the contract language. Many hospitals in CA pay straight time for twelve hour shifts if agreed to in the MOU/contract.

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In California, unless your an employer with some type of exemption, you pay overtime after eight hours. Working three 12s automatically gives me 12 hours of overtime a week. If I worked five 8s, I wouldn't get it. That's the most significant reason I can think of why an employer might want to change things up.

There is an alternate work schedule rule so that a hospital does not have to pay OT for hours 8-12. They can, and I know a hospital that does but not all do.

Now if you are a regularly scheduled 8 hour person and you work 12 hours those hours are OT, at least where I work. We have 8 and 12 hour workers on my unit and throughout the hospital I'm at.

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There is an alternate work schedule rule so that a hospital does not have to pay OT for hours 8-12. They can, and I know a hospital that does but not all do.

Now if you are a regularly scheduled 8 hour person and you work 12 hours those hours are OT, at least where I work. We have 8 and 12 hour workers on my unit and throughout the hospital I'm at.

True. The alternate work schedule is what I was calling an "exemption". I didn't know the technical term. I'm under the impression that an employer has to jump through some hoops to get to that point...

My hospital schedules twelve hour shifts and we do get overtime after eight hours in one day ...even if we only work one day a week.

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Specializes in Med-Surg, OB, ICU, Public Health Nursing.

When twelve hour shifts began in CA in late 70's or early 80's we did receive time and a half after 8 hours. That is why many nurses at many facilities agreed and voted for the change to twelve hour shifts. I believed then that the time and half would end and voted against the change. Within 5 years or so, I was proven correct. I believe that fatigue after 8 hours and the issue of errors should be considered. Patient safety really is important.

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Specializes in Critical Care.
When twelve hour shifts began in CA in late 70's or early 80's we did receive time and a half after 8 hours. That is why many nurses at many facilities agreed and voted for the change to twelve hour shifts. I believed then that the time and half would end and voted against the change. Within 5 years or so, I was proven correct. I believe that fatigue after 8 hours and the issue of errors should be considered. Patient safety really is important.

Patient safety is really important which is why 12-hour shifts are still pretty common. There is no legitimate evidence that shifts up to 12.5 hours in length are less safe than an 8.5 hour shift schedule. This is true for both studies that look at nursing specifically as well as other occupations with a high proportion of night shift workers.

There is however evidence of less errors and adverse events with 12 hour shifts compared to 8 hour shifts, as well as a reduction in established contributing factors for errors and adverse events. Excess of shift, for example, has been shown to correlate with an increase in errors, and excess of shift is far more common with 8 hour shifts. Various ways of measuring fatigue also show more overall fatigue with an 8-hour schedule. If you're looking at just a single shift, then there's more risk in those additional 4 hours of work, but the reduced time available for fatigue recovery in an 8-hour schedule produces far more cumulative fatigue.

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