Long shifts---how long is too long?

Posted
by Riseupandnurse Riseupandnurse Member Nurse

Specializes in Medical Surgical. Has 15 years experience.

How long are the nurses at your facility expected to/allowed to stay on duty consecutively? And how long do you think is too long, when judgment and abilties are too affected by fatigue to be safe? I'm hoping to hear from med-surg,

ER and OR nurses in particular.

Jaybird310

Jaybird310

Specializes in ER, Peds ER. Has 4 years experience. 116 Posts

I work in ER and have for most of my nursing career. I'm an insomniac and not someone who's naturally needs a lot of sleep. Long shifts are never fun and personally anything after 15 hrs (which I pull or come close to pulling at least once a week) I wouldn't consider a good idea. Fatigue, and just a general lack of focus comes into play for me around the 15hr mark. I've pulled quite a few 15-16 hour shifts due to under staffing and call ins. I've also been subjected to emergency situation hospital lock downs where you're 12hr on shift and then 12 hr on call while sleeping at the hospital. My longest single shift ever was 17.65 hrs (per time clock and it wasn't under 'normal' curcumstances). A 12hr shift is long enough but it's rare my shifts are only 12 hrs.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 16 years experience. 226 Articles; 27,608 Posts

For the past 3 years I have been working two 16-hour weekend double shifts at a local nursing home every Saturday and Sunday. This schedule enables me to have 5 days off in a row while being paid for 40 hours with benefits, so I enjoy it. It certainly beats having to come to work for five 8-hour shifts.

However, I admit I become mentally tired and emotionally drained during the last 4 hours of my shift on Sundays. This is due to a lack of sleep on Saturday nights, as well as the effect of being at the same workplace for 16 hours in a row.

wooh, BSN, RN

1 Article; 4,383 Posts

I do the occasional 16, but not if I have to be back at work the next day. It depends on the day if it's "too long" or not. I've had 4 hour shifts that were "too long" and at hour 3 I was having trouble thinking straight! But if I'm having a good day (like my last 16), then it's actually nice having enough time to catch up on all the things I have to do and then having time left over to actually talk to my patients!

BrnEyedGirl, BSN, MSN, RN, APRN

Specializes in Cardiac, ER. Has 18 years experience. 1,236 Posts

I work 12 hour noc shifts in ER. I personally don't like to do my three 12's in a row, the last one is tough for me. I have about a 45 min drive home and I'm one of those people who will be fighting to stay focused at 0400 and then really wired by the time I get home and it takes me about 2hrs to wind down and get to sleep.

Our policy doesn't allow us to be on the clock for more than 16hrs, and then we have to have 12 hrs off before we can clock back in, unless we are in "disaster" mode. I agree with an earlier poster, at about 15 hours it is real hard to stay focused. I was on for almost 22 hours once, during an ice storm. I was much younger then, and I was really a zombie the last 3 hours or so. I had a hard time remembering why I walked into the supply room, if I gave the meds in 4,.....I found myself triple and quadruple checking orders and charting just to make sure I did what I thought I did, not a good situation to be in.

travelcrazyRN

travelcrazyRN

Has 12 years experience. 86 Posts

I think anything over 12 is pushing it, and over 16 is dangerous. I've done several 16-17's over my career. I'm fine doing 12's, I still have energy when I get off of work. Some hospitals limit the number of days in a row. For 12 hour shifts I do not see the number of days being a big deal. I don't think it is unsafe, but (most) nurses lose compassion after 3 in a row.

kmoonshine

kmoonshine, RN

Specializes in Emergency. 346 Posts

We have 4, 8, 10, and 12 hr shifts in our ED.

I've seen people pull 16+ hrs before.

Personally, I think 12-hr shifts would be safe if staff were given a decent lunch break (at least 30 minutes) and at least two 15-min breaks to step away from pt care.

We rarely get breaks in the ED. I just finished a 12-hr day with a 10-minute "break" to grab a bite to eat; didn't even use the bathroom during my shift. I had 4-6 pts during my whole shift, most of who were admitted. At times, I am exhausted; but yet, another ambu is coming in 5 minutes so you gotta find the energy to make it through the night.

There needs to be mandated breaks for people providing pt care - you NEED to have a chance to sit down and eat a little something, especially when you are making patient-care decisions that may have disasterous outcomes. Hospitals will push you right until the edge - and things should not be this way. How can you care for someone if your employer won't even allow you to take care of yourself at work?

Edited by kmoonshine

lpnflorida

lpnflorida

Specializes in psych. rehab nursing, float pool. Has 30 years experience. 1,304 Posts

I work 12 hour shifts. I prefer to only work 2 days in a row, however for personal reasons I now work 3 shifts in a row. With 4 consecutive days off. The last hours of the shift are hard I find I have to drink 2 cups of coffee on the fly to make it through the final 4 hours

. I am not capable of working 4 shifts in row. I tried it once and and only once. By noon of the fourth shift I did not feel safe at work. My brain was sluggish. I will never do it again. I found out what my limit was to safely work.

I have not worked longer than 12 hour shifts since I was in my 30's. I recall working 2 back to back 16 hour shifts frequently. That second day was a killer. I would be absolutely slap happy so to speak. I do not believe I could them today. Fortunately I do not have to.

Roy Fokker, BSN, RN

Specializes in ER/Trauma. 2 Articles; 2,010 Posts

I've pulled 16s.

The longest (and by far the worst ever) was this stretch where I found myself working 6 straight "12s" in a row (during superbowl this year). That was absolutely brutal - no shift was shorter than 14 hours and we were chronically under-staffed (Superbowl Sunday we were short 1 nurse and 2 techs ... and we saw over 220 patients that day alone!)

I went home and slept straight for 10 straight hours - hadn't felt that exhausted since my time in the Army!

cheers,

HM2VikingRN, RN

4,700 Posts

16 hours no med passes after 12 hours of work...

CheyRN

CheyRN

58 Posts

:sleep:Are you asking about how long you can safely work or what's legal. Most states say that 16 hours is the max you can be MADE to work, after that the facility must let you rest/go home. Check with your State Board of Nursing and find out what's the legal limit in your state. Also check with your malpractice insurance carrier, as they may not cover you if you were to exceed that limit. I, personally, won't pass meds or do invasive procedures after 12 hours, but I know my limits and where my safty ends and my brain starts turning off. :sleep:

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