A new study in Health Affairs provides yet more support that reliance on 12-hour nursing shifts (or longer—we all know that shifts often extend a bit longer than scheduled) should be reconsidered. The study supports previous findings of increased burnout among nurses who work shifts longer than eight hours, but finds as well that longer shifts (13 hours or more) are associated with increased levels of patient dissatisfaction.
Despite these negatives for both nurses and patients, 80% of nurses surveyed across four states said they were happy with their hospitals’ scheduling practices.
I imagine that, with all the recent emphasis on patient satisfaction scores, this study will make nurse executives and hospital administrators take notice—especially as consumers become more aware of the research through coverage like this story at the U.S News & World Report site.
We’ve had evidence for a while that the 12-hour shift is not a best practice. For example, in 2004, Anne Rogers and colleagues also published research in Health Affairs. In their national survey of over 1,000 nurses, they found that most nurses generally worked longer than their actual shifts; nearly 40% of shifts were longer than 12 hours, and 14% of respondents had worked “16 or more consecutive hours at least once during the four-week period.” More importantly, they found that “the likelihood of making an error increased with longer work hours and was three times higher when nurses worked shifts lasting 12.5 hours or more.”
In 2006, Alison Trinkoff and colleagues published their research on the lengths of nursing shifts in AJN. Their conclusion: “The proportion of nurses who reported working schedules that exceed the recommendations of the Institute of Medicine should raise industry-wide concerns about fatigue and health risks to nurses as well as the safety of patients in their care.”
And just this May in AJN Reports, we examined the controversies surrounding 12-hour shifts, discussing the research and the issues involved.
In Nursing Outlook last January, American Academy of Nursing president Joanne Disch asked, “Are we evidence-based when we like the evidence?” It would seem so.