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Longer shifts lead to burnout and more patient complaints

Nurses working 12 hour shifts are more likely to experience burnout, job dissatisfaction, and complaints from patients dissatisfied with their care, according to US researchers.

Their study, published in the journal Health Affairs, is the latest development in the long-running debate on whether 12-hour shifts are better than eight-hour shifts.

The majority of nurses believe 12-hour shifts are worse for patient safety but they are often popular and perceived as better for work-life balance. The profession was equally split on which shift length they preferred to work in a Nursing Times survey earlier this year.

The new study examined the relationship between nurse shift length and patients’ assessment of their care. Nearly 23,000 registered nurses took part in the research by the University of Pennsylvania’s school of nursing over three years.

Researchers found nurses working shifts of 10 hours or longer were up to two and a half times more likely than nurses working shorter shifts to experience burnout and job dissatisfaction.

In hospitals that had higher proportions of nurses working longer shifts, higher percentages of patients reported that nurses sometimes or never communicated well, pain was sometimes or never well controlled, and they sometimes or never received help when they wanted.

Lead author Amy Witkoski Stimpfel said: “Traditional eight-hour shifts for hospital nurses are becoming a thing of the past. Bedside nurses increasingly work twelve-hour shifts. This schedule gives nurses a three-day work week, potentially providing better work-life balance and flexibility.

“When long shifts are combined with overtime, shifts that rotate between day and night duty, and consecutive shifts, nurses are at risk for fatigue and burnout, which may compromise patient care.”

Readers' comments (16)

  • no really!!!!!!

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  • We do a mixture of both but I would not want to work longdays where I am now, it's a 14 1/2 hour shift. The ward is non-stop, busy and understaffed.

    Staff ask to do them so that they only have to work 3 days a week, it also cuts down on travelling costs. The E/L shift pattern often ends up working 7 shifts in a row which is awful too.

    I see nurses really tired by the evening.

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  • Not necessarily so. On the ward I work on we do 12.5hr shifts, but if we do 8 hr shifts we still end up going off late due to workload, and needing to get documentation done. That makes every shift longer than it should be. At least with 12.5hr shifts you get more days off in which to have a life. It doesn't mean that the care is not good enough.

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  • Less staff, more patients, more admissions and discharges, higher expectations, the constant threat of being reported, unpaid overtime, no breaks,the threat of losing your job, the prospect of less pay more hours and reduced pensions, constant criticism from the media and no senior support - these are the things that are causing loyal hardworking nurses to burnout, not the shift patterns.

    We have to deal with 'customer' complaints as this is how they are seen now, however no-one deals with nurses complaints.

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  • Florence

    Our Trust is probarly going to implement a 12 hour shift pattern early 2013. There will be a shorter shift pattern avaliable for staff on flexible working.But most staff will be expected to go on to 12 hour shifts.The shift pattern for a ''12 hour shift' is proposed to be 0700 - 2000 and 1930-0730.
    They completed a ''consultation'' on this about 2 months ago.
    However the bottom line is that our contracts will be re-written and if we do not sign we will be made redundant. They have also told us they cannot rule out redeployment or redundancies.
    Personally I will manage 12 hour shifts and will be glad to have extra time at home.
    However I did 12 hour shifts years ago, albeit my son was younger then and you can't just rest on your days off !!
    Its a case of what suits Nurses best really. As sometimes with shorter days you can be on for up to 7 days at a time !
    However our Trust has taken the choice away for most of us.
    I just hope the savings my Trust makes from implementing these 12 hour shifts are worth it.

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  • tinkerbell

    Correct me if i'm wrong but won't they make a saving because they will need less staff to cover the off duty if everyone is working long days?

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  • a while back we were told we had to be fully flexible and not allowed to work long-days, this has now changed and we have to work long-days. Part-timers are also being asked if they could increase their hours - it saves them having to employ another nurse.
    Of course it's about saving money.
    Continuity of care - rubbish.
    Band 6/7 - short shifts of course.
    Rest of us - 'do as we tell you, you are lucky to have a job at all'.

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  • Florence

    Hi Tinkerbell. Yes they will make a saving in implementing the 12 hour shifts.They are bound too.Thats the real reason our Trust is doing it. Our Trust has been told to make savings. I cant remember the figure. To be honest the whole thing just cheeses me off big time .I still havent seen any senior posts go or be altered in anyway. Our Trust tried to dress up the 12 hour shifts in a positive way.
    They claim they improve continuity and care. And believe it or not they are claiming it is to help staff have a better work/ life balance !!
    Thats ok if the 12 hour shifts suit you.
    Our Band 6 Sister will have to do 12 hour shifts too. But not our Band 7 Ward Manager
    There has been NO cuts in senior posts in our Trust. There are Managers with titles like'' Transitional team Lead''.
    We definatley have too many Managers nursing and otherwise at Band 8 and above.
    A friend of mine in the Trust was banded at an 8 a couple of years back and he was first to admit he had been placed in too high a band for the responsibilty his job entails.
    Im tempted to find a private sector job & sort myself out with another pension ( Ive just turned 40 and have paid Super Ann since I was 18 and a little private pension).
    And for the first time in my career Id be prepared to strike.

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  • everything the NHS done regarding staff is to save money, do it as cheaply as possible, see what they can get away with without putting their management jobs in jeopardy.

    when nurses are tired, burnt-out, open to criticism, have no-one senior who will listen to them then they go off sick, lose confidence, become depressed, don't want to go into work.

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  • there is research to show that under-staffing and over-work leads to all kinds of problems, the research goes back years and yet nothing seems to have been done to improve the situation.

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  • Tell us something we don't already know lol

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  • tinkerbell

    Florence | 10-Nov-2012 10:36 pm

    Yes Florence but what happens when there are more managers than frontline staff.

    I'm no Einstein but even i can see that with all the workforce gone there'll be nothing left to manage. Surely management can't be that thick, or can they?

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  • Florence

    Our Managers are that daft Tinkerbell !!!
    Our Managers are also currently considering merging our Acute stroke ward, stroke rehab unit and Orthogeriatric rehab ward - thats where I work.
    We will potentially go from having 80 beds to 50. Between the 3 wards there are 4 Band 7's- one of whom is Stroke Specialist Practioner and 7 Band 6's.
    Surprise ! Surprise ! They are have just been given approval for 2 more Band 6 nurses.
    I know that at least it means that we will nurses who will still be mainly clinical but its Band 5's and HCA'S we are short of !!
    And also how can they justify 2 more Band 6 Nurses if they are to go ahead with this bed reduction plan??
    To be honest I just take what is said with a pinch of salt alot of the time and don't believe anything until its there in writing!!




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  • tinkerbell

    Florence | 12-Nov-2012 7:57 pm

    'Our Managers are that daft'

    Thought so but still one wonders. I guess it's what one calls 'madness'. Sadly you really can't trust things written down anymore now either, look how many contracts are about to be torn up and re-written.


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  • I wouldn't trust anything any manager says, whether it's verbal or in writing. We have been told lie after lie about ward closures, re-configuration, staffing levels, job losses.

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  • "Time to Care" - it's all about stating the obvious - more nurses leads to better patient outcomes.

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