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Essex trust switches to 12-hour nursing shifts to alleviate staffing and cost concerns

  • 8 Comments

Long day and night shifts are to be made compulsory for ward-based nurses at a Colchester General Hospital in a move that bosses have said will help to fill staffing gaps on rotas and save money.

The hospital wants to transfer ward-based nurses, midwives, assistant practitioners and healthcare assistants onto 12-hour shifts patterns, beginning at 7am or 8am in the day, and at 7.30pm at night.

“Any cost reduction will be realised via the removal of vacant posts from the establishment”

Chief nurse letter to Colchester Hospital University NHS Trust staff

For full-time employees this would mean three shifts per week for three weeks, plus one week of four shifts.

Colchester Hospital University NHS Foundation Trust, which runs the hospital, reviewed its rosters and found that “a huge number” of different shift patterns were in place, making it difficult to find cover for short-staffed wards.

This meant the trust was often forced to use more expensive bank and agency staff, according to consultation documents seen by Nursing Times.

In addition, nurses already on longer shifts were sometimes having to work beyond their planned hours to make up for the staffing shortfalls – which the trust found had resulted in some working up to 14.5 hours.

“Staff should be able to choose whether to do longer shifts or not, rather than being required to do them”

 Isaac Ferneyhough

The move to standardised, longer shifts – which is expected to affect inpatient wards, accident and emergency, and assessment units – will “help us to resolve these issues, along with improving our continuity of care for patients,” said director of nursing Catherine Morgan in a letter sent to staff in January.

No redundancies are planned as part of the changes and “any cost reduction will be realised via the removal of vacant posts from the establishment,” said the documents.

However, in its assessment of the impact of the changes, the trust noted that older staff with health needs or those with childcare considerations were likely to be adversely affected by the changes.

Staff with flexible working arrangements in place are having to re-apply to the trust for permission to be excluded from the move to 12-hour shifts.

“There is also very limited evidence to support that 12-hour shift patterns are more cost effective than eight-hour patterns”

 Isaac Ferneyhough

Following a consultation on the plans in February, the trust acknowledged there were also concerns about drug rounds taking place at the end of long night shifts. As a result, it now plans to include the drugs round at the start of morning shifts, the majority of which will begin at 7am.

The proposals, which are now being developed to include some further changes, are due to be brought in over the coming months.

But a union said that, while it acknowledged and supported the majority of staff who wanted to move to 12-hour shifts, it objected to others being forced into the new working pattern.

“Our argument is that staff should be able to choose whether to do longer shifts or not, rather than being required to do them,” Unison’s staff representative Isaac Ferneyhough told Nursing Times.

“Research has shown that working 12-hour shift patterns significantly reduces the quality of care to patients, he said.

“There is also very limited evidence to support that 12-hour shift patterns are more cost effective than eight-hour patterns and careful analysis needs to be made regarding patient outcomes, quality of service and longevity of quality care with an ageing workforce,” he added.

“We have been very clear that we are not introducing a trust-wide compulsory move to 12-hour shifts”

Catherine Morgan

He warned that staff may find it difficult to take their full break times during longer hours and that the changes would only be suitable for fitter employees.

“Effectively the trust will be designing for a smaller pool of staff. We are concerned that this will mean that those less able will be displaced. This may lead to a shortage of skilled staff due to early retirement, for example,” he said.

In a statement provided to Nursing Times, the trust’s director of nursing said it had been consulting with staff over the changes and was working with those who did not want to switch to longer shifts. 

“We have been consulting with our staff over the past few months on a proposal to standardise shift start and finishing times and the introduction of 12-hour shifts.

“We have been very clear to staff and trade unions that we are not introducing a trust-wide compulsory move to 12-hour shifts,” said chief nurse Catherine Morgan.

She added that the trust acknowledged 12-hour shifts were popular with some staff but not practical for others.

  • 8 Comments

Readers' comments (8)

  • I am retired but worked 12 hour shifts when working in residential care. I found them better there as they follow the natural rhythm of a normal life's day. However I'm not convinced that in a medical or surgical ward which by virtue of their nature are outwith normal life patterns that this would hold true. It could just exhaust already overworked staff. It will be interesting to see other people's responses.

    If it does not save time, could this be because handovers are not being conducted in an appropriate and properly time-consuming manner? Are nurses going on shift without being fully apprised of their patients' situations?

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  • I am an older nurse and work on an acute neonatal unit. The 12 hour shifts are exhausting for the younger nurses so obviously not ideal for those who are not so young. Yes it is easier to cover the 24 hour period, but if nurses have to be on their feet for 12+ hours with very little to drink and a chance they may not get any break at all, then sickness leave it undoubtedly going to go up. Why no drug rounds at ends of shift? Is it because nurses are not so able to concentrate at that time? What a sad admission, however even those nurses who prefer long shifts would agree they are 'not at their best' when so tired they can hardly stand. The latest practice is to give day and night shifts within the same week, and in that way reducing the true 'days off' to only two.

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  • If it's 2 times 12 hour shifts, how does that include the handover???

    Nurses MUST drink as and when needed. If jugs of water are made available to patients then they must be there also for staff. It's thoroughly dangerous otherwise.

    Day and night shifts within the same week is pure managerial stupidity.

    Would shifts 9.30 to 9.30 on a permanent days or nights with two and half days off a week work better? (Miss the rush hour and miss the drunks travelling. Keep the body clocks regular.) Senior Managers desperately need to do some market research on which hours staff would find preferable and why. Then it could be tailored to suit.

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  • I am semi retired as I only work part time now .I would never be able to do long days as I would be too tired to care for my patients at the end of shift .On the other hand some people might be happy with working 3 long days. For mums with children this might be detrimental as they may not see their kids in the morning or evenings .It is a saving but at the detriment of working moms. Flexibility would have to play a bigger role to let people work balance their daily lives.

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  • Going to be more burn-out's and more staff leaving.12hrs is too long to leave a famailly at home. Is there no consideration or feelings at all in these managers, sitting on their back-sides all day, 9-4

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  • Mixing days and nights- few who are responsible for the Rotas understand the concept of sleep days. My 7 on 7 off suited me even with young children. Two nights I struggled when my sister didn't give enough time to switch back to 2 long days which because they split the week... she would justify it! Also 3 long days covers 6 short shifts so win win for the managers!

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  • My previous hospital switched to long days in 2010 after a "consultation" (it was going to happen whatever staff said about it!). They were actually 12.5 hour shifts to allow for handover and everyone was made to do them. Those staff who said they couldn't manage long days due to childcare or health issues were basically told to leave!
    Trying to fit breaks in to a long day was very difficult. By the end of the shift (on a busy surgical admissions ward) I was so tired I couldn't think straight!
    I now work long days in a nursing home but the pace is far slower and so I don't feel tired like I used to .
    Long days are "sold" to staff as positive, more days off etc but the real reason is to save money and cover shifts.

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  • It's a disgraceful and heartless decision. Managers keep banging about the 6 Cs, healthand safety, bla bla bla... for the staff, but themselves are far from applying the 6 Cs! Hypocrites!

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