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Nurses more likely to be absent from work after 12-hour shifts, study finds


Nurses are more likely to call in sick following 12-hour shifts than if they have not worked a stint of this length, reveal early findings from a new study.

Academics at the University of Southampton noted the growing popularity of longer working patterns was not only possibly affecting nurses’ wellbeing, but also potentially leading to higher costs for employers who may have to use more expensive agency nurses to cover missed shifts.

“These longer shifts may lead to reduced nurses’ wellbeing and healthcare systems’ loss of productivity”

Study authors

As a result, those behind the study, called The association of nurses’ shift characteristics and sickness absence, said the routine use of 12-hour working periods should be questioned.

Researchers looked at around 600,000 shifts from 32 acute inpatient general wards at a teaching hospital in England in the three years up to March 2015.

They found that around 83% of the 1,997 nursing staff – comprising 1,312 registered nurses and 685 healthcare assistants – had at least one absence during that time.

The higher the number of 12-hour shifts worked, the greater chance there was of the person being absent in the following week, the study showed.

In particular, if nursing staff had exclusively worked 12-hour shifts in the past seven days, they were 40% more likely to call in sick compared to those who had worked no 12-hour stints.

The likelihood of not coming into work also increased if the person was about to work a 12-hour shift, compared with a more traditional eight-hour work period.

Though when looking at the two staff groups separately, the researchers found nurses were around a third less likely to be absent than HCAs.

Those behind the study told Nursing Times that it was unclear why the trend was occurring but noted that it reflected the higher sickness rates among HCAs, as backed up by NHS statistics.

“The relationship of ≥12 hour shifts and absenteeism suggests that these longer shifts may lead to reduced nurses’ wellbeing and healthcare systems’ loss of productivity and cost-effectiveness,” the paper concluded.

The study, led by research associate and doctoral student Chiara Dall’Ora, is still due to be published in full, but early findings were presented last week at the Royal College of Nursing’s international nursing research conference in Oxford.

The popularity of 12-hour shifts has been increasing in recent years, with growing concerns about the impact on staff and patients.

A 2015 study, commissioned by the chief nursing officer for England, found 31% of staff nurses on wards reported working 12-hour shifts in 2005 compared with 52% in 2009.

As part of the study, a review of previous research found “some degree of negativity” linked with 12-hour shifts – either for nurses, patients or both.

This included an increased risk of occupational hazards, including needle stick injuries and musculoskeletal disorders.


Readers' comments (15)

  • And this is a surprise? Nursing is a total expectation of giving of your social life, home life, and personal space, to others. It is no surprise that the 12 hour shifts - some even do 13 hour shifts - is directly correlated with sick time/abscences. Emotional and physical exhaustion and burnout are the reasons plus some of us do like to EAT and we do not have time to do so in peace, if at all, on a 12 hour shift, constantly interrupted and given more and more workload to complete. Small wonder that nurses literally cannot take it. Nurses are also humans - those things that need time to recharge, to see their friends (if they have any left after the hours prevent any social life), to eat proper food (how many nurses sit down to a meal, a proper meal, at work, on an undisturbed protected time break...). The 12 hour shift pattern was a management and profit based ease of tick box exercise for simplifying things for management. On or Off. Simple as. None of this nonsense of dare I say, an Early before your days off, and a Late after....oops...days off - plural - most nurses have DAY off - singular, then back on, then off - no time to even think, far less have any life at home. And for this a nurse is repaid how - need I say?

    Bring back the E and L pattern - consult with nurses - some may want the 12 hours on, and managers will say it is consistency - but to be honest, fatigue, no decent food, dehydration (a student nurse did research recently upon the fact that most of us are dehydrated) - many nurses are at risk of making errors due to a system and poor or no dietary intake, low fluids, no breaks, constant overload of information and interruptions....

    Anyone like to comment?

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  • I am physically and mentally tired after working a long day on the (really) acute wards. General medicine or elderly patients are not to bad. The key problem is having the regular breaks. I have found out, that on the 12000 steps/day shift, having about 20 minutes manager"s discretion + 2 x 30 min plus another 20 minutes in the late afternoon, really helps.

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  • I've worked both long and short shifts and my health is better on 12 hour shifts. I have a long term health condition and my sickness was worse on 8 hour shifts. It's much better for me working 3 or 4 shifts a week, I have had no sickness in the past year and my work life balance is much better! I would seriously consider leaving if I was made to work short shifts again

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  • I work 12.5 long days with 1 hour break, I prefer this to working short shifts, during the short shift I am less likely to be able to take a break and usually end up leaving couple of hours later. With the long day I feel I have a life.

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  • I prefer the long days! I don't miss working ten late-early shifts in a row which left me feeling more drained than working 3 long days in a row drained! My health and work life balance is so much better working 3 12 hour shifts a week.

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  • A lot of younger nurses prefer long days as it gives them more days off. Unfortunately, some relatively small short-term social benefits are gained are at the expense of much more serious longer term health problems.
    We are meant to be a research-based profession. Whilst the extensive research about 12-hour shifts is still inconclusive, collectively, the negative effect on nurses' health and patient care is compelling. Plus, there is absolutely NO research which suggests that longer shifts are better for patients. I find it alarming that so many Trusts are taking this step without ANY evidence that it improves patient care, whilst ignoring the huge weight of evidence that it has a negative effect on patient care and the long-term health of staff.
    There is evidence that the older you are the less you cope with shift work. As the retirement age goes up, either we are going to see good nurses having to leave the profession because they simply cannot cope or we will see a massive sickness burden on the profession, not to mention the effect on individual nurses and their families who will suffer as a result. We have to reverse this madness!

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  • Its not the long days that exhaust me and make me feel ill, it's the ad-hoc mixture of day and night duty. Something like this:

    3 twelve hour nights followed by sleep day, day off then longday then back on nights then another longday. This continues relentlessly.

    This absolutely devastates the body clock!!

    Furthermore, because we do annualised hours the longdays mean we can work so many condensed hours (including mixed days and nights) in a few days that we become exhausted

    Employers need to consider not just the safety concerns of this but also the health implications

    It also has a massive impact on social life, family life and general work life balance and planning

    Its not the long days that cause the problems its the poor rostering by management!

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  • Without doubt many younger nurses prefer to work 12 hour shifts because they allow them more full days off. I remember how energetic I felt when younger and could easily have coped with long days. However now I am nearing retirement I feel absolutely drained by the end of the shift and take a full day to recover. With the retirement age getting further and further away it is ridiculous to expect all nursing staff to suffer long days because it suits some. If it were a truly family friendly organisation there would be a choice between long and short days, but of course there is not, and unlikely to be. As for illness, having to work a mixture of long shifts, both day and night is inevitably going to result in poor health, and if you already feel under the weather, how on earth can you face a 12 -13 hour shift with little food and even less liquid to sustain you.

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  • Our service runs 13-hour day shifts and 11-hour night shifts. Oh how I wish they'd change the night shift to 12.25 hours and shorten the day shift to 12.25 hours. (I work 12 hour night shifts on the bank so know what that's like.) Day shifts are a different kind of tiring what with (in no special order) amongst other things, the incessant telephone calls; ward rounds; relatives' requests & updates; general ward maintenance; giving of meals; bathing or showering of patients; wound dressings; taking bloods; that just does not occur at night; and what with 3 medication rounds to conduct along with controlled drugs and pump set ups each afternoon - yes day shift is a different kind of tiring. At least on the ward I work it is. A now retired long term contract night staff nurse used say she was there to 'promote sleep'. For her this was shorthand for e.g. if that catheter is expelled overnight I'll leave it for the day staff so as not to disturb the patient's sleep. All the while collecting a few hundred pounds more every pay day than the rest of us with an enhanced pension because of it. Some band 5 night shifters get more than a band 6 and 7 on days. Some band 2s earn the same as new band 5s. Ho hum.

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  • Lot of nurses complain about long shifts and heavy workloads and then book into bank as per one of the comments. Agree a quick swap from days to nights is poor but interesting how many request that. All staff should rotate both day & night shifts for equate. I used to work 8x10 night shifts and had to stop driving home after the 6th as was not the fully alert. Yet I work with nurses that between substantive post , bank and nursing home shift they might get one day a month off yet complain they are tired.. remove the unsocials if staff do permanent nights as that is then their norm . Increase respect for day workers as pointed out unless you work in a true 24 hr area after midnight the workload decreases hence why twilight shifts are worthwhile.

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