Nurses report significantly lower quality of care if they work a 12-hour shift compared to a stint of eight hours or less, according to new analysis, which also found longer shifts were associated with higher job dissatisfaction.
The researchers, from the University of Southampton and King’s College London, also found nurses were more likely to leave a larger amount of care uncompleted if they worked for 12 or more hours.
“[This] raises a significant challenge to the assumption that 12-hour shifts can reduce costs without any deleterious effects”
The finding come from new analysis of data from the 31 acute NHS trusts in England that were included in a major European study from 2010, called the RN4Cast study.
Academics behind the latest analysis said their results showed that 12-hour shifts may not be cost effective or efficient – as some have previously argued.
“The analysis of data presented here raises a significant challenge to the assumption that 12-hour shifts can reduce costs without any deleterious effects,” they stated.
“In the absence of a more complete picture of both the effects and the costs of 12-hour shifts, managers should proceed with caution,” they said in their report, published in the journal BMC Nursing.
The results, based on a survey of 2,568 nurses, showed most trusts have a mix of eight-hour, 12-hour and other variety of length shifts, with few using just one type across wards.
“Working 12 hour shifts or longer are associated with poor ratings of quality of care and higher rates of care left undone”
Poor quality care was 1.64 times more likely among nurses working 12 hours or more, compared to those working eight hours or less.
Meanwhile, the amount of care left undone was 1.13 times higher for nurses working these longer shifts.
Nurses were also 1.51 times more likely to be dissatisfied with their jobs if they worked 12-hour shifts, compared to those working eight hours or less.
“Our findings add to the international body of evidence reporting that working 12 hour shifts or longer are associated with poor ratings of quality of care and higher rates of care left undone,” said the study authors, who were led by Southampton University principal research fellow Jane Ball.
They noted that, while anecdotal evidence suggested some nurses preferred 12-hour stints because it meant they worked fewer days and had more time off, others described them as exhausting and having a negative effect on their performance.
“When nurses are working 12-hour shifts, they were less likely to express satisfaction with their jobs”
“In our study, nurses working 12-hour shifts were…no more or less satisfied with their work schedule flexibility than those working shorter shifts,” said the study authors.
“However, our results highlight that when nurses are working 12-hour shifts, they were less likely to express satisfaction with their jobs when compared to those working less than 12 hours,” said the report.
The authors suggested that, even if nurses found working fewer days appealing for their work-life balance, this longer shift pattern may lead to stress and fatigue on the job.
“Individual nurses may hold a range of views on 12-hour shifts including personal efficiency benefits in working longer shifts whilst nonetheless finding them very tiring and being concerned about the effects of fatigue on their ability to deliver good patient care,” they said.