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Nurses split over shift patterns

  • 41 Comments

Nurses are divided over the length of shift they prefer to work and the impact of shift patterns on patients, a Nursing Times survey today reveals.

Of the 2,837 nurses and healthcare assistants who responded to our survey, 46% favoured a 12 hour shift while 43% preferred to work eight hours. They were similarly split over which work pattern was better for work/life balance.

However, there were five times as many respondents who believed 12 hour shifts were the worse of the two for patient safety as those who believed eight hour shifts were the worse.

And 22% of respondents noticed they had made more errors during 12 hour shifts compared to 2% who felt the same about a shorter shift.

Almost a quarter of respondents said their trust had increased the number of 12 hour shifts in the past year.

Professor James Buchan, from the School of Health Sciences at Edinburgh’s Queen Margaret University, told Nursing Times this was to be expected as financial pressure meant managers looked to which shift patterns suited “the bottom line”.

Earlier this year the Royal Berkshire Hospital Foundation Trust, which needed to save £21m, estimated it could save up to £500,000 by extending the use of 12 hour shifts.

Royal College of Nursing senior employment relations adviser Kim Sunley told Nursing Times she was aware of many recent reviews of shift patterns.

She said there needed to be safeguards in place for 12 hour shifts to make sure staff got appropriate breaks and finished on time as evidence showed the patient safety risk doubled when nurses worked beyond 12 hours.

She added: “The fundamental issue is about choice. Staff allowed a choice are happier and better at their jobs.”

Just a quarter of respondents always worked eight hour shifts while 37% always worked 12 hours; the remainder worked a mixture.

Many respondents said they preferred the 12 hour shift because it gave them more days off, reducing travel and childcare costs.

Overall 60% of respondents said they felt more physically exhausted after a 12 hour shift but respondents largely felt sickness absence rates were not influenced by shift patterns. Most nurses felt both types of shift carried the same risk of burnout.

Many nurses told Nursing Times that if they worked 8 hour shifts it often meant meant working up to 10 shifts on consecutive days, leading to tiredness.

Jill Maben, director of the national nursing research unit at King’s College London, said 12 hour shifts had been growing in prevalence over the past decade and were originally brought in to improve continuity across a day.

However, she said 12 hour shifts were often worse for continuity across a patient’s hospital stay as nurses working 12 hour shifts only tended to work three days in a row.

She said more research was needed into the impact of each shift pattern on nurses’ ability to do their job safely.

Professor Maben said: “I understand it’s really difficult for directors of nursing to hold the line with finance directors trying to make savings.

“Perhaps moving to 12 hour shifts means you don’t have to lose staff so I can understand how it can look quite seductive in this era of fiscal restraint but my caution is, do you really know what effect this is having?”

  • 41 Comments

Readers' comments (41)

  • George Kuchanny

    12 hour shifts are not good for patient safety - end of story really.

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  • 12 hour shifts are not good for patients or staff .Its largely due to trusts/private companies trying to cut costs= tired staff and patient care is affected

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  • tinkerbell

    She said there needed to be safeguards in place for 12 hour shifts to make sure staff got appropriate breaks and finished on time as evidence showed the patient safety risk doubled when nurses worked beyond 12 hours

    So anything over 12 hours is unsafe? Why introduce it yet again then? Money, money, money first, safety 'so what?'. There are enough mistakes being made already.



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  • I prefer 12 hours shifts as cost of transport is less, I have more days with my family which is a massive positive, and my patients are with me for the whole day, their care is better as the same person can assess their needs better throughout the day.
    I will continue to beat the drum about sufficient staff on the wards. If there is sufficient staff then the problem is solved, and nurses can have some flexabitity as to how they wish to work to have some balance in their lives.
    Why do we always have to interfere with every thingh else and avoid at all cost the REAL problem.

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  • Personally, as a student nurse, I've had to work 12 1/2 hr and 13 hour shifts on busy, understaffed hospital wards and found that utterly exhausting. I spent my days off recovering. During the final few hours of my shifts, I could barely concentrate and would shuffle along the long ward corridor to get to patients. It left me demoralised and I almost gave up my course.
    I also did 8 hour shifts and found that I could learn so much more on those shifts as I wasn't feeling as drained and exhausted.
    In fact, if a student gets a placement on ICU, they are not allowed to work 12 hour shifts, due to the intense nature of the learning.

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  • I don't believe in student nurses working 12 hours shifts as it would be difficult for learning to take place after certain hours in a shift, however for an experienced nurse as myself, 12 hours suits me for lots of social reasons. If my social life is happy, then I can cope better with all the xz0p#zzy we nurse have to cope with.

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  • we had about five shifts which we worked at random according to a plan worked out, usually for three month in advance, although sometimes it was only produced up to a few days before for the following week and was for less than three months depending on time available to those doing the off duty.

    we had two continuous shifts, two to three split shifts and one night shifts. I appreciated this rotation of day shifts as it meant we were free sometimes during the day and after five hours from 7 am to 12 noon I had usually had enough and had time to recover and lunch at a reasonable time before doing three more hours work from 4 or 5 pm. the late and early continuous shifts were also useful before and after days off. I have never worked a 12 hour shift and would not even consider it. our night shift was 9 hours which was quite long enough and we worked a 42 hour week which was good as it meant more nursing hours on the ward than with a shorter working week. it wasn't unusual to do a little extra unpaid overtime when the ward was busy, for emergencies, to help out a colleague, finish some paperwork we may not have had time to complete or more irritatingly when the organisation went haywire due to overuse of the computer system at certain times shortly after its introduction to the wards.

    we were paid overtime for unsocial hours and bank holidays which were considered to be all hours worked outside of what are considered normal national working hours.

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  • Anonymous | 18-Jul-2012 2:46 pm

    in addition to the above, if we had staffing shortages for whatever reason we worked an 84 hour fortnight instead of a 42 hour week but this was rare. we also sometimes enjoyed a series of more than two days off together if we had worked six or more days so sometimes we might even have an 8 day week and three or four days off.

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  • As a student I have enjoyed working 12 hour shifts while on placement. Agree it is less travel, more time to study when not on placement and also to spend time with family. I have learnt a lot while on placement through my mentor, other staff and patients. I had regular breaks to ensure I was not tired or exhausted and refreshed. Would prefer to do 12 hour shifts when I am on my future placements, am on nights at the moment and dont mind them either. I get to follow my mentors shift pattern, experience different shifts and see what shift hours will be like when I graduate. Saffy x

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  • I am in favour of long days as I find when you do an early shift and you are as tired as if you did a long day. Also I find that patients benefit from this as they have the same nurse for the whole day. Plus I get to have more days off per week it gives me time to do all my shopping housework, family things and still enough time to rejuvinate myself for work again.

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