Concerned mother asks about dangers of nurse’s shift work

A nurse’s mother asked about the dangers of 12-hour shifts present to patients and nurses. She said her daughter fell asleep six times on her way home from work. The concerned mother wishes there was a law against 12-hour shift assignments.

As you can probably imagine, there are many state and federal laws that regulate employment issues, such as hours worked, overtime pay, days off after specified hours worked, breaks during work and equal pay for equal work. However, there is no specific prohibition, either state or federal, that prohibits workers, including healthcare workers, from working 12-hour shifts.

Twelve-hour shifts are seen as beneficial in many ways for both employers and employees. For employers, it might mean hiring fewer employees to cover staffing issues. For you as a nurse, it might mean being able to manage your personal life easier without disruptions for shift changes and hours over which you have no control.

Shift work has been the focus of research and articles on its effects on a nurse employee’s health and well-being for years. Shift work takes many forms but is generally defined as work hours that are scheduled outside of daylight. Its effects on nursing staff include sleep disturbances, errors and injuries to nurses.

Traditional shift work in nursing, whether taking the form of covering day shift only, evening shift only or rotating shifts, has almost been totally replaced by the 12-hour shift.

If customary shift work raises health risks to you, you can readily understand that 12-hour shifts also would affect your well-being. Many research studies have soundly determined so.

In one such study by Jie Chen and others, “Fatigue and recovery in 12-hour dayshift hospital nurses,” data from 150 nurses in three acute care hospitals in the U.S. was collected and analyzed. Inclusion criteria for the study required the nurses were female RNs assigned 12-hour day shifts, three days per week. They were not to have second jobs and were not taking medications for treatment of insomnia, depression or anxiety.

The research results are numerous and clinically helpful to you if you are working 12-hour shifts. A few of the results will be briefly discussed here.

Researchers delve into shift work

The researchers’ investigation found, “on average, a moderate to high level of acute fatigue in [the] nurses [in the study] working a 12-hour day shift.” In addition, the average score of acute fatigue for 12-hour shift nurses was higher than that found in an earlier study of eight-hour shifts in which nurses worked regularly rotating shifts.

The study also found that nurses who exercised weekly had better “fatigue and recovery outcomes” than those who did not exercise. The researchers did not find an association between family caregiving roles and the nurses’ fatigue and recovery outcomes. However, they caution that with the many variables of family structure (e.g., younger children, spousal help), this finding needs more study.

So there is no doubt that the mother who submitted her comment should be concerned about her daughter’s well-being and the well-being of the patients for whom she provides care.

Based on this study and other research on the topic, it is clear 12-hour shifts may not be for everyone. Some factors to consider, if you are undertaking 12-hour shifts or are considering doing so, include:

  • Do you have any current medical or psychological health problems that might exacerbate fatigue that has been documented by research of colleagues who work 12-hour shifts?
  • Do you have a family structure that can help you with your family care responsibilities when you leave work?
  • Don’t overextend yourself by volunteering to do extra 12-hour shifts or overtime shifts at the end of your regularly scheduled shift.
  • If you are making patient care errors of any kind (e.g., missed documentation, administering the wrong medication, failing to share vital information with your colleagues at end of shift), take time off and evaluate your ability to continue 12-hour shift work.
  • Remember, you are responsible both legally and ethically for the care you provide patients, so any patient injury or death can result in liability, both in the form of a professional negligence case and in a professional licensure disciplinary proceeding.
  • Keep in mind that taking care of yourself is an everlasting obligation to you and your patients.
  • Where possible, help to initiate or support workplace policies that support limits on overtime after 12-hour shifts.
  • When not working, reduce fatigue by choosing healthy and restful activities.
  • Evaluate your current position with 12-hour shifts and consider a position change if other attempts to reduce fatigue fail.
  • Seek medical help if your own interventions with fatigue while at work are not successful.

What are your thoughts on shift work and 12-hour shift work specifically? Share them in the comments section below.

Courses related to ‘fatigue and self-care’

Fatigue Countermeasures: Preparing YOU for Shift and Overnight Work
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While long hours, shiftwork, and overnight work may be a necessary part of healthcare, there are interventions you can take to help you work safely. And, we can let you know what the interventions are! Have you prepared yourself for long hours on duty? Do you have an ethical responsibility to assess your readiness for work? Do you say “I can handle another shift” and power through on caffeine? Different generations may have various motivations for how they approach shift and overnight work. Join this webinar to discuss strategies and interventions to help you prepare yourself to work at your best during irregular or long hours.

Healthcare Worker Fatigue: Too Tired to Care?
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Healthcare workers live with the reality that people need care beyond standard business hours, including evenings, nights, weekends, and holidays Shifts can become very long stretches of time where one needs sustained focus and alertness. With the number of millennials in nursing doubling and baby boomers’ retiring rates increasing, how will the workforce change? Millennials place a higher significance on meaning and professional development than pay alone. How will this affect night workers? Can “a little” fatigue impair your thinking? Is working at night the same as working during the day as long as hours are consistent? …read more

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