With 12-hour shifts the prevailing staffing method, what can we do to address the negative outcomes? When NCF members gathered for an online video chat to discuss the issues involved, they came up with ten suggestions for promoting safe practice.
The Journal Club conversation centered around the article, "12-Hour Shifts: Literature Reviewed, Wise Use Challenges" by Dr. Betty Kupperschmidt, from Journal of Christian Nursing, Jan-Mar 2018. Members discussed additional research on 12-hour shifts, shared their work experiences, and proposed ideas that could help mitigate the negative effects of 12-hour shifts.
Recent research raises questions about the safety of 12-hour shifts for nurses and patients. Some nurses relayed higher job dissatisfaction, poorer quality of care, and higher ratings of care left undone. Yet other research was inconclusive about the negative or positive effects of 12-hour shifts and noted a paucity of research focusing on patient outcomes, patient experiences of care, and work productivity.
What mitigates negative aspects of 12-hour shifts? The quality of sleep can significantly impact quality of life for nurses and their work sleepiness, fatigue, vigor, anger, tension, and confusion. Less than six hours of sleep can double the risk for workplace injury. Research indicates that nurses who hydrated adequately during their shift were less sleepy, had more vigor, and reported less tension, anger, fatigue, and confusion.
Several of the nurses who participated in the NCF Journal Club said they had worked more than three 12-hour shifts in a week (only three is recommended) and more than 12 hours in a shift. Participants relayed difficulty in leaving work on time and how they were asked to stay later or work extra shifts. They said it was difficult to get enough sleep between consecutive 12-hour shifts and to eat well and stay hydrated while working.
10 Tips for Safe Practice
In our Journal Club conversation with NCF members, we came up with what we can do to promote safe practice while working 12-hour shifts. Here is our list:
- As Christians, the Holy Spirit dwells within us; therefore, we must commit to physical, mental, emotional, and spiritual self-care.
- Like Jesus, who worked long hours dealing with tough situations, spend committed time in communion with God.
- Commit to the biblical practice of Sabbath. Make regular times of rejuvenation, recreation, and whole-body rest.
- Share what we learned with other nurses, managers, and administrators.
- Refuse to work more than three 12-hour shifts in a week or more than three consecutive shifts.
- Take a water bottle to work and keep it filled; hydrate throughout the shift.
- Take a healthy meal or snacks to work.
- Practice sleep hygiene; learn and do what works for you to get adequate, restful sleep.
- Educate nursing students about proper use of 12-hour shifts; socialize students away from the idea that to be a good nurse you must work long hours and overtime.
- Model a balanced lifestyle for colleagues and students; help change cultural expectations of overwork.
It will be challenging to implement this list and difficult to change the culture of nursing and healthcare work practices. At the end of the Journal Club, each one of us committed to doing at least one of these practices from the list.
What action step will you take to make 12-hour shift work safer for nurses and patients?
—Kathy Schoonover-Shoffner, PhD, RN
Director, Nurses Christian Fellowship
Editor-in-Chief, Journal of Christian Nursing
Become a member and join the online NCF community for our monthly Video Chats on vital topics for Christian nurses and students. Receive Journal of Christian Nursing as a member benefit.
This blog post was adapted from "12-Hour Shifts: A Call for Action", from Journal of Christian Nursing: April/June 2018, p 75