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Ähnlich wie 8 Versus 12 Hour Shifts
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8 Versus 12 Hour Shifts
- 2. In long-term care settings, how does staff working 8 hour shifts, compared to staff working 12 hour shifts, affect safety and overall patient care?
- 3. Have to work 5 days in week to get full time hours More faces patients have to learn Less continuity of care CON Shorter work hours More time in day for other things Higher patient satisfaction PRO
- 4. Long hours Work fatigue, stress, burnout More prone to make errors Due to hand offs and finishing up the loose ends of work, longer than the 12 hours worked Decreased levels of alertness Increased instances of needle-stick injuries and musculoskeletal injuries Poorer quality of care and safety CON Shorter work week = more time off Better continuity of care Less vacancy rates More satisfaction with schedules Jobs fill more quickly with 12 hour shifts Patients learn who the staff are, meaning less shift changes PRO
- 5. Sentinel Event Reduce risks of injury or death Effort to reduce medical errors and worker fatigue Strategies
- 6. Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) Standardized survey instrument and data collection method to measure the perspectives of the patients in regards to hospital health care 9 key topics surveyed
- 7. Nope! Just give me the risks, boys. What was the HCAHPS Survey outcome? What does the survey mean? The contradiction found! The results.
- 8. Inadequate staffing Rotating shift schedules Consecutive shifts Incentives for being mandated or volunteering
- 9. Is there a conclusion to this? What does this all mean?
- 10. Ball, J., Dall'Ora, C., & Griffiths, P. (2015). The 12-hour Shift: Friend or Foe? Nursing Times, 111(6), 12-14. Retrieved January 22, 2016, from http://www.nursingtimes.net/nursing-practice/specialisms/patient- safety/the-12-hour-shift-friend-or-foe/5081694.article FMSCA. (2014, April 9). New Hours-of-Service Safety Regulations to Reduce Truck Driver Fatigue Begin Today . Retrieved from FMSCA: https://www.fmcsa.dot.gov/newsroom/new-hours-service-safety- regulations-reduce-truck-driver-fatigue-begin-today
- 11. Geiger-Brown, J., Rogers, V. E., Trinkoff, A. M., Kane, R. L., Bausell, R. B., & Scharf, S. M. (2011, November 28). Sleep, Sleepiness, Fatigue, and Performance of 12-Hour Shift Nurses. Chronobiology International, 29(2), 211-219. doi:10.3109/07420528.2011.645752 Rollins, J. A. (2015, July/August). The 12-Hour Shift. Pediatric Nursing, 41(4), 162-164. Retrieved January 22, 2016, from http://eds.b.ebscohost.com.ezproxy.rasmussen.edu/ehost/pdfviewer/p dfviewer?sid=44ee17a1- 8cf0-43fb-a170- b34904647a10%40sessionmgr112&vid=8&hid=104
- 12. Witkoski-Stimpfel, A., Sloane, D. M., & Aiken, L. H. (2012). The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, 31(11), 2501-2509. doi: 10.1377/hlthaff.2011.1377
Hinweis der Redaktion
- The debate seems to be ongoing, especially at my work, regarding what is better in the long run, working an 8 hour shift or 12 hour shift. What is safe for the patients and what is safe for the employee? I personally enjoy working 8 hour shifts, however my fellow employees are quite upset that their shifts were changed from the 12 hour shift into the 8 hour without their being asked. Every town hall meeting that is given, employees don’t miss a beat in requesting and even demanding that their 12 hour shift be brought back. I really want to know, how safe 12 hour shifts versus the 8 hour shift is.
- I wanted to start out listing the pros and cons of each shift, so I started out with the 8 hour shift. With the 8 hour shift, working less hours means more time in the day with family and doing life’s business, which translates into nurses and healthcare workers having an improved work/life balance. Nurses who work longer days have issues with burnout, tend to leave for jobs with shorter hours and fatigue is increased on longer shifts, especially when it’s the night shift and normally with older nurses, but I would add younger nurses that are not accustomed to working overnights as well (Rollins, 2015). Yet I read that those who work 12 hour shifts prefer to have these hours because of the increase in time off but then contradict themselves saying that 12 hours are preferred and wanted, yet they are leaving for jobs with shorter hours due to fatigue and burnout and then I hear and read that people are leaving the 8 hour shifts for those that use the 12 hour shifts. What gives? I guess it depends on who you ask and what article you are reading as to the viewpoint.
- The 12 Hour shifts have few pro’s while the con’s have the floor with more valid points. The most I could find was redundant when it came to why people wanted to keep the 12 hour shifts, and that goes the same for my place of employment at the VA. It all boils down to working less days in the week which increases the time off. I don’t see it, two 12 hour shifts and two 8 hour shifts, that just gives you one extra day off, I guess if that’s what you are looking for, then that helps. The 12 hour shifts in regards to patient care and satisfaction are worse for quality of care, pretty bad safety records with client care reports and care that is left undone (Rollins, 2015). Increase in hours also has been related to drowsiness while driving, especially if having to work overtime overnight (Geiger-Brown, et al., 2011), this is true among other professions such as truck drivers who were nationally mandated to drive no more than 11 hours daily (FMCSA, 2014). When doing the SBAR with the next shift, or finishing up tasks that have been started but cannot be held over for the next shift or the next day, it is easy for the shift to extend longer than the 12 hours. I see some of the charge nurses work at least an hour over their quitting time trying to finish up. When your ward is full and full of those who need a lot of assistance or constant 1:1 time, that work has to be taken care of first before the paperwork and that paperwork is last to get done when the nurse is needed on the floor for whatever reason. That is the issue at hand, whether its due to inadequate staffing or increased needs on the floor, these are all priorities over paperwork.
- The Joint Commission issued a Sentinel Event Alert which indicates a risk or an actual unexpected occurrence of death or serious injury within the healthcare industry. The Joint Commission has urged healthcare organizations to increase efforts to reduce risks for medical errors, such as those related to fatigue, from extended shifts, which includes assessing policies for shift work, development of strategies in an effort to reduce or prevent fatigue, increase teamwork and collaboration in support efforts for those on longer shifts. These would help ensure safe and smooth hand offs at the end of the shift and making sure everyone makes it to their destinations alive(Rollins, 2015).
- HCAHPS survey is in regards to study results that compared the nurse’s shift length alongside patient satisfaction. This survey is from the patient’s perspective and goes over 9 key topics such as: communication with the doctors and the nurses, the responsiveness of the staff, pain management, communication in regards to medicine, discharge information, cleanliness of the facility, how quiet the facility is and the facility’s transition of care (Rollins, 2015). Rollins further stated that the outcomes are more severe for those facilities where the staff worked 13 hours or longer and this includes if the patient would recommend the hospital to others. In contrast, those places that use shifts of 8 or 9 hours have better satisfaction amongst their patients.
- As I continue to read, and I may have to look more online, I am not finding anything of value in regards to increased hours equals increased errors. It does state that the review of evidence of the impact and effectiveness of 12 hour shifts were inconclusive in the areas of risks to patients, their experience, risks to staff and their experience and how it impacts the hospitals. INCONCLUSIVE! OK, got that off my chest. I shake my head and continue. So, what about that survey I mentioned earlier? For those hospitals that employ staff that work 12 hour or longer shifts, they have a higher number of patient dissatisfaction and they responded that they would not recommend that hospital to others. They also reported that those nurses sometimes or never communicated well and pain wasn’t very well controlled as well as not getting the help they needed when they wanted. Their conclusion is that patients perceive their care to be worse in the hospitals that employ nurses that work shifts of more than 13 hours. This means that changes are being made. In the fiscal year of 2013, hospitals face reductions in reimbursement if they fail to meet the benchmarks provided by the survey and their conclusions. One of the benchmarks included nurse working conditions that include shift length. Found the contradiction! Per the survey, most nurses said they were satisfied with their schedule and most of them worked the 12 hour shift. They also found that nurses who worked 12-13 hour shifts were more likely to intend to leave the job than those who worked shorter shifts (Witkoski-Stimpfel, Sloane, & Aiken, 2012). They suggest the reason for this is that nurses seem to underestimate the impact that working the longer shifts because of the appeal of working three days a week instead of five, not to mention this attracts those who want to work second jobs(Witkoski-Stimpfel, Sloane, & Aiken, 2012). Yes, 4 days off, yay! How many hours or days does it require to recuperate from those 3 long days, especially if they are consecutive? I have issues when I work 4 days a row on 8 ½ hours a day at my job. Of course it may just be a mindset, you set your mind to it and away you go, until the last day comes and you are dragging and getting sick. Then you add on overtime and having to work more hours due to mandate or otherwise and ta dah, you are calling in sick for what the military call a MWR (moral, welfare and recreation) day.
- 12 hour shifts rotate day and night or part of each in each shift. In order to have 12 hour shifts, you have to have a balance between those that enjoy or can tolerate the overnight shift with those who prefer days. If the work week goes from full time of 80 hours, the 12 hour shift would not work because it would be 4 days of work, two 12-hour shifts and two 8-hour shifts or would the full time status go to 72 hours in which three 12-hour shifts and then employ a weekend shift? Would these shifts be consecutive or spaced out? These types of shifts would allow for another job on the side or more home life potentials with flexibility to do whatever. The issue is the unpredictable nature of healthcare such as employees calling in sick, those who quit, patient needs that change and unpredictable shift lengths when trying to get the day’s work finished which then requires overtime (Witkoski-Stimpfel, Sloane, & Aiken, 2012). If a co-worker calls in to work stating they aren’t coming in for whatever reason, the calls go out to replace that person. If no one volunteers to come in, then someone is voluntold to come in, which is called mandating. NO ONE likes to be mandated, especially on their weekend off or when something else is going on, which of course there usually is. I have heard a lot of people say that they wont answer their phone if they know its work calling because they know they will be mandated to come in to work. Some places are putting incentives on the mandated shift to entice people to volunteer to come in such as bonuses, another day off, double time, etc.
- The only conclusion I can come up with is there is no overwhelming conclusion, no real consensus. My opinions are that the facts of that particular hospital has to speak for itself in determining which shift should be used by the staff. Perhaps it would be even better determined by going floor by floor or department by department, such as this department has low chance of injury and the patients are pretty self-sufficient, therefore a 12 hour shift can be utilized safely but that department is pretty intense with multiple risk factors that needs due diligence when working, therefore, a shorter shift such as an 8 hour should be utilized instead. This all means we really are spinning our wheels but going nowhere fast. If people want to work the 12 hour shifts, they will dig in their heels to keep it that way, regardless of the patient care surveys or how their hospital is perceived. That’s the gist of what I read in my references – “At the state level, boards of nursing should consider whether restrictions on nurse shift-length and voluntary overtime are advisable. This idea has been raised in the past, but it has been met with emphatic pushback fro nurses who wish to maintain the status quo” (Witkoski-Stimpfel, Sloane, & Aiken, 2012, para. 6).