Healthcare Profession Work Rotating Shifts In Health Care

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

The term 12 hour shift is used to refer to a two shift system associated with an extended working day, as supposed to an eight hour workshift. Twelve-hour shifts have become the normality and standard shift option for nursing over recent years across the United States (Harris, Sims, Parr, & Davies et al., 2014 p.606). Longer work hours are viewed as a positive impact on recruitment, potential financial savings, retention, and enhanced continuity of care (National Nursing Research Unit, 2013; NHS Evidence, 2010). However, it’s also evident that longer shifts result in nurse fatigue, errors, and reduced alertness. The concept of longer hour shifts have become quite the controversial topic among the healthcare system.

West, Ahern, Byrnes and Kwanten (2007) indicate that the new graduate nurses may have not worked full-time in the past; given that graduate nurses begin their career with a full-time job can lead to exhaustion. It was discovered that shift work leads to desynchronisation of physiologically determined circadian rhythms which has a major psychobiology effect and it is commonly perceived the effects of shift work contribute to graduate nurses attrition rate. The NGNs often have a high level of stress due to disturbed sleeping patterns, as they find to adaption to shift work or rotating work hours difficult. Eventually, it leads to feelings of lack of job satisfaction, exhaustion and spending of less time with their friends and family, which can eventually could lead to burnout (West et al., 2007).

Moreover, most shifts run into each other with day shifts extending into the night and night shifts extending into the day. This means that their circadian rhythms are distorted. Extended shift work for nurses eventually lead to them finding it difficult to adapt to normal life or any activities outside work.

1. Healthcare professionals often work rotating shifts. In your own words, why is this problematic? What are the psychological, social, and physiological challenges related to rotating shifts? Consider sleep deprivation, high levels of stress, or side effects from medication in your response.

The first topic focused on in an article by Stimpfel et al. (2012) looked at the effect of longer shifts on nurses. Compared to the past, nurses are working twelve-hour shifts, instead of eight-hour shifts. The reason for these changes in shift lengths is for it to allow for nurses to have more flexibility in their schedules and to give them more time at home. This study revealed that the hours actually worked by nurses are unpredictable. Due to the fluctuations of patient needs and unanticipated staffing on the unit, leads to nurses having to work over their scheduled time (Stimpfel et al. 2012). This study also pointed out that there are no national policies for nurses that dictate the maximum number of hours a nurse can work. Nurses often end up working several hours over their shift because they feel forced into working those hours and thereby leading to burnout.

Throughout the years there has been more attention directed towards healthcare worker fatigue. More specifically, fatigue associated among night-shift nurses. The Joint Commission has found that lack of sleep from night shifts has contributed to increased errors, leading to poor patient outcomes (Gardner, Dubeck, 2016).

12-Hour shifts have constantly been an argument in the field of nursing. This topic interests me because there is constant jitter around this topic, to whether if it’s safe, or not. This can be taken into view from the patients view and also the nurses. Nurses should not be allowed to work 12-hour shifts because, the physical and emotional impact on their bodies is too debilitating, and the length of the shifts could be a potentially hazard to the patients.

(Senteniel) Additional studies show risk of errors and close calls were related to longer shift length and were associated with decreased attentiveness. Nurses also suffer higher rates of occupational injury when working shifts more than 12 hours. (Joint Commision, 20111) The ANA acknowledges the relationship between working long hours and increased risk for sleep disturbances, injuries, musculoskeletal disorders, gastrointestinal problems, metabolic syndrome, cardiovascular disease, cancer, and adverse reproductive outcomes. (NANN, 2012) In addition to clinical outcomes, there is an association between nurses who worked 13 or more hours in the hospital and lack of communication with patients regarding pain control. Burnout is common among nurses working long shifts and they are more than likely to leave their job within the first year. Shifts scheduled for 12 hours often exceed that timeframe, as many as 40% of the work shifts logged for their study exceeded 12 hours. (Martin, 2012) There are many reasons for fatigue, but shift length is the one that is most obvious and easy to fix. It is no wonder for nurse fatigue when 12 hour shifts are the norm. Twelve hour shifts are standard practice even though the Institute of Medicine recommends limiting them. At a recent nursing management congress Cole Edmonson stated that 12 hour shifts may cause more problems than they solve. While research is aiding us comprehend the dangers nurse fatigue brings to patients and nurses themselves, he called 12 hour shifts “a dead idea whose time has passed”. Eliminating 12 hour shifts is obvious if the fact is acknowledged that nurse fatigue is a serious problem. (Hendren,

Moreover, comparing the effect of the two shift systems (12 vs. 8 hour shifts) on patient’s safety are also evaluated by several studies. Beside the effect on fatigue, Todd et al. (1989) and Reid et al. (1993) concluded that there is a variety of results with the effect of 12-hour shifts on quality of care, in which they found that in the later part of the day there was less direct patient’s care that has an influence on the quality of nursing care. Reid et al. (1993) added that the reason of declined the direct patient’s care was found with the increase number of the unofficial breaks during the shift. This finding draws our attention to the importance of having adequate break time for the staff. However, in my

Different medical organizations thought shorter shifts would improve patient care, but the shorter shifts have not improved patient care at all. Patient care hasn’t improved, because the short shifts mean doctors must be switched more often. As a result, errors often occur when one doctor’s shift is over and another doctor’s shift begins, because the doctor who knows what is going on in the particular case is leaving, so the new doctor may not know enough about the case to provide quality care for the patient. The longer shifts avoided these errors with abrupt transitions, because one doctor could stay longer and continue to care for the patient. Overall, longer shifts are better for patient care, because as long as the doctor can still work effectively, having the doctor stay at the hospital provides better quality care to patients, as the doctor who is caring for the patient knows what is going on, and they provide more continuity of care, which results in higher quality

In the past two decades, a lot of changes have been characterised in the healthcare working systems. One of these changes has been the assimilation of shift work systems and the flexibility in work schedules. The need for 24 hour care makes the healthcare professions to work with different shift systems such as 12 h, 8 h, 9 h or 10 hour shifts. However, the common shift work systems divide a 24-h day in two (12-h) or three (8-h) shifts. Nonetheless, this requires the staff to be adapted with the various forms of shift work schedules.

The effects of long work hours, resulting in insufficient sleep have been well documented (Rogers, 2008). Insufficient sleep alone has been noted to cause cognitive problems, mood alterations, reduced job performance, reduced motivation, increased safety risks, and physiological changes (Rogers, 2008). Failure to obtain a sufficient amount of sleep is even an important contributor to medical errors (Rogers, 2008). Now think of the effects of sleep, and add in stressful work environments, short-staffing, pressure from administration, and unexpected events, we can begin to realize how patient outcomes may be greatly compromised.

To begin with, nurses must work long hours at a time. Nurses, RN’s, must work long hours. They would have to work long shifts, weekends, nights, and holidays, if possible. The RN 's can only get around the long hours by working for a private company. One of my friends is a nurse, she works at St. Lucie Medical Center on the night shift. However, because she works nights she feels like she is not a real person, like her life is consumed with sleeping. So, she has decided to switch her hours to the day shift instead of the night shift. If one nurse feels like she was not a real person, then many other people must feel that way too. Another story about my friend, she just finished working a thirteen-hour night shift. She did not get much

Aside from noticing night and day and clocks our body has its own system to tell us when to sleep and when to wake, our circadian rhythm. The human body naturally runs on a twenty five hour clock, so living on a twenty four hour schedule is often hard on the body because it loses an hour each day. On top of this natural loss most people do not get the right amount of sleep each night which can cause a whole host of problems. This is part of