The Hour Shifts For Nurses

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.

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

Often when the hospital desperate in nurses they will offer incentivized shifts to nurses to cover up gaps. Besides, most of the time that will

Whether or not mandatory overtime is required varies from facility to facility. Like many other issues, there are both pros and cons to this topic. Witkoski,S, Sloane, D, and Aiken L (2012) did a study and concluded that nurses who worked 10 or more hours a shift were more likely to experience burnout and were dissatisfied with their jobs with an intent on quitting. Burnout can affect the quality of care a nurse provides to patients. Burnout can be the cause of a nurse not noticing subtle changes of patients which could potentially lead to patient neglect. Although there are cons to working long shifts there are some pros. When nurses work 12hour shifts, they often meet or exceed their weekly hours over the course of a 3day work week. Since they would only be working a three-day work week, it provides nurses with a better work-life balance and flexibility (Witkoski,S, Sloane, D, and Aiken L 2012), giving nurses more time outside of their job to do whatever they would like. Getting this kind of flexibility is great for nurses like myself who are either back in school or have families to take care of, or just need a little more time to recover and

Working overtime is a prevalent practice among nurses that hospital management uses to deal with staff shortages. According to Manitoba Nurses Union (MNU), 34% of Manitoba nurses reported working overtime (2014, p. 4). Most overtime worked by nurses in Manitoba is voluntary, however, it is legal to mandate nurses to work overtime if required. Three in 10 overtime shifts worked by nurses in Manitoba are involuntary (MNU, 2010, p. 6). MNU defines mandatory overtime as a situation in which the nurse refuses the offered overtime and the employer orders the nurse to continue working after their assigned shift has ended (p. 7). Mandatory overtime is seen as an absolute, last possible resort for hospital managers, after all other options and possibilities have been exhausted (MNU, p. 6).

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.

In the nursing profession, especially when working in a hospital, it is not uncommon to have 12-hour nursing shifts,

For some nurses, mandatory overtime can be an advantage due to financial instability but mostly mandatory overtime can cause fatigue, burnout, injuries, errors, inadequate sleep and deficits in performance. According to research working long hours which consists more than 40 hours a week or over 12 hours a day leads to an increased medication errors and patient mortality. The probability of making medication errors increases tremendously when nurses work longer than 12.5 hours a day. During surveys regarding reasons of overtime, 60 % of nurses stated that overtime was obligatory as part of their job, 29 % of nurses stated that they volunteered and 41% of nurses stated that they were “on call hours” (Bae, 2012)

Evidence also supports that bedside shift reporting is financially beneficial for staff nurses and nursing management. The average report time is significantly decreased from an average of 45 minutes to 29 minutes (Gregory, et al., 2014). This reduces overtime and saves hospitals money. Nurses’ satisfaction is improved because they get to end their shift on time. They get to proceed with shift report more quickly, with fewer distractions and in real time (when compared with writing or recording report). Increase in nursing satisfaction reduces turn over and, once again, saves hospitals money (Gregory, et al., 2014).

Does one ever think about the words “required” or “extended work shifts”? To countless nurses these terminologies or jargons mean mandatory overtime. In today’s healthcare, “required” overtime has sky rocketed, attributable to, the nursing shortages throughout the United States. Studies have revealed that working “extended work shifts or additional shifts” have a negative impact on both patient and nurse safety. The purpose of this paper is to inform and advocate for the Registered Nurse Safe Staffing Act. This author will discuss the key points, provide a critique of empirical evidence, and demonstrate the importance and impact of this Act to the nursing profession.

Within the recent years, hospitals and medical facilities have been experiencing nursing shortages that necessitate more nurses to be present to compensate for the care needed to be given. This requires nurses to be dealt with imperative extended work hours along with their normal shifts with no denial or excuse accepted. Working extra hours are accompanied with negative effects that have an impact on the nurse, coworkers, and patients. A major concern that occurs with overtime is that nurses become fatigued or burnout. Fatigue that is experienced is a result of sleep deprivation from working overtime that is associated with arduousness neurobehavioral functioning

A nurse’s typical day isn’t without stress; it is usually a lot of complex planning, critical thinking, time management, an abundance of communications with all departments of the hospital, and documenting events that have happened throughout the day on their entire patient assignment. “Nurses who are mandated following the completion of their regular shift are often ill-equipped to continue working. They have not planned for that situation with: proper advanced rest, arrangements for

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

Limited attention has been paid to the hours worked by nurses, or the effects of these hours on patient safety (Rogers, 2008). Even though most nurses favor 12- hour shifts and overtime, it is associated with difficulties staying awake during times of duty, reduced sleep times, and triple the risk of making an error (Rogers, 2008). The most significant risk of making an error occurred when nurses were scheduled to work 12.5 hours or more.

The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. (Trossman, 2009). Working longer hours in a high stress area will always increase the error rate. Designating an adequate number of RN positions to ensure nurses work an appropriate schedule without overtime and that their workload allows for breaks. Managerial staff must work to develop specific policies about the length of work times based on the setting, patient and provider needs. Those policies should limit nurses from working more than 12.5 consecutive hours. Provide education for all care providers on the hazards and causes of fatigue. Continue to document unsafe staffing conditions and work with others to change the current work culture so that it recognizes the effects of fatigue on patient safety, as well as the nurse. (Berger, et al. 2006)