Hour vs. 8-Hour Work Shifts the Effect

¶ … Hour vs. 8-Hour Work Shifts The Effect of 12 Hour vs. 8-Hour Work Shifts on Health Care in Intensive Care Units Critical care areas, such as intensive care units (ICUs), may be very demanding and challenging places to work. ICU's are typically populated by very highly dependent patients. This work requires an increased staff to patient ratio, entails periods of high activity, the use of advanced equipment, and the need for multiple and significant decision-making situations.

Since the late 1980s, the conventional shift work pattern of 8 hours has been increasingly re-engineered into the 12-hour shift pattern meaning nurses work longer, but fewer shifts. Research has been conducted on 12-hour shifts for nurses since this practice began, however consensus on the effects of this practice on healthcare and the individuals involved is still highly contentious and problematic. Discussion In general terms, the best kind of shift system to promote maximum staff satisfaction and patient care has been subject to considerable debate in the literature.

Research has shown that 12-hour shifts contribute to a more flexible pattern of work for employees. This work schedule creates more days off, less time spent traveling to and from work, and more choices over shifts to be worked. It has been suggested that this phenomenon helps bring a balance between work and life outside work and enhance staff performance for patients. Furthermore, it has also been suggested that supporting 12-hour shifts helps to improve nurse recruitment and retention.

However, there is evidence that this pattern of work has had less positive effects. Some studies have indicated dissatisfaction with hours and conditions of 12-hour shifts and the impact on staff's domestic and social lives. This has been supported by the suggestion that 12-hour shifts create too many nights and the turnaround between days and nights is too quick (Richardson et al. 2007).

Management's drive to change conventional shifts to 12-hour shifts over the past 20 years has had the effect of creating savings through the reduction of overlap time between day shifts. Furthermore staff demand for 12-hour shifts has also been an influential factor, as this shift pattern provides nurses with the option of a shorter work week to ensure that a better balance between ones work and ones private life can be struck.

It has been proposed that improving the working lives of staff through maintaining a work / life balance, is pivotal to overall productivity, the successful recruitment and retention of staff, increasing staff morale and lowering absenteeism, particularly for critical care nurses. Patients may also be offered better communication and more continuity of care under 12-hour shifts (McGettrick & O'Neill, 2006). However, disparity in the literature has been demonstrated. Many authors have reported concerns relating to nurses' job dissatisfaction and poor staff morale, reduced educational opportunities and increased staff-sickness levels.

Another effect of 12-hour shifts that has been investigated is the effect on the delivery of direct patient care. Again positive and negative reports have been suggested. Improvements have been found with continuity of care specifically with documentation and more time spent planning and providing care. Less pressure to complete assignments in a 12-hour period were reported because pacing of the workload was accomplished more easily.

Conversely, it has been reported implementation of 12-hour shifts increased days off, led to less continuity and significant reductions in the amount of patient care time, and corresponding increases in unofficial work breaks. Some studies found no significant differences between 8 and 12-hour shift patterns and reported no increase in nursing errors and no decrease in continuity or quality of care (Richardson et al. 2007). Nevertheless, it seems that the flexibility that this shift pattern brings to lifestyle and ultimately work, overcomes these disadvantages.

Despite discrepancies in the literature, many nurses, particularly younger nurses, prefer working 12-hour shifts as a way of life, and therefore 12-hour shifts are not likely to disappear easily (Rossen & Fegan, 2009). Conclusion There may be a finite time period for nurses to be sufficiently able to make acute clinical judgments. This highlights the need for further research into the number of successive shifts that can be done to maintain patient safety. Potentially, 12-hour shifts may pose a significant threat to nurses' fundamental ability to care for patients effectively.

Richardson et. al (2007) made a number of recommendations to improve upon the working practices of 12-hour shifts. 1) Critical care units should develop creative ways to train and teach staff such as establish bedside training in quiet periods and utilize lecturer/practitioners at the bedside to deliver work-based training. 2) When nurses work consecutive shifts, the nurse in charge of allocating the workload at the beginning of the shift should consider nurses who have worked in cubicles or with complex, demanding patients the previous day.

3) The maximum number of consecutive 12-hour day shifts that staff should.