¶ … 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…