Demand For Experienced Nurses And 12-Hour Shifts Lead To Work Burnout

Nurse administering a pediatric injection.
Nurse administering a pediatric injection. | Source

A Nursing Shortage May Be Global

With nursing work shifts becoming longer in the United States, researchers confirmed the same event in Europe among nurses working in 12 different countries. Thus, the situation seems to be at least partially global and spreading.

The BMJ Open online medical journal published the resulting paper as Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries on August 23, 2015.

Researchers involved are Chiara Dall'Ora, Peter Griffiths, Jane Ball, Michael Simon, and Linda H Aiken; and they represent agencies in the England, Switzerland, and the United States.

12 h shifts are becoming increasingly common for hospital nurses but there is concern that long shifts adversely affect nurses’ well-being, job satisfaction and intention to leave their job.

— BMJ Open, 8/23/2015

Presentation On Burnout For Nursing Students (With Beatles Music)

High Demand For Nurses Creates Burnout

Working in preventive medicine and health research, I have found that our local state university medical center works hundreds of nurses at varying levels of certification, from LPN and VPN to RN and NP (Nurse Practitioners), even including some PhD-holding nursing professors.

All the similar medical centers around the state are advertising for additional nurses and some of the ads seek NPs to work as physician assistants. Many hours of nursing coverage are unfilled and the current staff fills those hours in overtime. Private university hospitals and privately held hospitals are experiencing some of the same nursing shortage.

Hospitals like to keep beds full by continually treating patients and releasing them - too fast, some say. This can create additional stress for nurses.
Hospitals like to keep beds full by continually treating patients and releasing them - too fast, some say. This can create additional stress for nurses. | Source

Time Saving Changes Turned Into Stressors

In the late 1970s and early 1980s, we first heard about a time saving schedule change that would provide nurses with four days off every week. This was wonderful for the first several years it was used.

In Cincinnati, a nurse I knew jumped at the change to work three 12-hour shifts weekly on Friday, Saturday, and Sunday so that she could care for her three children the rest of the week. In addition, she was paid for 40 hours of work, an entire week.

Soon, this scheduling option was available to nurses in Central Ohio as well in state funded and private hospitals. Many people took advantage of that three-day schedule to attend classes at the Ohio State University during the week, especially since many classes did not meet on Fridays and increasing numbers of four-day classes began to replace five-day classes.

By the 1990s, nurses were working four 12-hour shifts weekly instead of three shifts, with requests for them to accept additional hours of two or four more hours after a shift. By the late 2000s, we saw nurses working five 12-hour shifts a week and their four days off vanished.

Burnout can lead to many negative emotions.
Burnout can lead to many negative emotions. | Source

A 60+ Hour Work Week Creates Health Problems

The latest in nursing news I have heard around Ohio is that some university medical center floor nurses often work 60 hours per week and are asked to accept shifts of 2, 4 or more hours after some of their shifts. They receive overtime pay after 40 hours and a higher wage rate on second and third shifts, but the higher pay is not relieving their work fatigue and burnout.

Some of these nurses are suffering the same types of health problems as workers who work variable shifts and/or hold more than one job (Shift Work Disorder). Many nurses are retiring on time or early and the remaining nurses are tempted to quit and find other occupations or to accept nursing positions in less demanding circumstances. In fact, up to 40% of RN nurses active in 2011 and 2012 will be retired in 2020.

The study mentioned above in Europe showed that Poland was the country where most nurses (99%) reported 12-hour shifts. In Ireland the figure was 79%, but England came in third with a much lower, 36%.

This is one reason that nurses sometimes quit a hospital in which nurses are in high demand and accept work with a Travel Nursing Agency. These employment and placement services are increasing in number around the world and offer attractive incentives in large numbers.

Travel Nurses can receive higher hourly rates of pay, bonuses, reimbursement of their travel expenses, and even payment of their rent or mortgage at the community to which they travel. These workers spend from three to twelve months in one place and avoid feeling trapped in long term situations that some describe as "politics." The travel nurse agencies can provide additional staff to stave off nursing shortages and supply other professionals as well, including doctors, physical therapists, and some others.

Nurse Burnout Symptoms

The symptoms of burnout most reported by European nurses working 12-hour shifts were the same as those reported by American Nurses: emotional exhaustion, a sense of low personal accomplishment, and feelings of depersonalization.

Experienced Nurses Are In Even Higher Demand

Some experienced nurses may already be close to burnout, but they are in high demand in the workplace. Job listings across the Untied States include many ads for nurses with related nursing experience.

TED Talks: Nurse Burnout

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Nurses Rap About Burnout

Current Job Listings and Highest Demand Locations

  1. Registered Nurses (RNs) with 1 to 5 years of experience - Houston, San Antonio, Dallas, and Austin, Texas; Los Angeles; Baltimore, Maryland; New York City; Seattle, Washington; Washington, DC; and Atlanta, GA.
  2. Nurse Practitioners (NPs) with 0 to 6 years of experience - New York City; Houston and Dallas, Texas; Seattle; Chicago, Illinois; Los Angeles; and Tampa, Florida.
  3. Licensed Practical Nurses (LPNs) with 1 to 3 years of experience - San Antonio, Texas; Puyallup, Washington; Columbus, Ohio; Louisville, Kentucky; Phoenix, Arizona; and Durham, North Carolina.

Summary Considerations

  • Effective experienced nurses are in high demand and 12-hour work shifts can cause them to suffer burnout if these shifts increase in number per week.
  • Nurses, like other workers, need to eat healthy diets and regular meals, take enough rest and exercise, and find ways to de-stress between work shifts.
  • Burnout may be lessened if nurses, particularly the floor nurse who is an RN is shown appreciation, consideration, and trust by doctors and other staff.
  • Experienced RNs and most workers, as described in the body of research literature for decades, seem to avoid burnout more often when they feel that they have some authority at work. Nurses like to feel that they are an important part of the treatment teams of their patients.
  • Nurses working 12-hour shifts more than three times per week may need to learn how to say "no" to additional work hours i order to preserve their health and well being. Some hospitals may require mandatory overtime a few times per year, but beyond that requirement, long shifts many times per week can become unhealthy for the nurse an unsafe for the patient.
  • Nurses in collective bargaining units may be able to bargain together with their employers for shorter work hours in their nursing contracts and may want to speak with their union representatives about this.

© 2015 Patty Inglish

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8 comments

RevRobinHarris profile image

RevRobinHarris 14 months ago from Georgia

Hi Patty, I come from a family of nurses and your article is spot on. It is very important that nurses and other's in demanding professions find ways to invest in self-care. It would be nice if the industry found creative ways to help with this. I am sure there are things that can be done if we just think outside the box.


Patty Inglish, MS profile image

Patty Inglish, MS 14 months ago from North America Author

@RevRobinHarris - So great to hear from you about this subject. Nurses certainly work hard and are dedicated. Any creative ideas I see put into use, I will add them to the material. Thanks for the work your family does!


mckbirdbks profile image

mckbirdbks 14 months ago from Emerald Wells, Just off the crossroads,Texas

Hello Patty. I happen to know a few nurses who write (or had written) here at Hubpages. They talked about the hours, the hazards and the overwhelming demands of the job. I even have been led to understand that nurses are now being required to get a four year degree, up from specialty classes with a two year program. So the profession is being squeezed. (Not unlike so many others.)

I think part of this may be the demographics of the Baby Boomers plus the impractical healthcare system operated here.


someonewhoknows profile image

someonewhoknows 14 months ago from south and west of canada,north of ohio

Worked A 12 hour shift for about 6 months straight. From 8 pm to 8 am.

It, isn't something I would recommend to anyone. The time displacement threw off my bodies need for regularity in eating as well as sleeping.Sleep deprivation is especially concerning for professions like nursing, doctors, firefighters ,police and any other job that demands a high level of skill and may be affected by such a change.Some may be able to adapt to it well. I don't know. I never really could. I would find myself dosing off very often in the early am hours about 1 am - 3 am.


BlossomSB profile image

BlossomSB 14 months ago from Victoria, Australia

Nurses are often between a rock and a hard place. They need a life of their own as well as work, but if they don't accept long shifts, they may lose their jobs.


drbj profile image

drbj 14 months ago from south Florida

A shortage of nurses here in the U.S. as well as elsewhere has been on the horizon for some time. Overlong shifts certainly do not aid in recruitment.


FlourishAnyway profile image

FlourishAnyway 14 months ago from USA

You can't take care of others adequately (family, patients, etc.) if you're running on empty. Burnout is not quick to recover from. Prevention is key.


Patty Inglish, MS profile image

Patty Inglish, MS 14 months ago from North America Author

That's right, FlourishAnyway - The system is burning out healthcare workers and needs an overhaul, more nursing instructors, and better work conditions.

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