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High Demand Nurses, 12-Hour Shifts and Burnout

Updated on March 21, 2017
Patty Inglish, MS profile image

Degrees in medicine, psychology & sports. 20+ yrs research/treatment in allopathic & alternative medicines, brain studies, space medicine.

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-hour 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 Can Become 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

Long Hours Create 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 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 and accept work with a travel nursing agency that offers variety, perks, and attractive incentives. Travel nurses receive higher hourly rates of pay, bonuses, reimbursement of travel expenses, and even payment of their rent or mortgage when they travel. These workers spend from three to twelve months in one place and avoid feeling trapped in long term situations.

At Risk Communities for Nurses

The United States has thousands of job ads for nurses with related experience and many of these nurses are already approaching job burnout. The metro areas highest at risk for this are:

  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. Georgia.
  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.

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:

1. Emotional exhaustion,
2. A sense of low personal accomplishment, and
3. Feelings of depersonalization.

TED Talks: Nurse Burnout

What Do You Think?

What is the biggest cause of nurse shortage and burnout that you see?

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Summary Considerations

  • Effective, experienced nurses are in high demand and required 12-hour work shifts can job burnout, if these shifts increase in number per week.
  • 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 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 need to eat healthy foods and regular meals, take enough rest and exercise, and find ways to de-stress between work shifts.
  • Nurses working 12-hour shifts more than three times per week may need to learn how to say "no" to additional work hours. Some hospitals require mandatory overtime a few times per year, but beyond that requirement, frequent long shifts 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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    • RevRobinHarris profile image

      Robin Harris 22 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
      Author

      Patty Inglish 22 months ago from North America

      @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 22 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 22 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

      Bronwen Scott-Branagan 22 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 and sherry 22 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 22 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
      Author

      Patty Inglish 22 months ago from North America

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

    • Jean Bakula profile image

      Jean Bakula 4 months ago from New Jersey

      This could have been written for a friend of mine. She does 3 12 hr. shifts on Sat., Sun. and Mon., so she's up all night. She's in her early 60's and needs the money, but it takes her 2 days to get her body and mind back in shape after the hard shift. Now the Mom of the patient wants her all week, and she doesn't feel she can do it, but has no other job offers that pay so well. But she has chronic health issues herself, not ones a patient can get, but I worry it's hurting her.

    • Patty Inglish, MS profile image
      Author

      Patty Inglish 4 months ago from North America

      Hi Jean - I feel bad for your friend and it sounds like she only feels pretty good two days a week, Thursday and Friday. I hope she can find some health-issue answers before she takes on a week-long assignment.

      This work is very hard on the employees and I feel they should be paid more. IF minimum wage is lowered bu this presidential administration, or eliminated altogether, then this work will kills those older folks who will have to work seven days a week. It's not fair and I will keep your friend in my thoughts.

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