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High Demand Nurses, 12-Hour Shifts and Burnout
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.
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.
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:
- 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.
- 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.
- 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?
- 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