This presentation is the result of an evaluation of 12 hour vs. 8 hour shifts. The current practice is evaluated and the environment’s readiness for change. The evaluation provides information as to what needs to be implemented regarding an evidence-based practice intervention.
According to the article, A Study Examining the Impact of 12-Hour Shifts on Critical Care Staff, the emphasis over the years has been placed on improving the working lives of the staff (838). A balance needs to be met between work and lives outside of the workplace therefore nurses may be more apt to performing better for patients and their needs. Also stated in this article, “twelve-hour shifts have shown to be an approach contributing to a more flexible pattern of work” (839).
The study our group conducted will show that having a choice between working 8 or 12 hour shifts is what most nurses would prefer.
Currently there are some facilities that offer a variety of shifts. However, over the years facilities have started to emerge into working 12 hour shifts. The problem arises when a nurse is expected to work more than 2 shifts at a time or when they are expected to work over that 12 hour time period. Someone who is expected to work 12 hour shifts and continue to work over that time will start to feel more fatigued and “burned out”. It is important to keep nurses on their toes and in order to do that we must start offering choices.
Nurses should have the opportunity to choose what shift they would rather work. As an individual, an employee will know how many hours they can handle when working to not put others in danger. When given the choice as to what shift one would rather work, the amount of job satisfaction increases.
The goal is to make employers more aware that if they offer 8 or 12 hour shifts to their nursing staff then job satisfaction and morale will increase. Patient outcomes will also see a change to the positive side and more continuity of care. We will have less nurses feeling “burned out” and overly stressed.
Working extended duration shifts can negatively effect the health of employees. Employees who work longer hours tend to exercise less and are more prone to drinking and smoking. Long shifts can interfere with the body’s natural circadian rhythm and can increase risk of chronic diseases (Keller, 2009).
Nurses who work long shifts face increased stress when dealing with difficult patients and families. It is also necessary to reorient after several days off from work and some nurses report this as lack of continuity of patient care (Keller, 2009).
Extended work shifts have proved to be a flexible approach allowing nurses more days off to meet off-duty requirements (Carson, Finley, Harris, Richardson, & Turnock, 2007).
According to Dinkel, the process of change has three basic steps, unfreezing, changing, and then refreezing (2010). As stated by Dinkel, “we identify the behavior we want to change, change the behavior by training, and then behaviorally reinforce the change until it has been internalized” (2010).
According to the survey results, 24.3% of the population surveyed had a lack of understanding of EBP, 27.0% lacked the ability to perform electronic database searches, 13.5% surveyed they had difficulty understanding research, 35.1% lacked access to electronic databases, and no one reported that they lacked value in EBP.
When nurses are forced to work certain shifts, many barriers come into play when implementing a new work schedule. According to Josten, Ng-A-Tham, and Thierry, some of these are the very idea of change itself. There are many nurses that are resistant to change no matter what the outcome. Overall job satisfaction is another factor. Some nurses feel that they might as well as stay at the shift they are working because it is something they are used to. A lot of nurses are also tired. Some do not want to work 12 hour shifts for that simple reason. Health is another important step in change. There are some nurses that medically cannot handle working a 12 hour shift (2003).
When looking at topics that would facilitate the need for change we can see that giving nurses the choice of which shift to work has a lot of positive outcomes. It will increase their overall morale and job satisfaction. Choosing what shift to work will also lead to less fatigue and “burn out” because the nurses will be working the shift they feel is most beneficial.
When a nurse’s overall morale is increased as well as job satisfaction and less fatigue, you get more positive patient outcomes.
The survey was necessary to determine the readiness for change and implementation of whether or not having a choice to work an 8 or 12 hour shift would be effective.
The nurses who were surveyed also worked in a wide range of areas of nursing. It ranged from Med-Surg to ICU to home health care. Our survey was completed by 37 nurses. The survey yielded that 73 % of participants held an Associate’s Degree and the other 27 % had their BSN.
Allowing employees to make their own schedule will increase job satisfaction, morale, and free time. Making out their own schedules will also decrease health problems and fatigue. The employees know how often they can work and how much they can work. The employer has the ultimate decision to make sure that staffing is adequate everyday (i.e. no days with one nurse and days with eight nurses). Competitive salaries and benefits will increase job satisfaction and help retain staff. If employees do choose to work 12-hour shifts, ensuring they do not work more than three will decrease fatigue, burn out and associated health problems and better patient outcomes. Allowing employees two free weekends a month increases job satisfaction because it is not only fair but it helps distribute working shifts equally with days off. Breaks will help decrease burn out and allow nurses to “re-charge” (Keller, 2009).
12 Hour vs. 8 hour shifts<br />Presented By: Stephanie Posey, Stephanie Morrell, PammelaPoore, Sierra Spencer-Mitchell, and Amanda Rodgers<br />
Background Information<br /><ul><li>For years nurses have been working all kinds of various shifts that include extended hours and overtime with no consideration being given to the impact on patients and staff.
Preference to work eight or twelve hour shifts is a very controversial issue in organizations where 24 hour coverage is necessary.
Research is being conducted that will help us understand the impact of eight and twelve hour shifts on staff, patient safety (in hospitals), and job satisfaction. </li></li></ul><li>Background Information(continued)<br /><ul><li>The increased economic, technological, and social pressures of today’s society has many organizations going to a 24 hour work day.
Nurses have become no exception to the rigors of shift work, whether it is 12 hours or 8 hours we all deal with biological disruption to physiological processes including the sleep-wake cycle; the impairment of physical health and psychological wellbeing; problems with alertness, performance, and safety, and lastly, interference with social and domestic life.</li></li></ul><li>Background Information(continued)<br /><ul><li>In organizations where 24 hour coverage is necessary, preference to work eight or twelve hour shifts has become a very controversial issue.
12 hour vs. 8 hour shifts; for nurses this has become a debate for the ages literally. Most nurses who are in their 20s and 30s will tell you they would rather work 12 hour shifts as apposed to their older colleagues who would rather work 8 hour shifts.</li></li></ul><li>Introduction<br /><ul><li>Nurses who work 12 hour shifts receive the added benefits of receiving twice as many days off per pay period as opposed to their fellow nurses who only work 8 hour shifts.</li></ul>8 Hours<br />12 Hours<br />
Introduction (continued)<br /><ul><li>Some nurses will argue that 12 hour shifts are unsafe, because it can affect the quality of care a patient receives.
While other nurses argue that 12 hour shifts have nothing to do with quality of care due in part to the increased time off between days worked.
It seems as though this is a hot button issue among the nursing community and research will need to be conducted to help us understand the impact of eight and twelve hour shifts on staff, patient safety (in hospitals), and job satisfaction.</li></li></ul><li>Focus of Current Research<br />
Current Practice<br /><ul><li>More and more facilities only offering 12 hour shifts.
Depression of immune system and more prone to chronic diseases such as diabetes, hypertension, and cardiovascular disease</li></li></ul><li>Review of Literature<br />Negative effects of extended duration work shifts on employees (cont):<br /><ul><li>Staff need to reorient after return to work having several days off
Less fatigue and “burn out”</li></li></ul><li>Facilitators to EBP<br />
Purpose of the Study<br /><ul><li>A survey was conducted to evaluate whether current work environments were ready to implement evidence-based practice to have a choice between an 8 or a 12 hour shift.</li></li></ul><li>Analysis of the Survey<br /><ul><li>37 people in the population surveyed
The average age of those who participated was 22-28 and 43-50.
Completed by nurses who work in a variety of health care facilities from hospitals to home health.
The level of education is as follows: 73% AAS and the other 27% have their BSN. There were not any nurses who participated in this survey that held a MSN, or PhD.</li></li></ul><li>Survey Results<br />
Recommendation for Implementation<br /><ul><li>Employers can allow employees to make their own schedules but the ultimate decision is with the employer (employees can choose 8 vs. 12 hour shifts when scheduling)
Offering employees competitive salaries and benefits
Ensure employees do not work more than three consecutive 12-hour shifts