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Is The 12-Hour Nursing Shift Causing Burnout?

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Published December 15, 2022

Working 12-hour shifts is popular among nurses, but burnout and other health risks are linked to long hours. Find out the history of 12-hour shifts for nurses and strategies to survive them.
Is The 12-Hour Nursing Shift Causing Burnout?
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  • It wasn't until the 1970s that hospitals introduced the 12-hour shift to combat a national nursing shortage.
  • The 12-hour shift for nurses causes burnout due to long hours, heavy workload, and poor social support.
  • Strategies to survive 12-hour shifts include taking breaks, self-care, and changing shifts. 12-hour shifts can also benefit those going back to school.

The American Association of Colleges of Nurses reports that 55% of nurses work in hospitals. The majority of these nurses will work 12-hour shifts.

Many nurses love 12-hour shifts because it provides work/life balance and flexibility. But does working 12-hour shifts also cause burnout?

Studies on nursing and burnout consistently report that a combination of a heavy workload, low control over the job, poor social support, and long working hours can lead to nurse burnout.

Explore how nurses can gain control over their workday, resulting in a healthier work/life balance.

History of the 12-Hour Shift

The nursing profession has a long history of nursing shortages. After World War II, nurses left the profession, citing low wages, poor working conditions, and lack of respect. Nurses demanded better salaries, better benefits, and a 40-hour work week.

It wasn't until the 1970s that hospitals introduced the 12-hour shift to combat the national shortage.

The new longer shifts allowed nurses to have more work/life balance and work fewer hours during the week. It also provided continuation of care for patients.

For hospitals, the 12-hour shift meant less payout for overtime. They also relied less on agency nurses to fill in shortages.

It was a win-win situation.

The 12-hour shift is still used today to incentivize nurses to remain in the profession and continue working in the hospitals. Karen Donofrio, RN, MSN, agrees.

"I would not be a bedside nurse if I had to be there five days a week. I think 12-hour shifts keep a log of nurses at bedside," Donofrio says.

But after decades of nurses working 12-hour shifts, research found that many suffer from fatigue, sleep deprivation, and burnout.

Donofrio has been working 12-hour shifts for over 15 years. Although 12-hour shifts have allowed her more flexibility and less need for babysitting, she acknowledges the disadvantages of working extended shifts.

"It is a very long day that is draining both physically and mentally," Donofrio says.

How 12-Hour Shifts Can Cause Burnout

Burnout Defined

  • Feelings of energy depletion or exhaustion
  • Increased mental distance from one's job
  • Feelings of negativism or cynicism related to one's job
  • Reduced professional efficacy

Source: World Health Organization

Sarah Corallo, RN, AE-C, felt burnt out years into working 12-hour shifts. She describes feeling physically exhausted and emotionally drained.

"I found that I dreaded going into work because I knew how tired I'd be at the end of my shift," Corallo admits. "I was frustrated because I started losing interest in the work I did even though I absolutely loved what I did for a living."

With the current nursing shortage crisis affecting all states, many hospitals are short-staffed and nurses don't get proper breaks, Donofrio points out. This is another reason why nurses are burnt out.

"There is often no time for self-care in a 12-hour shift. A nurse cannot meet multiple patients' needs if [their] basic needs aren't met," Donofrio says.

Although the longer shift is popular among nurses, 12-hour shifts are linked to long-term health risks. Research shows continual exposure to stress is taxing on the body and affects mental health, causing nurses to feel the effects of burnout. Nurses who work 12-hour shifts are more likely to report feelings of:

  • Stress
  • Fatigue
  • Depression
  • Anxiety

Corallo worked 12-hour shifts for over 15 years. She has since transitioned to an eight-hour shift position.

"The 12-hour bedside shift was definitely more tiring than my eight-hour office-based shift. Even after a year, I still feel like I'm working half days," Corallo says.

Working "three in a row," a term coined by nurses to describe working three consecutive days, is also linked to burnout. Corallo points out that a 12-hour shift isn't simply a 12-hour day. It's more like a 14-16-hour day when you factor prep and commute time. That can equate to working over 40 hours in three days.

"In a hospital-based setting, those days are long. Sometimes going in when it's dark and coming out when it's dark just adds to the mental exhaustion," Corallo says.

A 12-hour shift is exhausting, especially when it comes to bedside nursing.

"Bedside nursing is physically and emotionally demanding, and 12-13 hours on your unit takes a toll on the body and psyche," Corallo points out.

Studies find that nurses who work longer, consecutive days have an increased risk of injury. Shift work or work that falls out of the hours of 7 a.m. to 6 p.m. is also linked to a greater risk of:

  • Higher body mass index
  • Obesity
  • Poor diet
  • Less exercise
  • Circadian rhythm disruption
  • Cardiovascular disease
  • Diabetes
  • Back, knee, and shoulder pain

Nurses need to be conscious of these risks. When working long shifts, they must create a plan and recognize when their health is affected.

Pros of 12-Hour Nursing Shifts

There are benefits to working 12-hour shifts. Having days off during the week is a huge bonus. Knowing you can have consecutive days off helps plan your life and helps you catch up on much-needed rest. Another benefit is spending more time with family, especially your children.

Corallo points out that when she had younger children, being home more days of the week and having only 2-3 weekdays to worry about childcare and paying for it was a major benefit.

Working a 12-hour shift also allowed Corallo to finish school.

"It allows for flexibility for clinicals and other class time," Corallo says.

How to Survive a 12-Hour Nursing Shift

When you are a new nurse or a nurse who chooses to work in the hospital, you may not have the luxury of picking your shift. If you work 12-hour shifts, here is some advice on how to survive it.

  • Take Your Breaks

    If your facility offers breaks, take them. Get off the unit and decompress whenever you can. "Let your days off be restful and find time to do things that help you recharge for your next shift," Corallo says.

    Know the laws in your state. Here is a list of meal break labor laws by state in the private sector.

  • Break Up Your Days

    It's a good idea to stack up your work days, but have at least 2-3 days off after you work consecutive days. When you are off, Corallo recommends finding time to keep up with hobbies, exercise, or do activities that make you feel good about yourself.

  • Listen to Your Body

    Becoming self-aware takes time. But once you start paying attention and listening to your body, you will be able to feel confident enough to say "no." Use these extra hours to plan if you need to recharge. Self-care for nurses is a great way to help you re-energize.

  • Change Shifts

    If you notice the effects of burnout, switching to another shift isn't a bad idea. Nursing jobs have eight- and 10-hour shifts. If you can, work part time or per diem nursing jobs. Changing shifts temporarily or permanently can positively affect your physical and mental health.

  • Get Your Master's

    Many nurses decide to go back to school to get their master's as a way to increase their shift options. Many nurses decide to become nurse educators or nurse practitioners (NPs). NPs are one of the fastest-growing professions today, so becoming an NP is a sure way to control your working hours.

    You can negotiate your shift hours, salary, and benefits. To have full control over your shifts, consider opening your own practice as a nurse practitioner.

Meet Our Contributors

Portrait of Karen Donofrio, RN, MSN, CPEN, TNCC

Karen Donofrio, RN, MSN, CPEN, TNCC

Karen Donofrio has been a pediatric emergency room nurse for over 15 years. She has a master's degree in nursing education. She is also a certified pediatric emergency nurse and trauma nurse core course certified.


Portrait of Sarah Corallo, RN, AE-C

Sarah Corallo, RN, AE-C

Sarah Corallo is a registered nurse and certified asthma educator. She worked at a major children's hospital for 16 of her 17 years working as a nurse. Corallo has experience in both pediatric psychiatric nursing and pediatric emergency and trauma nursing. Her true passion is community health and injury prevention. She currently works as a school nurse at a local elementary school and loves every minute she gets with her little patients.

Sources

Burn-out an "occupational phenomenon:" International classification of diseases. (2019).

https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

d'Ettorre G et al. (2019). Assessing and preventing low back pain in nurses. Implications for practice management. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776174/

Minimum length of meal period required under state law for adult employees in private sector 1. (2022). https://www.dol.gov/agencies/whd/state/meal-breaks

Nursing fact sheet. (2022). https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet

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