Pros and Cons of 12-Hour Nursing Shifts

When a facility has 12-hour nursing shifts, the number of patient handoffs is less than a facility with 8-hour nursing shifts. During a patient handoff report at the change of shift, crucial patient data is communicated from the outgoing nurse to the incoming nurse, and this transfer of data, both objective and subjective, is central to continuity of patient care and positive medical outcomes. According to The Joint Commission’s 2017 report, the average teaching hospital experiences 4,000 handoffs per day. Failures in communication were a culprit in 30% of all malpractice claims, resulting in over 1,700 deaths. Handoffs are a core aspect of high-quality care, and limiting their number reduces patient mortality rates.

The flexibility of working three days followed by four days may offer nurses better work-life balance. Nurses can use this time to tend to their own personal needs, such as attending doctor’s appointments, home maintenance, banking, and caring for family members. Working three days a week also allows for more flexibility in terms of travel, pursuing advanced education, being involved in children’s schools, or volunteering.

Many RNs with young children may also choose to work night shifts as it lessens the burden of childcare. This can allow some households to split parenting responsibilities. Night shifts also typically pay 5% more in shift differentials than day shifts.

Commuting to work can quickly add up in a week. The average commute time ranges from 24.5-31.2 minutes each way, according to a Center for Health Workforce Studies 2020 report.

A nurse working three 12-hour shifts per week will spend significantly less time commuting than a nurse working four or five shifts. Aside from the time spent traveling to and from the workplace, the cumulative cost of gas is also less.

There are clearly documented health risks associated with 12-hour shifts (especially 7pm to 7am). Shift Work Sleep Disorder (SWSD) impacts a considerable number of workers with nontraditional schedules and can result in difficulty with getting to sleep, staying asleep, or sleeping when the individual wants or needs to.

SWSD can lead to cardiovascular and other complications, as well as accidents, work-based errors, and unstable mood. Night-shift workers have considerably lower levels of serotonin, according to the American Academy of Sleep Medicine.

Nurses may also find it challenging to eat and hydrate themselves during a 12-hour shift. Some hospitals may only provide nurses with a 30-minute unpaid lunch. This in combination with the ramifications of frequent fatigue, a higher risk of burnout, and the physical exertion of 12-hour shifts can take a toll over time.

In reality, 12-hour shifts rarely last only 12 hours, and long hours can contribute to the feeling of burnout.

For instance, during a 12-hour nursing shift, a nurse arrives at 6:30 or 6:45 am for their shift. At 7am they’ll clock in and receive a handoff report from an exhausted nurse who has been on duty for the previous 12 hours. Unfortunately for that exhausted nurse, catching up on charting may cause their 12-hour shift to stretch into 13 or more hours (even though they’re only paid for their scheduled 12). Meanwhile, the nurse who arrived at 6:30am for their 7am shift will likely work well beyond 7pm for the same reason — giving a change of shift report to the oncoming nurse and then catching up on charting before leaving for the night.

Patient safety is an ongoing concern in healthcare, which brings up questions about whether nurses really should work 12-hour shifts. If nurses’ health suffers from these long shifts and their ability to focus is decreased, the increased potential for error is a factor that requires attention. If nurse burnout indeed leads to a feeling of cynicism and negativity about one’s job, a burned out nurse may be more likely to make errors. Nurse fatigue, insufficient sleep, and long hours put patient well-being at risk, according to the National Library of Medicine. Researchers found a 3.4% chance of an error when nurses received six or fewer hours of sleep in the previous 24 hours and 12 or fewer hours of sleep in the previous 48 hours. This translates to 34 incidents per day in a teaching hospital with 1,000 shifts per day.