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12-hour shifts. Sacrificing job satisfaction for days off?


The pros and cons of 12-hour shifts are a much debated topic within nursing as they now make up about a third of all shifts. Brought in over the last 20 years or so to make efficiencies and cut staffing costs, they have proved popular with nurses who find they offer significant advantages for running their lives.

Compressing a week’s working hours into three long shifts leaves four days entirely work free. Which can be appealing for those with families or those who want to study or do other activities.

But new research this week has added to the growing body of evidence that suggests that in fact many nurses are struggling with 12-hour shifts. It might seem like a good idea in principle but their experience of days at work is not always so positive.

“Nurses working 12-hour shifts were more likely to be dissatisfied with their jobs”

Researchers from the University of Southampton and King’s College London, surveyed 2568 nurses from 400 wards in 31 acute trusts in England as a secondary analysis of data collected as part of the RN4Cast study. They found that nurses working 12-hour shifts were 1.51 times more likely to be dissatisfied with their jobs than if they worked eight-hour stints or less.

This dissatisfaction may be related to the fact that the survey also found nurses doing 12-hour shifts were 1.64 times more likely to report poor care. And that nurses were more likely to leave a larger amount of care uncompleted if they worked for 12 or more hours.

“The likelihood of not coming into work also increased”

Add this to findings earlier in the year about sickness rates around 12-hour shifts and it is even clearer that these longer shifts are putting a strain on workers. This study, also from the University of Southampton, found nurses are more likely to go off sick in the days after a 12-hour shift compared to a shorter shift. The likelihood of not coming into work also increased if about to work a 12-hour shift, compared with shorter work periods.

This study also revealed that those doing 12 hours shifts had increased odds of 31% of intending to leave their job as a result of their job dissatisfaction. The authors of this study suggest that “Nurses may be choosing to sacrifice work satisfaction for benefits in other spheres of life”.

So the questions about 12-hour shifts continue. Are they really more cost-effective if they increase sickness rates and affect staff satisfaction and therefore retention? And there are other factors such as longer shifts being more difficult for older nurses. And losing the afternoon crossover period makes it harder for teams to get together for teaching and team building which can leave staff feeling isolated and out of the loop.

And most importantly this latest research reinforces the evidence that longer shifts are not the best option for patients as they increase the possibility of poor care.

“Are there things can that can be done to decrease the negative effects of 12-hour shifts?”

But the authors of this latest study led by principal research fellow Jane Ball raise an interesting question. They say: “The key issue of 12-h shifts is that ‘it depends on how it’s done.’”

So are there things can that can be done to decrease the negative effects of 12-hour shifts? If they are going to remain part of the landscape what action can managers take? More breaks? Making sure the team still comes together? Working out how many 12-hour shifts should be worked in one week?

As the authors conclude: “The question we have sought to address has been ‘what are the effects of working 12-h shifts?’ controlling for other factors. Future research should focus on how 12-h shifts be optimised to minimise the potential risks.”



On The Pulse is a weekly round-up of what’s happening in nursing or an analysis of a key nursing issue, written by Nursing Times staff.


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