When we think of the health, safety and well-being of nurses, the first thing that usually comes to mind is 12-hour shifts. When I do presentations about shiftwork, the first question I am always asked is “What do you think of 12-hour shifts?” A recent social media post picked up on this exact issue by asking ‘Are 12 hour shifts the worst thing we’ve ever done?” The implication from these questions is that ‘yes, 12-hour shifts are horrible and should be done away with’ and many who contributed to the discussion absolutely agreed with that assumption. But if one read all the comments, it is readily apparent that 12 hour shifts are an easy target in a much more complex workplace situation.
For example, best practice when scheduling 12 hour shifts, is to schedule no more than 2 of the same shift in a row. Yet, many discussion contributors said they regularly worked 3 or 4 shifts in a row.
In addition, many worked longer than 12 hours on shift because of work contingencies like late admissions and poor work planning.
Others indicated that high patient loads and excessive workloads prevented them from having food or rest breaks which contributed to their fatigue.
Many frequently worked overtime mostly because of short-staffing but also due to poor work planning and high patient loads and acuity.
Conditions such as short-staffing, overtime and excessive workloads are the purview of management. But there were other reasons mentioned that are in the realm of the nurse’s responsibility.
For example, many discussion participants indicated that they were studying while working and this consumed many hours beyond work. As a result, they were going to work already tired.
Others indicated that they had other jobs on their days off. Rather than taking the rest that their schedule allowed they were further contributing to their fatigue.
When we focus on 12 hour shifts as the reason for nurse fatigue we are choosing an easy target and giving our attention to the wrong question. Reducing nurse fatigue requires a more comprehensive approach that incorporates all the determinants of a healthy workplace, including leadership, health and safety, relationships and human resource management.