Patient safety is one of the most important factors that influences change in modern nursing. The United States is currently grappling with the problem of an inadequate nursing workforce, which is caused by issues in recruiting younger nurses, an aging workforce, and retaining a workforce. The 8-hour shifts dominated nursing practice in the past (Stimpfel, Sloane, & Aiken, 2012). However, nurses are currently working 12-hour shifts. Such a schedule results in a three-day workweek and is believed to provide a better work–life balance for the nurses. The actual length of the shift may be unpredictable due to the fluctuation in patient needs and unanticipated staff changes. This means that nurses may find themselves working beyond their scheduled …show more content…
A nurse may sign up for a 12-hour shift, but this may easily spill into overtime resulting in the nurse spending more time in the hospital. The longer shifts have the potential of increasing fatigue while also lowering reaction time of the nurses. This has the effect of exposing patients to danger therefore reducing their safety. Nursing is a very involved career—mentally, physically, and emotionally. The strains in a long shift may manifest themselves into nurses and cause potential errors. Some of these errors would have been avoided had the 8-hour shifts been used. For example, 8-hour shifts help to reduce the risk for personal injuries, specifically through needles (Penner, 2016). Being discontent with their job, as well as feeling burnt out, are other issues nurses can experience when working longer shifts (Penner, 2016).
One of the benefits of 12-hour shifts is the decrease in handoffs, as only two nurses take care of a patient within a 24-hour period. This is different from the 8-hour shift where three nurses attend to a patient within the same period. Less handoff means reduced chances of miscommunication among the nurses, and this increases patient safety (Chen, Davis, Daraiseh, Pan, & Davis,
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As it has been mentioned, this schedule results in better work-life balance and allows nurses to engage in other social and economic activities (Stimpfel, Sloane, & Aiken, 2012). However, much care should be taken while implementing any schedule. Health care administrators should be cautious and be able to identify fatigue-related risks that result due to extended shifts. Fatigue may compromise the quality of care delivered to patients. The work hours should be limited to 12 as this encourages flexibility and effectiveness in the nurses performing their duties. This reduces absenteeism and boosts nurses’ morale. The implication is that a 12-hour schedule can help nurse administrators find the adequate or optimum number of staff members needed to take care of patients at any given
The United States offers some of the most established and advanced health care in the world. Practitioners and administers are constantly trying to improve the quality of care received by patients in the US. Data has consistently shown that the presence of a registered nurse contributes directly to positive patient outcomes (Cho et al., 2016). The debate across the country, however, concerns the precise number of staff required to provide safe, high-quality care. The issue of safe staffing is one that is of great importance to all involved in the delivery of health care across the country.
Overall, 12 hours may seem long but it is relatively productive for a week. Nurses who work 12 hour shifts and being able to do something they like are more likely to want to work for 12 hours. They find it flexible and balance between work and families. It is a duty to the heart to help those in need if it requires more time. It is similar to anyone who really works hard to get better results. Nurses work hard to get to where they are now and therefore should have the right to choose 12 hour shifts. It is important for nurses to understand that all jobs have negative outcomes, but as long as they make the choice to maintain the level of their health and sleep by taking breaks and adequate exercise. They can further be energized in helping patients and finding work more effectively.
Over the past several years extended work shifts and overtime has increased among nurses in the hospital setting due to the shortage of nurses. Errors significantly increase and patient safety can be compromised when nurses work past a twelve hour shift or more than 40 hours a week. Hazardous conditions are created when the patient acuity is high, combined with nurse shortages, and a rapid rate of admissions and discharges. Many nurses today are not able to take regularly scheduled breaks due to the patient work load. On units where nurses are allowed to self-schedule, sixteen and twenty-four hour shifts are becoming more common, which does not allow for time to recover between shifts. Currently there are no state or federal regulations that restrict nurses from working excessive hours or mandatory overtime to cover vacancies. This practice by nurses is controversial and potentially dangerous to patients (Rogers, Hwang, Scott, Aiken, & Dinges, 2004). Burnout, job dissatisfaction, and stress could be alleviated if the proper staffing levels are in place with regards to patient care. Studies indicate that the higher the nurse-patient ratio, the worse the outcome will be. Nurse Manager’s need to be aware of the adverse reactions that can occur from nurses working overtime and limits should be established (Ford, 2013).
7). In an article by Rosalina Butao, RN, MSN, “Hitting Two Birds With One Bullet: Bedside Shift Reporting; “bedside reporting solidifies compliance to the Joint Commission’s 2009 National Patient Safety Goals: improve the accuracy of patient identification, improve communication among caregivers and encourage patient’s active involvement in their own care” all of which improves patient safety (Butao, 2010 p. S50). In a synthesis of literature by Sherman, et al., (2013), patient benefits include the patient being more knowledgeable and involved in their health care, improved the relationship between the nurse and patient, also improving patient satisfaction, as well as patient safety thus decreasing the number of falls, and increasing discharge times (p. 310). Bedside reporting allows the patient and family the opportunity to intervene during
A considerable amount of literature has been published on the impact of working hours (8 vs. 12 hour shifts) on fatigue among the nurses. These studies revealed that twelve-hour shifts increase the risk of fatigue, reduce the level of alertness and performance, and therefore reduce the safety aspect compared to eight-hour shifts (Mitchell and Williamson, 1997; Dorrian et al., 2006; Dembe et al., 2009; Tasto et al., 1978). Mills et al. (1982) found that the risk of fatigues and performance errors are associated with the 12-hour shifts. Beside this, Jostone et al. (2002) revealed that nurses who are working for long hours are providing hasty performance with increased possibility of errors.
In the case of nurse staffing, the more nurses there are the better outcome of patient safety. When there enough staff to handle the number of patients, there is a better quality of care that can be provided. The nurses would be able to focus on the patients, monitor the conditions closely, performs assessments as they should, and administer medications on time. There will be a reduction in errors, patient complications, mortality, nurse fatigue and nurse burnout (Curtan, 2016). While improving patient satisfaction and nurse job satisfaction. This allows the principle of non-maleficence, do no harm, to be carried out correctly. A study mentioned in Scientific America showed that after California passed a law in 2014 to regulate hospital staffing and set a minimum of nurse to patient ratios, there was an improvement in patient care. Including lower rates of post-surgery infection, falls and other micro emergencies in hospitals (Jacobson,
...hological preparation. After a nurse is done working their regular shift being forced to work overtime can out them a greater right of medical mistake in part due to fatigue and tiredness consequently putting the patient at high risk of complications.
Witkoski Stimpfel, Amy , Douglas M. Sloane, and Linda H. Aiken. "The Loger the shifts for hosital nurses, the higher the levels of burnout and patient disstisfaction." Health Affairs 31.11 (2012): 2501-2509. Proquest. Web. 11 Mar. 2014.
...ork shifts depending on their ability. In addition, it is important for nurses to understand that it is their ethical responsibility to only practice when they are fit to do so. Moreover, nurses should take responsibility for self care and take adequate time to rest and recover after shifts. In general, nurses should be aware of their mental and physical capabilities and only work when they are well enough to do so.
These articles have many similarities when discussing the issue of staffing shortages. For patients, their loved ones and the general population, they don’t understand the ramifications and strain that staffing shortages have on nurses. People expect and deserve complete, competent and safe care when they are patients. These articles bring to light all the struggles that nurses have to deal with. Nurses are fearful that they will make mistakes, will harm patients, and will harm themselves. (Bae, 2012; Erlen, 2001; Martin, 2015) Overtime can be overwhelming and exhausting, which can lead to errors being made. (Bae, 2012; Erlen, 2001) These articles perceive that it may be beneficial for nurses, patients, and healthcare facilities to decrease the nurse-to-patient ratio, however, this option is not always
...staff would not be required to put in the overtime to compensate for the lack of workers. Patients would no longer have to suffer the neglect of the staff because he or she was too busy. Making sure the patient gets the best quality care reduces the time spent for recovery. Reducing the time spent for recovery increases the organization’s finances. Providing a safe facility also reduces the expenses on the private hospital’s budget. Ensuring a patient is safe can reduce potential use of ongoing treatment and services. Hiring the appropriate nursing staff needed can save the organization money. Instead of cutting back on staff, more staff needs to be hired to fulfil the needs of the patient. In the economy today, private hospitals need to focus on the overall long term effects of each action opposed to quick reactions resulting in financial strain for the facility.
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
Notably, having higher proportions of nurses working shorter shifts—8–9 hours or 10–11 hours—resulted in decreases in patient dissatisfaction” (Stimpfel et al.). This is essentially saying that the longer the shift length, the more negative outcomes result. This study proves that eight to nine-hour shifts are more effective, and should, in turn, be worked more than longer shifts. This is a problem because hospitals are likely to continue to schedule nurses for twelve hours shifts out of
Working in a fast-paced environment and being on their feet can really take a toll on a person. In addition they have to be prepared for anything to happen during their shift. A study of overworked and stressed nurses found that nurses are overworked suffered from physical sickness like type two diabetes (Stress and overworked 2006). For most nurses, their work week consists of more than sixty hours. Working that many hours can double their chances of sicknesses. When they compare the working week hours of nurses who worked the normal 21 to 40 hours with those that work more than 40 or 60 hours a week, they found that in comparison the ones who worked 40 hours or more a week increased the risk by almost 50 percent for type 2 diabetes (Stress and overwork 2006). If nurses were to work their normal work hours without mandatory overtime, then their health would improve.
Maynard, W., & Brogmus, G. (2006). Safer shift work through more effective scheduling. Occupational health and safety, 16.