Are 12-Hour Shifts Safe?

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Twelve-hour hospital shifts may pose threats for nurses and their patients.Working three 12-hour shifts per week has become the norm for nurses employed by hospitals. But some healthcare professionals wonder about the safety issues that can arise from working such long hours.

The 12-hour shift began in the 1970s as a way to retain staff during a national nursing shortage, according to Jeanne Geiger-Brown, a researcher for the National Institutes of Health and the Centers for Disease Control.

In the article “12-Hour Shifts” on, she explains: “Nurses wanted more time at home, which the 12-hour shift allowed. Staff nurses were really the impetus for change to this 12-hour shift solution. The shifts also allowed hospitals to use fewer agency nurses.”

However, continuing 12-hour shifts for nurses may pose threats to the health of nurses and their patients.

Concerns About Long Hours

While many nurses enjoy having four days off, the three 12-hour days they do work are typically in a fast-paced, high-stress, mentally and physically demanding environment. How can nurses maintain their quick thinking and reflexes, clear judgment and make good life-and-death decisions during a grueling 12-hour shift?

They also need time to get ready for work, commute and transition off their shift. After factoring in the extra hour or two needed for those activities, nurses may get only five or six hours of sleep.

Besides not getting enough sleep, many nurses don’t take breaks to eat or rest, which could become a recipe for disaster.

“Nurses are one of the top 10 professionals who depend on coffee to get through their workday,” according to nurse Donna Cardillo’s article, “Are 12-hour shifts safe?” on the American Nurse Today website, based on a survey commissioned by CareerBuilder.

Should nurses need stimulants to do their jobs? After all, not only can caffeine stay in a body for up to 10 hours, which can cause insomnia or reduce the effectiveness of sleep, but it’s also addictive.

“In addition to the issue of our fitness to practice while on duty, what about our degree of alertness while driving to and from work while working 12-hour shifts?” Cardillo asks. “Then there’s the issue of the long-term wear and tear on our physical and mental health. We are not machines and we are not indestructible. Yet we are pushing ourselves, and those who work for us, beyond the limit of what humans are capable of short term and long term.”

Nurses’ hours can lead to an abundance of health issues, including an increased risk of depression, anxiety, cardiovascular disease, obesity and even some cancers, according to “The Pros And Cons To Working ‘Only’ 3 Days A Week” by nurse Kathleen Coldwell on

Sleep Study

Geiger-Brown was the principal investigator of the Nurses Sleep Study that looked at 80 full-time RNs who worked three consecutive 12-hour shifts. The nurses studied worked either day or night shifts, and had been off two days before their shift.

The study, a three-part series in the Journal of Nursing Administration, showed a pattern of sleep deprivation that led to slower reaction times.

“Even before the first of their three shifts, 25 percent of nurses slept less than six hours,” according to the article. “… One of the nurses studied averaged 2.7 hours of sleep between shifts.”

Preceding the first 12-hour shift, the day-shift nurses averaged 5.4 hours of sleep, with the night nurses sleeping only 5.2 hours. Attempting to combat sleepiness, one nurse drank 160 ounces of caffeinated beverages in a 24-hour period.

Managing the 12s

While there may be plenty of disadvantages to working a 12-hour shift, most nurses appreciate its advantages, such as the flexibility and work-life balance, as well as the ability to have a continuity of care with their patients.

Of course, nurses can avoid extended shifts by working in settings outside of the hospital — such as a doctor’s office, public health facility or private clinic — where they’ll typically put in eight to 10 hours four or five days a week. But those who want to work fewer days per week should be prepared to adjust to more hours.

“Twelve-hour shifts aren’t going anywhere, and nurses will continue to want to work only three days a week,” says nurse Kathleen Colduvell in “The Pros And Cons …” article on “The hours are long and the work is exhausting, but nurses continue to do it, first and foremost for the patient.”

To help combat the side effects that may accompany 12-hour shifts, she offers these tips:

  • Get plenty of sleep before work
  • Eat a healthy, well-balanced diet
  • Take breaks
  • Engage in deep-breathing exercises
  • Take a walk off the unit as the workload allows

Geiger-Brown believes that administrators and nurses should share the responsibility of making 12-hour schedules work.

“I was really struck by the fact [during the sleep study] that there are some units that always leave on time, and they always take breaks and they take breaks off the unit,” she says in her “12-hour Shifts” article. “And there are other units where that never happens. I think that’s a place where management can make a difference by changing the culture.”

About the Duquesne University Bachelor of Science in Nursing Degree

Nurses enrolled in Duquesne’s RN-BSN online program enjoy the flexibility to study when and where it’s most convenient. The curriculum includes courses in information technology, ethics and leadership.

Based on the American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care, the Duquesne’s BSN program focuses on how to deliver the services that best address patients’ needs. BSN nurses can qualify for more jobs — such as RN case managers, clinical research nurses and corporate wellness coordinators — which can also earn them higher salaries over the course of their careers.

For more information about the online RN-BSN degree, contact Duquesne University’s School of Nursing.




12-hour Shifts –

Are 12-hour shifts safe? – American Nurse Today

The Pros And Cons To Working “Only” 3 Days A Week –