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Twelve-hour shifts for hospital-based nurses have been used in New Zealand since the 1990s to enhance staff retention and recruitment, and provide greater flexibility for rostering. Recently, some district health boards have removed 12-hour nursing shifts from hospital wards without staff consultation and have signalled that intensive care units (ICUs) may be next.
Why is there such a negative attitude towards 12-hour shifts in nursing? Does it relate to the cost of replacing staff for sick and annual leave, or maybe concerns for staff and patient safety, and are these views and concerns based on research?
I work in an ICU where both eight and 12hour shifts are worked. Twelve-hour shifts were introduced to this ICU in the late 1990s, after consultation with staff, to provide greater flexibility and staff retention. Staff view them very positively. I decided to conduct a literature review to establish what positive and negative impacts 12-hour shifts have on ICU nurses and their patients, and what evidence there was to justify continuing or removing 12-hour shifts from the ICU nursing roster. Only articles that were research-based, published in a peer-reviewed nursing journal and relating to hospital ICU nursing, patients and 12-hour shifts were selected.
Nurses are the largest workforce in hospitals and are monitoring and caring for patients 24 hours a day, seven days a week. Since the 1960s, a nurse's working week has undergone numerous changes in response to nursing shortages, rising health costs and funding cutbacks.1 The introduction of 12-hour shifts and flexible shifts for nurses was a way of addressing these issues, and an attempt to increase nurse retention and attract new nurses to the profession.2 Some research has identified that accommodating flexible work hours for shift workers benefits the employer by increasing nurse recruitment and retention.3
Shift work's negative impacts
The negative effect of shift work on employees is well documented in all industries. Shift work has been described as detrimental to an individual's health, causing disruptions to their circadian rhythms, altered activity-rest patterns, increased stress levels,4 and creating issues with social and domestic life.5...