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Are 12-Hour Shifts Safe?

Published December 5, 2011 6:24 AM by Scott Warner

When nurses switch to 12-hour shifts, I wonder if back injury claims increase. Nurses and nurse assistants literally do the heavy lifting in hospitals, and patients aren’t getting smaller. Forcing fifty- and sixty-something people with a lifetime of cumulative spinal stress to lift an extra four hours a day seems foolhardy.

The question was recently asked in an Advance forum with mixed opinion, although I sense most feel 12-hour shifts are less safe. One respondent replies that 8-hour shifts are “safer for the patients because their caregiver is more rested and alert.” It is still all about the patient, isn’t it?

A National Institute for Occupational Safety and Health (NIOSH) study quantifies the general risk of accidents relative to 8-hour shifts as 13% higher for 10-hour shifts and 27.5% higher for 12-hour shifts. There is greater risk (18.3%) into afternoon and (30.4%) night shifts, with increasing risk on successive night shifts (6%, 17%, and 36%). More breaks do not necessarily decrease the risk. NIOSH concludes “the risk of an incident associated with long work hours may be influenced more by the precise work schedule, including the length and timing of the duty periods, and the provision of breaks, than by just the accumulated working hours.”

This suggests effects of scheduling can be predicted with modeling. Switching to 12-hour shifts increases the relative risk of accident (physical or otherwise), which can be measured.

An organization using 12-hour shifts as a recruitment strategy can also apply fitness screening. At the end of a long day alertness and problem-solving abilities decrease, and blood pressure and sense of fatigue increase. The older the worker, the more likely he or she is to become exhausted and prone to serious errors.

Of course, if short staffing is the perceived reason for 12-hour shifts, periodic risk assessments may give way to “wait and see.” Maybe there will be more accidents, or maybe all the extra days off will let the nurses rest. Ditto for labs.

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About this Blog


    Scott Warner, MLT(ASCP)
    Occupation: Laboratory Manager
    Setting: Critical Access Hospital
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