Nurses are voicing their need for flexible schedules that enable them to maintain a healthy work-life balance. In response, many employers and agencies have begun offering a wider range of shift options, but eight- and 12-hour shifts remain the most popular choices for employers.
The most suitable shift for each nurse depends on their needs and obligations. Would part-time hours work best to accommodate their family responsibilities or another job? Do they require the benefits of a full-time position? Do they prefer shorter work weeks?
8- vs. 12-hour nursing shifts
How many days per week a nurse works usually depends on whether they’re a full-time or part-time employee. Nurses who work eight-hour shifts at hospitals generally work day, evening, or night shifts that slightly overlap to make time for patient handoffs and other briefings.
These days, eight-hour (or even 10-hour) shifts are more common in outpatient settings such as clinics, private practices, and schools — where care is provided within typical daytime office hours, and in some long-term care settings.
Hospitals, on the other hand, are more likely to operate on 12-hour nursing shifts. A study shows between 65% and 80% of nurses work 12-hour shifts. Typically, these nurses are on duty three-to-four days per week from 7:00 a.m. to 7:00 p.m. or 7:00 p.m. to 7:00 a.m. with some overlap for patient handoffs.
Here, we consider the pros and cons of eight- and 12-hour shifts — and which is better for nurses and patients.
8-hour shifts for nurses: The pros
Decreased risk of burnout — Burnout is a result of chronic workplace stress and is characterized by emotional exhaustion and depersonalization. Studies show that nurses who work eight or nine hours during a shift are less likely to experience burnout than nurses who work 10 hours or more.
Lower turnover rate — According to research, nurses who work eight-hour shifts with minimal overtime exhibit higher job satisfaction and are less likely to leave their current positions. This could be attributed to several factors, including having more personal time on workdays than nurses working longer shifts.
Consequently, they are typically more alert and focused and experience comparatively lower levels of fatigue.
Reduced errors — In a study of nearly 400 hospital nurses, researchers found that the risk of making an error increased when nurses worked overtime or extended shifts (those longer than 12 hours). Fatigue from working extended shifts can lead to poor judgment and decreased vigilance, among other risks.
8-hour shifts for nurses: The cons
Fewer days off per week — For full-time nurses, two days off per week may not provide enough time for rejuvenation, recreation, and family time.
Change-of-shift communication breakdowns — Patient handoffs during shift changes are the crucial transition point when nurses from the outgoing and incoming shifts share information vital to each patient’s care and comfort such as treatment, challenges encountered during the previous shift, and pain level, which is why smooth handoffs are so important.
Yet, according to a Joint Commission Sentinel Event Alert, communication gaps during handoffs increase patient safety risks. With three shift changes per day, the probability of inadequate communication during handoffs and subsequent patient safety risks can increase.
More time on the road — On average, Americans spend about 55 minutes per round trip commuting to work, translating to nearly five hours per week in a five-day work week. Research shows that commutes, especially long ones, can lead to higher stress levels, poor cardiovascular health, and reduced sleep time.
12-hour nursing shifts: The pros
Longer “weekends” = better work-life balance — For many nurses, 12-hour shifts offer more flexibility than the standard eight-hour workday.
While 12-hour shifts limit free time on scheduled workdays, they provide nurses with three-to-four full days off each week to pursue other interests, spend time with loved ones, further their education, or even work a second job.
“For me, work-life balance is extremely important, and working three 12-hour shifts allows me to do that,” said Andrea Borrasreed, BSN, RN, who works in the maternal/child float pool at Renown Regional Medical Center in Reno, Nevada.
“In addition," she continued, "I work the day shift, and 12-hour shifts allow me to build my skills and communicate with an interdisciplinary team at a faster pace than I would on the night shift. Plus, I still have the time to take care of myself and my family on my days off.”
Fewer patient handoffs — Having 12-hour nursing shifts means fewer shift changes each day and a decreased risk of communication breakdowns during patient handoffs. Many nurses also believe that longer shifts allow them to provide better care by increasing their time with each patient.
“Spending 12 hours with my patients allows me to get to know them better and carefully dive into their diagnoses and their needs before switching out with another nurse,” said Borrasreed, who has worked in nursing since 2017 and recently transitioned from LVN to RN.
The more involved a nurse is with a patient during their shift, the better equipped they are to notice the nuances of that patient’s particular condition and side effects. These details often help nurses provide more effective pain management and pinpoint sudden changes in the patient’s condition.
Boost morale — In many cases, the flexibility that accompanies longer shifts can help boost morale among nurses and allows them to provide better care by increasing the amount of time they spend with each patient. The more involved a nurse is with a patient during their shift, the better equipped they are to notice the nuances of the patient’s condition and side effects.
12-hour nursing shifts: The cons
Increased chance of burnout and fatigue — A 12-hour shift is taxing enough, but when it turns into 13 or more hours, the chance that a nurse will experience emotional exhaustion and fatigue — and the resulting burnout — increases. Fatigue also has an accumulating effect. So nurses who work longer shifts may sleep poorly and then return to work the following day still exhausted from the previous shift.
Patient safety risks — According to an article in the International Journal of Public Health, a systematic review found that working more than 12 hours a day or more than 40 hours per week was related to adverse patient outcomes. The higher risk to patient safety and nurse burnout has some nurse leaders endorsing a move away from the 12-hour shift and toward more flexible work schedules.
Although each type of shift has its advantages when it comes to ensuring patient safety, it’s important to remember that other factors may compromise patient safety such as the implementation of effective safety protocols and whether nurses have the necessary time and resources to prioritize patient care.
Decreased job satisfaction — While some data has shown that nurses prefer the flexibility and other perks of 12-hour shifts, other research suggests that longer shift lengths can negatively impact nurses. The results of a BMC Nursing study indicated that nurses who worked shifts lasting 12 hours were prone to expressing reduced job satisfaction, elevated levels of burnout, and an increased inclination to quit their current positions.
Some insights about job satisfaction
Nurses’ satisfaction with their jobs depends on multiple variables, and work shift is just one of them. Nurse.com’s 2022 Nurse Salary Research Report explains that regular merit increases and using their full scope of skills can also have a positive effect on job satisfaction. According to a Forbes article, employee satisfaction in any profession is also influenced by several fundamentals that can be applied to nurses, including:
- What you do has to suit you — A job should match your strengths and skill sets.
- Why you do it matters too — What’s your motivation for being a nurse, and are you personally recognized for your contributions? As the article states, “Never let any job at your organization be a thankless one.” Meaningful recognition has been shown to be important to nurses.
- Growth brings gratification — Being given opportunities to expand your skill sets and pursue educational goals shows nurses their employers are interested in seeing them reach new heights in their careers.
To optimize nursing shifts, leadership teams should regularly assess the impact of shift work on patient care and nurses’ job satisfaction and well-being. Allowing nurses to share their opinions and experiences without judgment can be pivotal in identifying and addressing shift issues before they escalate into unhealthy environments for everyone.
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