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How Nurse Executives Can Help Tired Nurses

Rebecca Hendren, for HealthLeaders Media, May 17, 2011

Working long hours can compromise patient safety, yet 12-hour shifts are the norm in nursing. Nurses love the flexibility offered by 12-hour shifts and healthcare facilities find them easier to schedule and manage. But research shows incidents of medical errors increase after nurses work more than eight hours.

Nurse fatigue and cognitive overload are topics of increasing concern to the healthcare industry, but simply doing away with 12-hour shifts is not a realistic option. They are extremely popular with staff and management alike.

Twelve-hour shifts allow nurses to complete a full-time job in only three days, a big benefit for a female-dominated profession as it allows more time at home. Another important consideration is that 35% of all nurses are the sole wage earner for their families. Twelve-hour shifts give nurses the chance to earn extra money through overtime or picking up shifts at other organizations.

"So many nurses are single head of household and are the primary wage earners for their families," says Cole Edmonson, DNP, RN, FACHE, NEA-BC, vice president of patient care services/CNO at Texas Health Presbyterian Hospital Dallas. "It explains a lot about why many nurses have multiple jobs, which could also explain why they feel the need to have overtime or 12-hour shifts or volunteer to take holiday and weekend shifts to be able to maximize income."

Statistics are unavailable for how many nurses work two or more jobs. Edmonson estimates 20% to 35% of nurses at his facility report secondary jobs, either at another facility in the system or through agency work. Extra work on top of regularly scheduled full-time hours increases the risk of nurse fatigue.

Attempting to limit such a popular practice is impossible and any talk of doing away with 12-hour shifts is met with vehement protest. In the ongoing debate over 12-hour staffing, nurse fatigue, and patient safety, chief nursing officers must set the tone for the organization.

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