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NIOSH Training for Nurses on Shift Work and Long Work Hours

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Extended Shifts

Because of the concern for patient safety, the report by the Institute of Medicine titled ‘Keeping Patients Safe’ (2004)18 recommends that work hours for nurses be limited to 12 hours in any 24-hour period and 60 hours per 7-day period. A systematic review of studies examining nurses’ work hours, published in 2014, concluded that more than 40 hours of work a week is associated with adverse patient care outcomes as well as risks to the nurse’s health.19

Use extended (12-hour) shifts with caution. These are often referred to as compressed work schedules, since they allow nurses to put in more hours in fewer days and have more rest days in between. Although 12-hour shift systems are sometimes favored by nurses and managers, studies comparing them with 8-hour systems have shown mixed results on sleep, alertness, safety, and health factors.

Bae and Fabry examined 13 findings from studies that looked at patient outcomes when nurses worked long shifts compared to 8-hour shifts, and they reported mixed results. Five findings showed long shifts increased negative outcomes, 7 findings showed no significant differences, and 1 finding showed decreased negative outcomes.19

Concerning the health of nurses, Bae and Fabry reported long shifts showed a strong adverse relationship to nurses’ health outcomes: 21 findings showed increased negative outcomes, 5 findings showed no significant differences, and 3 findings showed decreased negative outcomes.19

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