Nursing Researchers Offer 'Harm Reduction Strategies' for Long Work Shifts

According to University of Maryland School of Nursing researchers, nurses in hospitals and other health care facilities may perform better by following the lead of airlines, trucking, and nuclear plants by limiting hours of service, ensuring prompt and definite breaks during shifts, and other scheduling strategies.

In the third of a series of reports, "Is It Time to Pull the Plug on 12-Hour Shifts?" Jeanne Geiger-Brown, Ph.D., RN, associate professor, and Alison Trinkoff, professor, ScD, RN, FAAN, recommend harm reduction strategies to institutions that use 12-hour nursing shifts.

The researchers acknowledge that some nurses prefer working a compressed series of 12-hour shifts and then having more time off. The trend for 12-hour shifts started in the 1970s and 1980s when there were nursing shortages.

In the first part of their series, the authors summarized research evidence to challenge the 12-hour shift paradigm. In the second part, they described barriers to nursing executives moving away from the practice. In the newest paper, the professors offer strategies they developed from their extensive research, surveying, and traveling in the nursing profession.

The authors' suggestions to help mitigate the possible negative effects of the 12 hour shifts include:

  • Eliminate all overtime (voluntary and mandatory) for 12-hour nurses.
  • Leaving on time must become a guarantee rather than an unlikely occurrence.
  • Don't call a nurse back to work after a 12-hour shift because it disrupts their sleep and implies that time off is a luxury, as opposed to necessary for practice and performance.
  • Corporate napping, also called power napping. Both laboratory and workplace studies have confirmed (by electroencephalogram) that a brief 15- to 20-minute nap during a work shift confers additional alertness.
  • Completely relieved breaks, where nurses are relieved of their responsibilities are important for performance, and need to be part of the cultural norm.
  • Schedule easier tasks at the end of the shift, more difficult tasks at the beginning.
  • Provide nutritious healthy food on night shifts so that workers can eat and refuel properly.

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