The 12-hour shift is now the norm in the nursing profession. Although many nurses welcome a flexible schedule, is it good for the patients?
The Facebook post — uploaded in November 2014 — had been shared 636,912 by the afternoon of July 9, 2015.
And the momentum was still going. A few hours later, there were 2,500 more “shares,” and by July 10, another 11,151 people had shared the post, which attracted more than 5,000 comments. The hot topic?
Nurses and their long hours.
“I can make myself get up at 5 a.m. to make sure your mother had the medicine she needs,” reads the message posted on the NursingGuide.ph Facebook page. “I work all day to save the lives of strangers. I make my family wait for dinner until I know your family is taken care of. I make myself skip lunch so that I can make sure everything I did for your wife today is charted…”
It goes on, ending with: “Repost not only if you are a nurse or you love a nurse, but most importantly, repost this if you respect our work.”
Time was when the only “viral” aspects to nursing were the patients’ illnesses. But these days, the topic of nurses’ work hours and stress level has spread like measles on social media. Google “nurse bathroom breaks,” and you find social media posts and cartoons galore about nurses having to “hold their pee” for 10 or 12 hours. One cartoon shows a patient pointing to a restroom and asking, “What’s in that room?” and the hurried nurse replying, “I don’t know. I’ve never been in there.”
Are nurses really working on empty stomachs and full bladders? Is the hospital workplace becoming more grueling just as our millennial-influenced society is demanding greater “work-life balance?”
Interviews with nurses, nursing instructors, hospital officials and nursing organizations confirm that 12-hour work shifts have become the norm. A highly popular full-time schedule is 36 hours per week: three 12-hour shifts on and four days off. Froedtert Hospital has become known for its 7-70 schedule, in which nurses work 70 hours a week (seven 10-hour days in a row) and then take the next week off.
It does appear breaks are rare. But Brenda Bowers, chief nursing officer for the Milwaukee area’s extensive Wheaton Franciscan system, says it’s often the nurses themselves who are voluntarily skipping breaks.
“We know that’s a hot topic – it always has been in nursing,” says Bowers. “Nurses will say they’d rather just work through, so we have our charge nurses making rounds and ensuring that those breaks and lunches are being taken.”
At Aurora Health Care, another system with a large presence in southeastern Wisconsin, a 12-hour shift includes just 30 minutes for lunch. Other breaks are neither scheduled nor enforced, says Marie Willmann, a registered nurse at Aurora St. Luke’s Medical Center. (All nurses interviewed for this story are RNs who work, or have worked, in hospital settings.)
“You kind of take a five- or 10-minute break in between when you’re charting,” says Willmann. “But if I have stuff to get done, and I don’t need to take a break, I’m fine with it, I’ll keep going.”
Jessica Rotier, a clinical nursing instructor at the University of Wisconsin-Milwaukee’s College of Nursing, says her students, for a class project last semester, observed that nurses at Aurora Hartford Hospital “never took their breaks.” They concluded it was often by choice.
“I try to teach my seniors that you have to take your break to get some nutrition in your body so you can think better for the rest of your shift,” says Rotier. “Everywhere I go, management is trying to figure out how to get nurses to take their breaks. I just think it’s from nurses wanting to do for others before they do for themselves. I think it’s a choice we make, not forced on us.”
Willmann agrees. “I think if a nurse doesn’t get a break, it’s almost their fault,” she says. “I think maybe they’re mishandling their time-management. Nurses are very good at being martyrs as well. That’s where having a good charge nurse or manager there to say, ‘Hey, go take five minutes,’ helps a lot.”
So if nurses rarely take breaks, is it wise for so many of them to be working for 12 straight hours?
“I like the 12-hour day,” says Natalie McDonough, who works in the St. Luke’s surgical intensive care unit, “because I feel like I have more continuity of caring for my patients. If I’m exhausted at the end of the day, then I know I did a good job.”
“There is some data out there that a 12-hour shift is safer for patients, because only two nurses are taking care of them instead of three,” says Kim Litwack, associate dean for academic affairs at UWM’s College of Nursing. “There’s less chance for medication errors and a better chance of recognizing subtle changes in a patient’s status.
“Some are doing it by choice and some are not,” she says. “For me personally, I worked 12-hour days because it allowed me to go to school on the other days.”