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Sunday, May 25, 2014

12-hour shifts work well, study says

Most respiratory departments staff for twelve hour shifts.  However, there are those who believe the end result of this is staff that are too tired, particularly at the end of the shift, resulting in too many errors.  Considering errors in healthcare may result in serious consequences, many hospitals are now shifting back toward eight hour shifts.

This was a subject that the Lincoln Police Department (LPD, of Lincoln, Nebraska, put to the test by performing a study.  Of a police force of 300 personnel, 37 officers and supervisors volunteered to work 12 hour shifts. Researchers went on to evaluate these workers on a basis of both their personal opinion and their performance.  

Two of the main concerns was fatigue at end of shift.  Getting enough sleep was a top priority, and the only time this became a concern was when a long shift turned into over time.  However, this concern was resolved.  As noted by the researchers: 
Supervisors played a key role in managing calls that came near the end of the shift, holding some and stabilizing others until fresh officers were available to work the call and complete reports. Officers were encouraged to manage their calls and to notify supervisors if a late call was likely to extend into overtime. The resentment that some officers might feel when someone appears to be ducking work was replaced with the realization that other officers would do the same for them at the end of the shift.
This is something that we respiratory therapists experience, and the solution was quite similar.  While we don't get a ton of overtime, there are times when doctor orders late in the shift were handed off to the oncoming shift.  However, most of us realize that we will be equally tired at the end of our shift, so as long as someone doesn't abuse this system, it usually doesn't cause resentment.

Upon interview, the majority of the people who participated in this study had positive opinions of 12 hour shifts.  However, it was noted that all of the participants willfully volunteered for it, so it would only make sense that they would support it.

While most people reported feeling tired at the end of the shift, 100% said they were fully capable of performing their duties.

At the same time, an evaluation of performance also had positive results.  During the period of the study, there were no disciplinary actions and no complaints related to the longer work shifts.  Productivity measures were also good, as the number of traffic tickets and and intelligence reports went unchanged.

In response to this, the researchers said:
Some officers reported a new enthusiasm for the job with the 12-hour shifts that had a measurably positive effect on their work output, but there was no evidence that satisfaction with the work schedule affected the total output of the team.
The researchers concluded the following
Officer perceptions of the 12-hour shift were extremely favorable. Two of the 37 officers reported that before implementation of the new schedule, they were actively looking for a career change. The 12-hour shifts provided the right balance in their lives and renewed their enthusiasm for police work. Job satisfaction and morale are extremely high with this group of employees. This reaction is not likely to be universal, however, as these participants had positive expectations going into the schedule change and bid into the schedule by choice. In the department as a whole, a significant number of employees have a negative view of the schedule, though the schedule has sparked growing interest and may be expanded within the department.
The employee survey also indicates that 12-hour shifts have a mitigating effect on the negative aspects of shift work. Officers report being more rested and ready to return to work after days off but also note there is little time for anything but work during their work days. A more scientific approach might provide more conclusive data, but the survey and employee comments suggest that in addition to being happier, 12-hour shift workers are probably healthier as well.
This is not much different to how most of the people I work with every day feel about 12 hour shifts.  Most people are tepid about working them, but once they begin they find that they have more time off, and therefore more time to spend with friends and family, and more time to catch up on sleep.

Furthermore, the researchers concluded:
Before implementation, the main concern was whether 12-hour shifts would have a negative impact on the quality of the service provided by the department. Objective data suggest that it does not. There was no negative fiscal impact, and a trend toward less sick leave use was noted.
Good managers always look for ways to improve employee job satisfaction that do not adversely affect the organization’s mission. For a significant number of police officers, 12-hour shifts have proven to be a dramatic improvement and a viable scheduling alternative
Bottom Line:  While this is just one study, it shows that 12 hour shifts improve satisfaction and result in similar, if not slightly improved, performance compared to those who work 8 hour shifts.  So, hospital administrators should not shy away from 12 hour shifts due to unwarranted fears of diminished satisfaction and performance.

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