• It wasn't until the 1970s that hospitals introduced the 12-hour shift to combat a national nursing shortage.
• The 12-hour shift for nurses causes burnout due to long hours, heavy workload, and poor social support.
• Strategies to survive 12-hour shifts include taking breaks, self-care, and changing shifts. 12-hour shifts can also benefit those going back to school.

The American Association of Colleges of Nurses reports that 55% of nurses work in hospitals. The majority of these nurses will work 12-hour shifts.

Many nurses love 12-hour shifts because it provides work/life balance and flexibility. But does working 12-hour shifts also cause burnout?

Studies on nursing and burnout consistently report that a combination of a heavy workload, low control over the job, poor social support, and long working hours can lead to nurse burnout.

Explore how nurses can gain control over their workday, resulting in a healthier work/life balance.

History of the 12-Hour Shift

The nursing profession has a long history of nursing shortages. After World War II, nurses left the profession, citing low wages, poor working conditions, and lack of respect. Nurses demanded better salaries, better benefits, and a 40-hour work week.

It wasn't until the 1970s that hospitals introduced the 12-hour shift to combat the national shortage.

The new longer shifts allowed nurses to have more work/life balance and work fewer hours during the week. It also provided continuation of care for patients.

For hospitals, the 12-hour shift meant less payout for overtime. They also relied less on agency nurses to fill in shortages.

It was a win-win situation.

The 12-hour shift is still used today to incentivize nurses to remain in the profession and continue working in the hospitals. Karen Donofrio, RN, MSN, agrees.

"I would not be a bedside nurse if I had to be there five days a week. I think 12-hour shifts keep a log of nurses at bedside," Donofrio says.

But after decades of nurses working 12-hour shifts, research found that many suffer from fatigue, sleep deprivation, and burnout.

Donofrio has been working 12-hour shifts for over 15 years. Although 12-hour shifts have allowed her more flexibility and less need for babysitting, she acknowledges the disadvantages of working extended shifts.

"It is a very long day that is draining both physically and mentally," Donofrio says.

How 12-Hour Shifts Can Cause Burnout

Source: World Health Organization

Sarah Corallo, RN, AE-C, felt burnt out years into working 12-hour shifts. She describes feeling physically exhausted and emotionally drained.

"I found that I dreaded going into work because I knew how tired I'd be at the end of my shift," Corallo admits. "I was frustrated because I started losing interest in the work I did even though I absolutely loved what I did for a living."

With the current nursing shortage crisis affecting all states, many hospitals are short-staffed and nurses don't get proper breaks, Donofrio points out. This is another reason why nurses are burnt out.

[their] basic needs aren't met," Donofrio says.

Although the longer shift is popular among nurses, 12-hour shifts are linked to long-term health risks. Research shows continual exposure to stress is taxing on the body and affects mental health, causing nurses to feel the effects of burnout. Nurses who work 12-hour shifts are more likely to report feelings of:

• Stress
• Fatigue
• Depression
• Anxiety

Corallo worked 12-hour shifts for over 15 years. She has since transitioned to an eight-hour shift position.

"The 12-hour bedside shift was definitely more tiring than my eight-hour office-based shift. Even after a year, I still feel like I'm working half days," Corallo says.

Working "three in a row," a term coined by nurses to describe working three consecutive days, is also linked to burnout. Corallo points out that a 12-hour shift isn't simply a 12-hour day. It's more like a 14-16-hour day when you factor prep and commute time. That can equate to working over 40 hours in three days.

"In a hospital-based setting, those days are long. Sometimes going in when it's dark and coming out when it's dark just adds to the mental exhaustion," Corallo says.

A 12-hour shift is exhausting, especially when it comes to bedside nursing.

"Bedside nursing is physically and emotionally demanding, and 12-13 hours on your unit takes a toll on the body and psyche," Corallo points out.

Studies find that nurses who work longer, consecutive days have an increased risk of injury. Shift work or work that falls out of the hours of 7 a.m. to 6 p.m. is also linked to a greater risk of:

• Higher body mass index
• Obesity
• Poor diet
• Less exercise
• Circadian rhythm disruption
• Cardiovascular disease
• Diabetes
• Back, knee, and shoulder pain

Nurses need to be conscious of these risks. When working long shifts, they must create a plan and recognize when their health is affected.

Pros of 12-Hour Nursing Shifts

There are benefits to working 12-hour shifts. Having days off during the week is a huge bonus. Knowing you can have consecutive days off helps plan your life and helps you catch up on much-needed rest. Another benefit is spending more time with family, especially your children.

Corallo points out that when she had younger children, being home more days of the week and having only 2-3 weekdays to worry about childcare and paying for it was a major benefit.

Working a 12-hour shift also allowed Corallo to finish school.

"It allows for flexibility for clinicals and other class time," Corallo says.

How to Survive a 12-Hour Nursing Shift

When you are a new nurse or a nurse who chooses to work in the hospital, you may not have the luxury of picking your shift. If you work 12-hour shifts, here is some advice on how to survive it.

Meet Our Contributors