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Thursday, Dec 18, 2014
Commentary

Let us resolve not to overwork nurses

McClatchy-Tribune
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This is National Nurses Week, and we should honor the work that nurses do, and insist that they get their long hours reduced.

The hours worked by registered nurses — the largest profession in health care — have actually increased over the past several decades.

The average hospital nurse now works a 12-hour shift. Studies on nursing hours have documented that most nurses do not leave after 12 hours but actually work 13 or 14 hours. (In some hospitals, nurses are required to work mandatory overtime, which could mean an additional eight to 12 hours at work.) When combined with commute times, nurses may be spending 16 or even 17 hours at work and getting to work. This significantly limits the time they have to rest between shifts.

To make matters worse, there are no regulations limiting the amount of back-to-back 12-plus-hour shifts an RN works. As a result, many RNs suffer from chronic sleep deprivation.

Nursing unions have been adamant that banning mandatory overtime is critical, since working extra hours is unsafe to both nurses and patients. The Massachusetts Nurses Association, for instance, has successfully lobbied for legislation banning mandatory overtime in the Commonwealth.

But bans on mandatory overtime, while certainly necessary, do not address the safety issues inherent in 12-plus-hour shifts. Errors that lead to patient harm increase after eight hours and rise dramatically after 12 hours, particularly when a nurse suffers from chronic sleep deprivation.

Plus, the harm to nurses themselves is significant. Fatigue increases the chance of a needle-stick injury, makes concentration on complex tasks more difficult, and creates the kind of irritability that makes it hard for RNs to be empathic or function effectively.

What’s more, numerous nurses suffer from injuries sustained while driving home when fatigued. Ideally, nurses should go back to the eight-hour shift that so many working people fought for over the past 150 years. Until that happens, 12-hour shifts should be banned at least for those working in critical care areas — intensive care units, emergency rooms, and labor and delivery.

Similarly, working more than three back-to-back 12-hour shifts should not be permitted. Airline pilots aren’t allowed to fly for more than eight hours, and truck drivers aren’t allowed to drive for more than 11. Both professions have minimum rest periods between their shifts. So how can we countenance 12-plus hour shifts for the RNs upon whose skill, alertness and judgment so many patients’ lives depend?


Suzanne Gordon is the author of “Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety” and is co-editor of the Culture and Politics of Health Care Work Series at Cornell University Press. She wrote this for Progressive Media Project.

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