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By Suzanne Gordon
National Nurses Week is from May 6 to May 12, and we should honor the work that nurses do, and insist that they get their long hours reduced.
The hours worked by registered nurses (RNs) — 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 another 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 a RN works. As a result, many RNs suffer from chronic sleep deprivation. Nursing unions have been adamant that banning mandatory overtime is critical, sinceworking extra hours is unsafe to both nurses and patients. The Massachusetts NursesAssociation, 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 needlestick 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 last 150 years. Until that happens, 12-hour shifts should be banned at least for those working in critical care area — 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? Journalist Suzanne Gordon’s latest book is “Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety,” published by Cornell University Press. She is co-editor of the Culture and Politics of Health Care Work Series at Cornell University Press and can be reached at firstname.lastname@example.org.
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