Before you consider hospital nursing as a career you may want to weigh the pros and cons of 12-hour nursing shifts. I wish someone had shared this information with me before I became a nurse so that I had a better idea of what to expect. Especially as a working mother.
Pros of working 12-hour shifts:
More work flexibility
When you work 12-hour shifts you can get more creative with a work schedule. That is so important to me as a working mom. I want to be available when my kids need me to be home from work. In addition, I often feel that I get to experience what it’s like to be a stay-at-home mom and have the ability to also work full-time (although I am a very tired mom these days).
I try to make my schedule the same every week for consistency. I usually work every Monday and Wednesday, and every other Sunday. However, if I need to be home on one of my usual work days then I can request to work a different day or switch days with another nurse.
In addition, working as a per diem nurse has given me even greater flexibility with my schedule. I can work as little as one day a week or as many as 4 or 5 as long as the hospital has a need for nurses (although I choose never to work more than 2 or 3 max).
More days off
Who doesn’t want to work fewer days in a week? When you work 12-hour shifts as a full-time nurse, you get to work three days a week instead of 5. That also means that you have 4 days off every week instead of 2.
On the flip side, keep in mind that a 12-hour shift makes for a really, really long day. Never underestimate the exhaustion that comes with working as a nurse for 12 hours a shift! You will need those extra days of to recover.
Less commuting to work (save time & gas!)
Working three days a week instead of a more traditional Monday through Friday schedule means that you spend significantly less time commuting to work. In addition, if some of those days fall on a weekend then you can miss traffic completely! Personally, I don’t love working on the weekend because I prefer to be home with my family, however I do appreciate how fast I can get to and from work. That is something to consider when you live in a high traffic city like Los Angeles.
Congruence of care
When nurses work 12-hour shifts they only give report to oncoming nurses twice in a 24 hour period. Working 8-hour shifts requires that nurses give report 3 times in 24 hours. With a 12 hour shift, nurses do less handoff and are able to spend more time with the same patients.
Less caregiver change could potentially translate into a decrease in nurse error because you are handing over patients less frequently. There is less chance for miscommunication.
Congruence of care is more important on nurse units where patients stay for longer periods of time. As a ER nurse we are used to having several new patients and handing care over to floor units more frequently so this may not be as much of a benefit if you work in ER.
Possibility of taking “mini-vacations” without using vacation time
When you have the option to have several days off in between workdays, it becomes possible to take mini-vacations without putting in a vacation request. In fact, I have taken up to a week off at a time to go to Mexico without using any vacation days.
When you consolidate your hours into longer periods of time per day, then you can take more days off in a row. For example, if I am putting my schedule in for a two week period, I can request a Sunday, Monday, Tuesday for the first week and a Thursday, Friday, Saturday for the second week. That leaves me with 8 days off in between!
There are pros and cons to working 12-hour nursing shifts that you may want to consider.
Cons of working 12-hour shifts:
May put a nurse’s health at risk
It is no surprise that nurses work incredibly hard. I come home at the end of a 12-hour nursing shift with an aching back and burning feet. This is because I, like most nurses, often don’t have time to rest while at work. When I do have a minute to sit down to chart, I’m lucky if I can find a chair. I know a few older nurses who have been working bedside for 25 years and they literally have a permanent limp and can barely stand up straight.
Many nurses work 12-hour shifts with minimal breaks. We are lifting and pulling patients, often spending the majority of our day on our feet, managing stressful and sometimes critical situations while doing everything we can to hold our pee for hours on end! Some days when I finally get a break to eat lunch and I am at my weakest, I find that our break room is stocked with donuts and cookies. My exhaustion can be overwhelming and the temptation for a little pick me up is never higher than right at that moment.
A University of Pennsylvania study on hospital nurses found that the longer the shift, the higher the levels of burnout and patient dissatisfaction. The researchers discovered that nursesworking shifts that were ten hours or longer were up to two and a half times more likely than nurses working shorter shifts to experience burnout and job dissatisfaction.
One reason may be that longer shifts give nurses less time in a day to care for themselves. I have found it challenging to do any self-care on days that I work 12-hour shifts because nearly every waking hour is spent caring for patients. Furthermore, the study found that nurse burnout associated with longer shifts increased the chances of the nurse wanting to leave the job.
If you have kids, you won’t see them on the days you work
As a nurse and mom, one of the worst parts of working 12-hour shifts is that I don’t get to see my children at all on the days that I work. They are still asleep when I leave for work at 6 o’clock in the morning and they are already in bed by the time I get home at 8:30 PM. Even worse, when I work back-to-back shifts I may not see them at all for 24 to 36 hours at a time. I could as easily have been out-of-town as far as they are concerned. Nursing is a good career for moms, but this still something you may want to consider.
Working a 12-hour nursing shift makes for a very long workday. But that is the price I must pay for getting to spend more days at home. So, the benefits of the 12-hour shift far outweigh the cons for me. Admittedly though, I really do focus on the benefits of working 12-hour shifts as much as I can. I must remind myself to stay positive. There are some days I wonder how long I can physically keep up with the job before I permanently injure myself or completely burn out.
Right now I remain passionate about helping others as a nurse and I am grateful to have work flexibility that allows me to spend more uninterrupted days off with my family than I would have with a standard 9 to 5 schedule. When I think about it in that way I realize I am lucky to get to have the best of both worlds.
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*Updated on 4/9/20 to include pregnant nurse precautions for COVID-19. *Affiliate links.
As an ER nurse who delivered my second baby in early 2018, I have done a lot of research about pregnant nurse precautions to be aware of when you work in a hospital. My goal was to make sure that it was safe for me to continue working in such a physically demanding environment with so many potential occupational hazards.
Fortunately, I was able to work safely right up until a few weeks before giving birth. As a per diem nurse, I did not have any maternity or disability benefits, so I wanted to save up as much money as possible before I went out on leave. Thankfully, I was able to do just that. But safety was still my number one concern. I hope this information can help other nurses stay safe during their pregnancies as well.
Talk to your OBGYN
First off, you must talk to your doctor to discuss any occupational concerns you have during your pregnancy. Continue the dialog at your prenatal appointments as you move along your pregnancy. If you have questions in between your appointments, then contact your doctor.
My goal in writing this is not to make pregnant nurses afraid to work in the hospital. I am so glad that I was able to safely work as a pregnant nurse for as long as I did. Still, there is no shortage of occupational hazards for the pregnant nurse within the hospital setting. Working safely is the number one goal.
You must communicate with management and your charge nurse about your pregnancy. They cannot help you avoid potential pregnancy hazards if they don’t know that you are expecting.
Pregnant nurse precautions and hazards to consider:
The novel coronavirus (COVID-19) has many pregnant healthcare providers, especially frontline nurses, uniquely concerned. Because COVID-19 is so new, there hasn’t been enough time to study its effects on breastfeeding or pregnant women. Also, many nurses who are working directly with COVID-19 patients say they don’t have enough personal protective equipment (PPE) to protect them from the virus safely. That maybe even more problematic for pregnant nurses who directly care for COVID-19 patients.
“We do not have information from published scientific reports about susceptibility of pregnant women to COVID-19. Pregnant women experience immunologic and physiologic changes which might make them more susceptible to viral respiratory infections, including COVID-19. Pregnant women also might be at risk for severe illness, morbidity, or mortality compared to the general population as observed in cases of other related coronavirus infections [including severe acute respiratory syndrome coronavirus (SARS-CoV)* and Middle East respiratory syndrome coronavirus (MERS-CoV)] and other viral respiratory infections, such as influenza, during pregnancy.”
“Pregnant healthcare personnel (HCP) should follow risk assessment and infection control guidelines for HCP exposed to patients with suspected or confirmed COVID-19. Adherence to recommended infection prevention and control practices is an important part of protecting all HCP in healthcare settings. Information on COVID-19 in pregnancy is very limited; facilities may want to consider limiting exposure of pregnant HCP to patients with confirmed or suspected COVID-19, especially during higher risk procedures (e.g., aerosol-generating procedures) if feasible based on staffing availability.”
Essentially, the CDC does not know at this time if pregnant women are at a higher risk when working with COVID-19 patients because the evidence is limited. As a precaution, pregnant women may want to consider working in lower-risk areas where they have less exposure to COVID-19 patients.
The most important take away is to always take care of yourself first. You can’t care for your family and your patients if you become sick.
Radiation from diagnostic imaging
In the ER and on most floor units within the hospital, patients often receive portable X-rays at the bedside. So naturally, I was concerned about radiation exposure and how it could impact the health of my unborn child. I felt it was wise to air on the side of safety by not exposing myself to unnecessary radiation during pregnancy.
If you are in an area where x-rays are being taken, you must wear a lead radiation apron to protect yourself, especially if you are within six feet of the machine. If possible, it is also a good idea to step outside the room while the image is taken.
In my nursing experience, x-ray technicians usually notify anyone within the vicinity of where imaging is being taken. I was able to leave the area for a few minutes, whether I was wearing a lead apron or not.
Notify management of pregnancy
Wear lead radiation apron
Step outside of the room when portable x-rays are taking place
Dangers from working with chemo or other teratogenic medications
There is evidence that handling some medications, such as chemotherapy drugs, can cause adverse reproductive outcomes, including fetal loss, miscarriage, infertility, and preterm births. In addition, it may cause learning disabilities in babies exposed to some drugs if nurses are exposed during pregnancy.
Nurses working in oncology or other areas where antineoplastics are prescribed may want to speak with management about the safest way to continue working. In addition, you can insist on getting help from co-workers or management to give teratogenic medications to patients. Moving to another work area may be a consideration if safety for the fetus is still a concern.
Wear protective equipment when giving medications
Ask for help from co-workers when working with teratogenic medications
Consider temporarily working in another area of the hospital during pregnancy as your management allows
As a pregnant ER nurse, I was very concerned with the risk of infection from patients such as c-diff, tuberculosis, cytomegalovirus, and influenza during my pregnancy. Since the ER is often the first stop in the hospital for sick patients, I often didn’t know that a patient had a contagious infection until after they had been admitted. By then it was too late to protect myself if I hadn’t already.
Pregnant women need to be especially proactive with protective equipment and hand hygiene. It is ideal for all hospital employees to have their measles, mumps, and varicella-zoster vaccinations before pregnancy (most facilities require these vaccinations to work anyway). Hep B and influenza vaccination can also safely be administered during pregnancy.
As an added precaution, I made sure to change my clothes and shoes before leaving the hospital to minimize the risk of work-to-home contamination. The first thing I did upon getting home was take a shower to rid myself of any other possible bugs I could have inadvertently carried home with me.
Stay up to date in all vaccines including the yearly flu vaccine
Adhere to strict universal precautions and hand hygiene
Request job modification to minimize exposure to specific patient populations
Minimize work-to-home contamination by changing work clothes and shoes before going home
Shower as soon as you get home from work
The physicality of nursing while pregnant
Being a nurse while pregnant is exceptionally hard work. Not only are we on our feet for up to 12 hours a day, but pregnant nurses are also carrying an extra 25-plus pounds towards the latter part of pregnancy. Additionally, the extra girth makes it significantly more challenging to fit into tight spaces.
Movement becomes even more awkward for pregnant nurses due to having an altered center of gravity. Also, high serum levels of progesterone and relaxin loosen muscles, ligaments, and connective tissues. For nurses who do a lot of heavy, repetitive work requiring lifting, pulling, or pushing their risk of musculoskeletal injury is increased.
It is wise for pregnant nurses to use patient transfer equipment and to ask co-workers for help with moving patients. However, if your work situation is still too physical for you to manage safely during pregnancy, you may want to consider a modified duty in a lower risk setting with a less physical patient load.
On another note, pregnant nurses also have a higher risk of developing varicose veins due to an increase in total blood volume caused by pregnancy. The added blood volume, combined with being on one’s feet all day, leads to poor circulation, puffy legs, and swollen ankles. Compression socks or stockings can help reduce the risk of blood clots and varicose veins as well as prevent swelling.
Pregnant nurses may want to inquire about modified duty
Understand how the altered center of gravity and hormonal changes in pregnancy predispose a nurse to injury (despite using best lifting practices)
I worked in our ER psychiatric hold area several times throughout my pregnancy. There were a few incidences where I had patients verbally threaten me or begin to escalate towards violence. I always had a security guard with me, and I stayed a reasonable distance away from patients when I felt that my safety could be at risk. I was likely overly cautious at times, but it is better to be safe than sorry.
Violence against nurses is not uncommon, especially in the ER setting. Stay vigilant and keep away from any potentially threatening situations. If a patient is escalating towards violence, then leave and call for help immediately.
Working during flu season
The CDC recommends that pregnant women get a flu shot. Not only do hormone changes during pregnancy often make pregnant women more susceptible to getting the flu, but a common flu symptom is a fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby. Getting vaccinated can also help protect a baby after birth from flu through passive immunity.
My experience: The flu season in December 2017 was unusually bad. Many patients came to our ER for flu symptoms. Unfortunately, almost every nurse was infected with the flu or a cold at least once during the season. Myself, included.
At the time, I was over eight months pregnant, and I was struggling with how horrible I felt. I always get a flu shot to reduce my chances of getting sick during flu season. However, if I ever got pregnant again, I might consider starting my maternity leave towards the beginning of the flu season – especially, if I was that close to my due date.
An unexpected benefit of working as a nurse during pregnancy
One of the best gifts that pregnancy gave me was that it forced me to not be sedentary on days that I felt fatigued. (Although while you are carrying an extra 25-35 pounds of extra weight, you may not consider it a benefit).
Many studies show that not moving enough during pregnancy is bad for both mom and baby. If fact, exercise during pregnancy can boost your baby’s brain development and make them smarter. Who knew that working a 12-hour shift might promote health for both you and your unborn baby?
Good luck to you during your pregnancy and take care of yourself!
If the answer is yes, that’s awesome! You are working in an honorable and philanthropically rewarding field. But unfortunately, if you are like a lot of hardworking shift workers, you may at times feel overworked, exhausted, and even burned out.
With a little preparation and focus on your well-being, you can be both a healthy nurse and give great care to your patients. Its time to focus on nurse self-care!
11 tips to THRIVE as a nurse during 12-hour shifts:
Nurse self-care should be a priority. That includes getting a good night’s sleep!
Nursing schedules revolve around a need for 24/7 patient care. Sleep deprivation is a real concern, especially for those working night shifts. Nurse self-care starts with a good night (or in some cases day) of sleep. Here are a few tips to encourage healthier sleep habits after you complete a 12-hour shift:
Turn off the tv (an hour of sleep is always more important than another episode)
Get your heart rate up on your days off! The benefits of exercise have been well documented is essential for nurse self-care. It is no secret that regular exercise helps control weight, boosts overall energy, improves your mood, and helps decrease stress levels. Not only does exercise benefit the nurse personally, but it also allows nurses to have the stamina to give better care to patients as well.
Need to blow off some steam after a stressful day? A yoga session or brisk 30-minute walk can help. Physical activity stimulates various brain chemicals that may leave you feeling happier and more relaxed. Which, in turn, will help manage caregiver burden and help you feel your best.
#3. Grocery shop
A well-balanced diet is essential for nurse health and wellness.
Grocery shopping is so important for nurses and other hospital workers to ensure proper nutrition. It is no secret that healthy food choices are crucial for overall good health and well-being. Make sure you are filling your plate with high-density vitamins and minerals. You simply can’t maintain good energy and stamina over a 12-hour shift on sugary snacks and fast food!
Plan ahead by creating a grocery list of the foods you want to eat while you are at work. That way, you won’t be tempted to reach for something unhealthy when you have a few moments to eat in-between caring for patients.
Tips for nurses to make healthy meals fast: Try making a big batch of quinoa, brown rice, or black bean pasta to have handy in the fridge. These are a few great staples that you can build a nourishing meal around. When you get hungry, you can mix in a protein, veggies, nuts or seeds, dried fruits, or even just enjoy them with a little olive oil and sea salt. The key is to have healthy food that is easy to prepare BEFORE you get super hungry.
#4. Eat a healthy breakfast
Oats: a nutritious yet straightforward way to start a 12-hour shift (nurse self-care can be tasty!)
Studies show that eating a nutritious breakfast (as opposed to the doughnuts and other goodies often found in the breakroom) can help give you:
More strength and endurance to engage in physical activity and maintaining stamina to survive through a 12-hour shift.
Improved concentration, which can help you give better patient care.
A diet higher in complete nutrients, vitamins, and minerals.
Tips for nurses to ensure that you have a nutritious meal ready before each 12-hour shift: Make several mason jars of overnight oats with a variation of these flavors: blueberry/strawberry/raspberry, peanut butter, and maple, banana and walnut, or almond and raisin. You can add ground flaxseed or chia seeds for extra protein and antioxidant benefits. Then top it off with a dash of cinnamon for a delicious ready-to-eat breakfast.
Nurse break rooms are notorious for having sugary snacks like donuts, cookies, or other unhealthy junk food all within an arms reach. Sweets are so tempting to nibble on when you are tired and need a little extra energy. But then a few moments later you crash and are even more tired. On another note, eating nutritious and easy snacks will keep you energized during a 12-hour shift.
Pack snacks like these in your lunch bag to help keep your blood sugar levels balanced during your shift:
Baby carrots, broccoli or other veggies & hummus
Celery and almond butter
Granola and yogurt
Almonds or cashews
Sliced apples and peanut butter
Cottage cheese with pineapple or banana
#7. Don’t overdo caffeine
Green tea: a healthy drink for 12-hour shift workers!
Many studies suggest that coffee and tea have incredible health benefits while also giving you an extra boost of energy. Unfortunately, caffeine can also have the opposite effect by leading to rebound fatigue after it leaves your system. Therefore, it’s a good idea to aim for moderate caffeine intake to help minimize rebound fatigue.
Additionally, one of the drawbacks of too much caffeine late in a 12-hour shift is that it can also cause insomnia. And nurses need their sleep to help recover from the hard work we do taking care of patients each day!
Extra tip: Green teas (like this one) can give you an energy boost with additional antioxidant benefits and without the caffeine jitters!
#8. Get good shoes
Nurses must invest in good shoes to maintain foot health.
I have been alternating between my Dansko clogs and New Balance tennis shoes as a nurse for over six years. My feet thank me for it. Invest in quality footwear that is built to protect the feet of busy hospital workers who are on their feet all day.
“I wish I didn’t invest in comfortable, sturdy shoes,” said no nurse ever.
Drink water throughout your 12-hour shift and stay hydrated!
Have you ever worked an entire shift and realized at the end that you forgot to drink water for the whole day. It is so easy to do when you are extremely busy with back to back patients and heavy work assignments.
Invest in a good water bottle with a seal-able lid (to prevent accidental spillage). Keep it where you do most of your charting in the nurse’s station. And try to make it a priority to drink your water every hour during your shift to stay hydrated.
Make your own chia seed water: Add 3 tbsp of organic chia seeds to your water bottle and mix well (you can add more or less to your liking). Within a few hours, the seeds will blow up in size and into a gelatinous consistency.
(Chia seeds are an excellent source of omega-3 fatty acids, rich in antioxidants, fiber, iron, and calcium. Just another easy way to add nutrients into your busy day!)
Prevention of varicose veins: Standing for extended periods causes valves in the veins to become weakened, causing blood to collect in the veins. This causes the veins to enlarge, increase in pressure and stretch, causing unsightly varicose veins.
Improved blood flow and decreased risk of blood clots: A study by The Society of Occupational Medicine found that wearing compression stockings significantly decreased lower limb venous pressure in nurses who stood for very long hours.
Decreased swelling of ankles and feet: Swollen ankles and feet are a common side effect of being on one’s feet for a 12-hour shift.
Many nurses who wear compression socks say that their legs “feel more energized” after a 12-hour shift. Pregnant shift workers are especially at risk of leg swelling (due to increased blood volumes during pregnancy) and should consider wearing them to prevent venous issues.
Nurses need yoga, period. Not only does yoga replenishes depleted reserves after a 12-hour shift, but a relaxed and more focused nurse can give better patient care.
Yoga’s amazing benefits on physical and mental health are well documented in the literature. The Mayo Clinic has stated that “yoga may help reduce stress, lower blood pressure and lower your heart rate,” among many other benefits.
Nurse self-care in the form of yoga is scientifically proven to be beneficial:
Stress management. A study published in the National Institute of Biotechnology Information investigated the effects of yoga on stress coping strategies of ICU nurses. After only eight weeks of yoga, the results showed that the participating ICU nurses had significantly better focus coping strategies and a major reduction in perceived mental pressure. (If that is what can happen after only eight weeks, imagine the impact a regular, permanent yoga practice could have on stress management levels!).
Prevent or eliminate chronic low back pain. Chronic back pain in the nursing population is a common ailment. An evidenced-based review at the Texas Women’s University reported that estimates of chronic low back pain among nurses range from 50%-80%. Yoga not only increases flexibly but increases muscle strength and prevents injuries such as chronic lower back pain.
Are you a nurse who is experiencing burnout and want to live a healthier life? Nurse self-care should not be an afterthought. Do you have any other self-care tips for nurses that you would like to add? Leave a comment!