Nurses working long work hours can be deadly for patients

Kathleen Blanchard's picture
Nursing Jobs

Patient mortality is found to be more likely when nurses work longer shifts.

Researchers from University of Maryland School of Nursing and Johns Hopkins University School of Medicine have been studying the impact of staffing in hospitals on patient outcomes, and also on the well-being f nurses. In a new analysis, they found deaths related to pneumonia and acute myocardial infarctions were more likely to occur when nurses reported working long hours.

Alison Trinkoff, ScD, MPH, RN, FAAN, professor at the School, and co-authors Meg Johantgen, PhD, RN; Carla Storr, PhD, MPH, RN; Yulan Liang, PhD; Ayse Gurses, PhD;and Kihye Han, MD, RN previously found working 12-hours shifts sets nurses up for injury, leads to sleep deprivation and increase the chances of patient errors. This time they investigated patient outcomes relative to schedules that mandate longer work hours.

"Alertness and vigilance required for providing good nursing care depend upon having an adequate duration of quality sleep and rest," says Trinkoff, "and long work hours can impact the quality of nursing care and can increase the potential for error."

For the study, the researchers randomly surveyed 633 nurses working in hospitals in Illinois and North Carolina. The findings, published in the journal Nursing Research, titled "Nurses' Work Schedule Characteristics, Nurse Staffing, and Patient Mortality," found though 12-hour shifts might be appealing to many nurses, shift work in general can lead to sleep deprivation.


Since the 1980's, hospitals almost exclusively ask nurses t work 12-hour shifts as opposed to 8 hours - something that started during the nursing shortage.

Nursing work hours may also be increasing to compensate for decreasing physician work hours in hospitals because the medical profession has taken steps to limit the hours a physician in training may work, whereas nursing has not taken similar steps," says Trinkoff.

She adds, the findings that long work hours can lead to poor patient outcomes is "important and should lead to further study and examination of nursing work schedules." She adds, "Now that we have data that these conditions affect the public adversely, there is even more reason for providers in each hospital and clinic to look at the situation and find solutions."

The new study that is part of a series investigating how long work hours impact patient safety and mortality found higher chances of patient deaths from pneumonia and acute heart attack when nurses work longer, 12-hour shifts. The findings from the researchers found nurses are more prone to errors from working long hours and lack of time off.

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