Nursing Shifts

This research will examine issue fronts relevant to a changing nursing shifts from three eight-hour to two twelve-hour daily periods. The research will set forth the background and context in which such a change might be contemplated and discuss the benefits and strategies associated with instituting this change in a clinical health-care setting.

1. Over the course of the 1990s, as the American unemployment rate has steadily fallen and the level of general prosperity steadily risen, there has emerged a body of cross-industry discourse on the subject of how best to manage workers and retain valued workers. Flexible staffing and scheduling have been one such response.

In its most general sense, flextime, as it is called, changes starting and ending times of a worker's schedule but retains the same total hours of regular employment (Bank, 1998). advocated from workers' point of view as a method of balancing work and family life, and from employers' point of view as an strategy that can allow an organization to "realize its short-term service and production goals and to reap the low-cost benefits of a contingent work force" (Brown, 1998). Some version of formal or informal flextime is offered by an estimated 85% of all larger organizations. One health-care corporation, CIGNA, has nearly one-third of its 37,000 employees in flexible scheduling arrangements, on the theory that "letting employees work part-time or compressed work weeks with full benefits saves money in the long run

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ysicians aren't asked twice about the same concerns nurses might have. Increased communication with less repetition of information between the nurse and the patient/family members occurs. Patients know who their nurses are" (Levesque, 1998) A key hindrance to implementation of 12-hour shift structures may lie with nurses who resist change from the 8-hour structure: "More than 90 percent of us are over 30 years old. Twelve-hour shifts are just too long. After eight hours, our mental acuity, tolerance level and ability to care starts fading" (Creagan, 1998). Emotions run high on this aspect of the issue, but the core concern appears to be that the physical wear and tear on the nurses who must adjust to 12-hour shifts would be excessive. A second hindrance to implementation of 12-hour shifts is the historical tendency of clinical organizations to prefer the administrative simplicity of the 8-hour structure. This is so especially in the context of health-care organization mergers and acquisitions, and it is in the background of labor disputes cited earlier, which reveal the cost consciousness of institutions seeking economies of scale. Consider the so-called "8 and 80" structure, often made a part of union agreements and a feature of

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