posals and/or policies that change eight-hour shift structures do appear to be in the works in a variety of settings (American Nurses Association, 1999a, 1999b, 1999c). The benefits of change can be inferred from the structure of the standard shift. Typically during an eight-hour shift, three sets of nurses must report to their supervisors three times over the course of one day. Embedded in this practice is the possibility of losing important patient-care information, as staff hand data to the next rotating shift. In a 12-hour shift structure, daily staff rotation occurs twice only, thereby creating a lesser chance of losing information. There is a view that productivity may slip, especially for persons older than 50, who have been on duty for more than eight hours (Creagan, 1998). However, the benefit of maintaining continuity and integrity of data during transfer has been thought to outweigh this risk:
Having only two nurses care for the same patient in a 24-hour period allows for more concise and complete evaluation of the patient's outcomes, which expedites the shift report. . . . Having to give only two shift reports instead of three allows for more time for patient care, patient education and/or time to catch up on documentation (Levesque, 1998).
The fact that flexible scheduling protocols have become a part of hospital-nurse contract language is instructive about a rather significant change in thinking on the issue, at least in some settings. The American Nurses Association (ANA) (e.g., 1999a) lists flexible-schedule contract language for nurses current in ten health-care facilities (nine in Ohio, one in New York).
The typical American work week is 40 hours in length, which means that a 12-hour shift structure in a clinical health-care setting that were spread over three days would amount to a three-day work week comprising 36 hours. In order to arrive at a 40-hour standard for full-time nurses, full-time work weeks hav...