Are these really the people that should be required to work so much? Isn’t their job about handling life and death daily? Wouldn’t we want exactly these people to come fully rested to work every single day and be fully staffed?
I don’t know if there are jobs with similar stakes that are so carelessly staffed and disgustingly paid.
If I recall, most medical mistakes take place over shift changes. Things like a patient getting a double dose of meds because they didn’t realize the prior shift already gave them. The idea is that minimizing the number of shift changes reduces the number of mistakes.
This is the explanation I’ve heard. It seems like someone should have thought of a better solution by now, though.
This is accurate. It has to do with minimizing handoff risk.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7539758/
Lots of uneducated responses in this thread that are pure conjecture and drivel.
That study doesn’t really address the issue here though. That study demonstrated hand-off risks. But as far as I can read, it didn’t address shift length at all. All the providers in question had 8 hour shifts.
Obviously hand-offs produce certain risks. But that’s a trivial question. Obviously changing shifts will have some negative effect as providers must get up to speed. But the right question to ask isn’t “do hand-offs produce risks?” The right question to ask is, “if long shifts are used, do the reduced medical mistakes from the shift change counteract the increased medical mistakes from fatigue and unreasonable shift length?”
Do you have any studies that show this? Otherwise the benefits of long shifts are pure conjecture and drivel.
It’s a balance between minimizing handoffs and ensuring fatigue is managed appropriately.
https://www.nurseregistry.com/blog/12-hour-nursing-shifts-pros-and-cons/
https://medprostaffing.com/nursing/12-hour-shifts-in-healthcare-benefits-challenges-and-how-nurses-can-thrive/#%3A~%3Atext=By+spending+longer%2Cbuild+stronger+patient
https://nann.org/wp-content/uploads/2025/04/1.4.1_Effect-of-Staff-Nurses-Shift-Length-and-Fatigue-on-Patient-Safety-and-Nurses-Health-f89.pdf#%3A~%3Atext=Overtime+is+often%2Cand+healthcare+errors.&text=From+an+administrative%2Chand-offs+and+shift
https://www.hseblog.com/frms/#%3A~%3Atext=Healthcare+has+long%2Cthe+key+benefits
https://pmc.ncbi.nlm.nih.gov/articles/PMC3608421/
Yeah but those studies are about longer shifts (12 or 13 hours), not doubles or triples as OP asked. I don’t know how common it is for nurses to have 16-24 hour shifts, but it seems like that was the original question.
When I worked as a nurse in CA, the standard for shifts was 8 hours, we had 3 shifts in 24h. Some travel nurses took 12h shifts, but staff RN had 8s. Not saying we never made mistakes, but it can be done with proper staffing (4 patients to hand off instead of say, 7) and a culture that respects the handoff time. We did it at the bedside in most cases so the patient could hear what was going on. In CA there are strong unions advocating for patient safety, and as a result, minimizing exploitive working conditions. We were still exploited to be sure, but not like if you’d dropped that hospital in any other state without those protections. Pay was outstanding as well.
Strong unions are the answer to this problem, at least for nurses/support staff. Idk about docs and residency but that is a big part of why becoming a doc never seemed attainable to me.
As a patient I really liked bedside handoff. Because I’m supposed to theoretically be in charge of my own care, right? Can’t do that unless you tell me what’s going on.
do the travelling make more than the ones staffed in the hospitals, i heard they do in some areas.
It depends on several factors, the staffing company, specialty, etc. but yeah they probably make a little more, but there is the trade-off of longer shifts, health coverage (mine was 100% covered by the HMO I worked for), and workplace culture. But even staff nurses had opportunities for extra shifts or staying extra to make a little more money. My base pay was good enough the thought of staying one more minute over almost never appealed to me, though.
that make sense, if there is a region that is very understaffed i assume those place would pay alot more too.
Yeah during Covid you should have seen my inbox, recruiters offering like $12000 sign on bonus for 9 week contracts, like $4000 a week in rural New York or Florida. But I had fucked off to Norway by then so, wasn’t for me. And I’ll never work as a nurse anywhere but California anyway (until the other states follow suit and mandate safe staffing by law).
yeah our unit recently started a “quiet hours during handoff” policy. Patients kept coming up to the window to ask for drinks which is both a privacy thing and a more interruptions = more mistakes thing. Patients hate getting told to keep it moving but like. Trying not to kill you here bud.
I’ve never known a thirstier bunch of people until I was a nurse, and I used to wait tables. Like surely you’re not going through this much liquid at home.
The study only concludes that this manner of handing off is risky, nothing more. Going “our method of handing off is bad, so we will extend work hours and continue handing off in the same way” is piss-poor conclusion. Change the way things are handed off e.g let the physician tail the other physician for 1hour to 30 minutes into their shift, improve the data collection and data display methods to allow a clear patient status to be shown, etc.
Additionally, the study doesn’t compare handoff risk to work-length risk. You’re taking one single data point and drawing wide-ranging conclusions from it.
I mean, in my experience a lot of those “mistakes” are kind nurses saying “fuck this idiotic Emergency Department Physicians Assistant. Someone go get the MD. This patient is in a shitton of pain why did they only prescribe a half a milligram of relief? I cannot find the patient’s face or butt or really tell the difference to tell how much pain they are in exactly though so I will just write down a 7. Whoopsie poopsie they just got the dose twice oh no look at them they are not screaming anymore we will call treatment a success” type mistakes.
But I have also had some very excellent nurses
This! The long shift benefits the patients.
The number of hours worked per week is what should be reduced (without loss of pay).