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Cracks in the 12-hour shift: Some retired nurses would return for 6-hour shifts

Female nurse examining medical records in the corridor

Within the nursing profession, the hangover from the Great Resignation isn’t going away anytime soon. Covid hospitalizations have plummeted (thank goodness), but the nursing shortage is keeping hospitals stretched to the limit.

As you know all too well, your staff is still leaving.

To become travel nurses.

To retire, often years sooner than planned.

To work in entirely different industries.

For staffing managers, especially those overseeing critical areas like ERs and ORs, this begs the question: What do nurses really want? How can you give nurses the work-life balance they crave so they stay? 

This is no longer an idle question for hospital leaders. The nursing ranks have been thinning for years: Since 2016, the average hospital turned over about 90 percent of its workforce and 83 percent of its RN staff. And Covid sent these burnout rates off the charts: In 2020, the turnover rate for staff RNs was at 18.7 percent, a 2.8 percentage point increase from 2019.

With the nursing scarcity at an all-time high, hospitals are scrambling to accommodate the needs of their nurses to keep them from heading toward the exits. And that starts with understanding what their needs are.

The challenge is this: nurses have different ways of defining work-life balance. Some love the traditional marathon 12-hour shifts with 4 days off. Others want shorter shifts with more days on. Many nurses simply want more flexibility from week to week.

Above all, your nurses want more control over their lives. And guess what – they’re in the driver’s seat now. So if you can’t give them that control, they’ll find it elsewhere.

It turns out that there’s no one-size-fits-all for nurses. That means that your approach to staffing can’t be one-size-fits-all, either.

Leaders like you are facing a reckoning in how you approach your work. To attract and retain staff,  scheduling needs to be customized to the preferences of employees. This requires a paradigm shift in how we manage nurse scheduling.

Your world has changed. Are you changing with it?

Escaping the stranglehold of the 12-hour shift

If you want to hold on to your nursing staff, it’s time to toss old assumptions and biases aside. 

For starters, operators need to move away from the sacred cow of the 12-hour shift. Sure, this decades-old model is easy for schedulers to work with. It’s neat, clean, and the stated preference of many nurses.

But it’s also backfiring.

Even though we think that many nurses want to work long shifts to free up bigger chunks of their time, this is by no means a universal preference. 

And hospitals may need to shatter this standard for the sake of both their nurses and patients. One survey of more than 22,000 registered nurses concluded that longer shifts are leading to burnout, dissatisfaction, and many nurses leaving the profession entirely. Other studies have found that 12-hour shifts lead to increased health problems, absenteeism, risky behaviors like drowsy driving, and more medical errors and patient safety.

The cookie cutter 12-hour shift also creates inefficiencies for administrators.

Yes, it’s easy to just check the box and keep the scheduling math simple. But operators know that there’s plenty of waste in this approach. Overstaffing may be the simplest route, but it’s the least economical. 

If operators evolved their staffing models, moving away from a lockstep allegiance to the 12-hour shift, all sides could benefit: patients, nurses, and hospitals. So what’s trapping us in the 12-hour shift mindset?

Inertia and a failure of imagination are keeping everyone stuck. 

Most operators only know how to do things the way they’ve always done it. That is to say, the laborious process of building out nurse schedules manually. Customize narrowly around the schedules of individuals? Are you crazy? It takes all day as it is to try to piece the puzzle together.

That’s because most hospitals don’t have the tools to approach staffing any other way than the hard way.

But that’s changing. Modern AI and machine learning tools (horn toot here: like Polaris AI) are changing the game for operators, allowing them to meet the new demands of nursing staffing.

How does AI change the staffing game? 

In the case of Polaris AI, the power of AI enables operators to predict patient volume by the hour, set parameters around nurse ratios, and then automatically create efficient schedules in minutes that are tailored to the precise needs of both the department and its employees.

This represents a radical change in the dynamics of staffing. From a top down rigid model to a win-win collaboration.

The definition of insanity is doing the same thing repeatedly and expecting a different result. Nurses have voted with their feet, and hospitals can’t expect the trendlines to reverse without a drastic change. 

The 12-hour shift needs to be dismantled as the only way for nurses to work. New technologies are overdue to modernize a manual process. Nurses want control and flexibility over their schedules, and if hospitals want to reduce turnover, staffing leaders need to step up to give them what they need.