The quantity of nursing care on wards working 8- and 12-hour shifts

Int J Nurs Stud. 1993 Oct;30(5):403-13. doi: 10.1016/0020-7489(93)90050-5.


Interest in 12-hour nursing shifts has been renewed in response to demands for improved cost-effectiveness in the NHS, but the effects of this shift on the delivery of patient care have been unclear. This paper describes the results of a repeated-measures study of 10 wards, using activity analysis to describe patterns of care under an 8-hour compared to a 12-hour shift system. Significant reductions in the amount of direct patient care were found under the 12-hour shift, with corresponding increases in unofficial work-breaks. It is suggested that these findings, which were consistent over all study wards and throughout the whole 12-hour day, demonstrate a "pacing" effect by nurses who face 12 hours on duty. Such a detrimental effect should be a major consideration when coming to any decision to implement a 12-hour shift.

Publication types

  • Comparative Study

MeSH terms

  • Hospital Units* / organization & administration
  • Hospital Units* / statistics & numerical data
  • Humans
  • Nursing Service, Hospital* / organization & administration
  • Nursing Service, Hospital* / statistics & numerical data
  • Personnel Staffing and Scheduling* / organization & administration
  • Personnel Staffing and Scheduling* / statistics & numerical data
  • Quality of Health Care / organization & administration
  • Quality of Health Care / statistics & numerical data
  • Task Performance and Analysis
  • Time Factors
  • United Kingdom
  • Work Schedule Tolerance
  • Workforce