How do Hospitals save money changing 12 hr shifts into 8 hrs?

I'm a RN in the Bay Area, CA and there is a trend in the past 3 yrs that I've noticed. Hospitals are getting rid of 12 hr shifts and converting them to 8 hrs; can anyone tell me why? Does this save money from the Hospitals in the log end?

A Managers insight would be great!


- ER RN, "You're here for what?"
I'm not a manager, but I applied at a hospital in California that recently converted to 8 hour shifts (which turned me off because I prefer 12 hour shifts).Anyway, most of the California hospitals that have made the conversion to 8 hour shifts are scheduling nurses for 32 hours per week, which is four 8 hour shifts in a one week period. The hospital systems save big money if floor nurses are working 32 hours per week instead of 36 to 40 hours per week. In addition, a nurse can pick up one additional shift per week without going into overtime.

When a hospital looks at the bottom line ($$) they consider many factors. The largest percent of a hospital budget is in staffing with nursing taking the largest of that. So indeed that is a consideration. However they also look at compliance with codes, reimbursements, litigation risk etc. Evidenced based research has shown that after the 8th - 9th hour on duty the risk of nurse error especially in medication administration. To reduce this high risk of error and the high cost of settlements many are returning to the 8 hour shift. You can research this subject on the ANA, JACHO, and CDC website for more information.

Let us assume that more employees will be needed to cover on 8-hr shifts vs. 12-hours. The cost of benefits will be increased as that is a fixed number for each employee. So the way to save is to decrease overtime and decrease the skill mix. Fewer aides and other ancillaries. For the record, it is getting very difficult for hospitals to make a profit. Ours collects about 27-29 CENTS on every dollar billed and I have been told some facilities collect less. I would not want the bean-counters job.

Quote from PrayeRNurseWhen a hospital looks at the bottom line ($$) they consider many factors. The largest percent of a hospital budget is in staffing with nursing taking the largest of that. So indeed that is a consideration. However they also look at compliance with codes, reimbursements, litigation risk etc. Evidenced based research has shown that after the 8th - 9th hour on duty the risk of nurse error especially in medication administration. To reduce this high risk of error and the high cost of settlements many are returning to the 8 hour shift. You can research this subject on the ANA, JACHO, and CDC website for more information.

8 hour shifts is the new fad thanks to at least one consulting group and some articles in Health management magazines. Our hospital made the switch to 8's but it didn't last long, as it turned out it cost us much more money. The idea is that with 8 hour shifts you can up-staff and down-staff more frequently. In theory, it also means that it's easier to get people work extra shifts since it's a shorter shift. As it turns out, it's much harder to get someone working 5 or even just 4 nights a week to pick up a 5th or 6th. Nights in general are nearly impossible to hire for. And the primary problem was that Nurses were feeling "burnout" even at an FTE they had tolerated as a 12 hour schedule which produced a a large demand to reduce FTE's, which required hiring more Nurses which costs money.The additional 30 minute overlap (typically more like an hour especially with 8 hour shifts), and less time that could be counted as unpaid breaks ended up adding to the cost as well.

Quote from Adenosine6I'm a RN in the Bay Area, CA and there is a trend in the past 3 yrs that I've noticed. Hospitals are getting rid of 12 hr shifts and converting them to 8 hrs; can anyone tell me why? Does this save money from the Hospitals in the log end?A Managers insight would be great!- ER RN, "You're here for what?"

Quote from DoGoodThenGoThese should get you going on your research:Medical Errors and Nursing - NYTimes.comStudy Reveals Widespread Fatigue, Risk For Errors With 12-Hour Nursing Shifts

I've been working 8 hour shifts for years now, and I love it. I don't feel rushed. I get 8-9 hours of sleep per night, so I always feel rested.

When I worked 12's, they always scheduled them back to back to back, and that was the problem for me. When you accounted for driving, getting out late, etc., I would end up with absolutely no time for anything else. I never got enough sleep. They took 30 minutes out of our day for our unpaid lunch, then I had to drive 45 min. each way. Then count on the "late in the shift" admission. I feel so much more rested working 8's.

Lots of wrangling in trying to figure out how to drop people from receiving healthcare coverage.... look for that number to drop under 30.... they won't tell you up front. I see a huge effort to "use" this as a way to eliminate healthcare coverage for many more employees than you may think. Those who currently have it, too might be on that list very soon.

One job I had worked seven 12's in a row, then had 7 off. The off-time was great, of course, and most of the other nurses liked it for that reason. I, however, ended up working five 12's on, 2 off, 2 on, 5 off, because I never felt safe with so little sleep. I remember one time I literally fell asleep during a history-taking session. And once driving home. If I ever have to go back to 12's, they won't be back-to-back.

Isn't having only 2 nurses is a 24 hour period (ie 12 hour shifts) better for continuity of care?