Long Nurses' Hours Endanger Patients

November 7, 2003
Many hospitals and nursing homes are endangering patients by allowing or requiring nurses to work more than 12 hours a day, according to the National Academy of Sciences.

Such long hours cause fatigue, reduce productivity and increase the risk that the nurses will make mistakes that harm patients, the academy said in a new study:

• Many nurses and nursing assistants worked more than 12 consecutive hours, with some working double shifts of 16 hours.
• In an earlier study, 27 percent of nurses at hospitals and nursing homes reported that they worked more than 13 consecutive hours at least once a week.

The academy found overwhelming evidence that as levels of nurse staffing rose, the quality of care improved because nurses had more time to monitor patients and could more readily detect changes in their conditions. Therefore, they recommend:

• Intensive care units at hospitals should have one licensed nurse on duty for every two patients; nursing homes, should have one registered nurse for every 32 patients and one nursing assistant for every 8.5 patients.
• To reduce "error-producing fatigue," state officials should prohibit nurses from working more than 12 hours in any 24- hour period or more than 60 hours a week.

However, the Bush administration said last year that it had no plans to set minimum staffing levels for nursing homes, in part because such requirements would generate billions of dollars in additional costs for Medicaid, Medicare and nursing homes.

The complete text of the study is available online.

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