All hospitals should work 24/7

Rotating shift: Tips for shift work in the hospital

Working in rotating shifts is a great challenge in many ways. Due to the different working hours, private life is often more difficult to organize with shift work than with a job with fixed working hours.

Nevertheless, around six million employees in Germany work alternating shifts - especially in sectors in which shift work is indispensable, such as B. in the hospital.

Changing shifts in the hospital are unavoidable

Treating and caring for patients in the hospital is a 24 hour job. Accidents happen or operations are necessary at night too. There is therefore no other option for hospital employees than to work alternating shifts. This affects both nurses and the doctors employed in the clinic.

In this respect, outside of the hospital administration and the staff for catering and cleaning, a large number of hospital workers are expected to align their own lives with the clinic's shift schedule. As a rule, there is only room for special requests in particularly well-founded exceptional cases.

Rotating shift vs. shift work: Clearly separate terminology

When working in shifts, it is important to first clearly separate different terms from one another. According to the classic definition, as can be found in Section 7 (1) TVöD, there is a rotating shift if the entire company or a clearly defined sub-area is worked in early, late and night shifts throughout the day and this rhythm also continues Sundays and public holidays is retained. Hospitals almost always fall into this category as they usually never close, but operate continuously.

In contrast, alternating shift work is used when an employee can be deployed in all three shifts. The term alternating shift therefore refers to the company, while the term alternating shift work refers to individual employees. If there is talk of alternating shifts for individual workers, this means that the worker concerned is only employed in one or two but not in all three possible shifts. There is no need to go into the finer details here, as most of those affected can be deployed in all shifts in the shift schedules of the hospitals.

Legal regulations on shift work

Since working in changing shifts occurs not only in hospitals, but also in many other economic areas, there are clear legal requirements for the protection of employees who work in this form. According to the Working Hours Act, the following requirements apply:

  • No more than eight hours of work may be performed per working day.
  • In exceptional cases, the daily working time can be extended to ten hours
  • There must be a rest period of at least eleven hours between the end of a shift and the start of the new view.

Special precautions must be taken if work is carried out regularly at night. If overtime is incurred in this context, it must be compensated for within a period of four weeks. Furthermore, employees who work at night are entitled to compensation for time off or a supplement to their wages.

Young trainees and expectant and nursing mothers are generally excluded from shift work. In the first case this results from Section 14 (1) ArbSch and in the second from Section 8 (1) MuSchG. It follows from both regulations that reworking is excluded in any case and that the working hours for the workers concerned must be between 6 a.m. and 8 p.m.

What can be done in the event of violations

Working in shifts is usually only carried out where it is essential, e.g. B. in many social jobs in hospitals, in nursing or rescue services, but also in the police and fire brigade, security services and shipping companies, but also in many production companies and the automotive industry.

Otherwise, most employers would usually save themselves the hassle associated with this type of employment. All the more so since the supplements to be paid for night work are quite considerable. In this respect, shift work means a burden for everyone involved. Accordingly, if violations occur in the hospital, a personal conversation with the management of the department or the clinic should always be sought first.

If this consultation does not lead to success, compliance with the legal requirements can be checked by a court. It should be noted, however, that there may be exceptions to the legal rules described above. This can be done by way of a collective agreement or a company agreement.

Different agreements are also made in individual employment contracts. These then often stand up to court despite the basic legal rules, because the individual contractual agreement takes precedence over legal requirements. In this case, action cannot be taken against the operational exercise with regard to the design of the shift plans. Depending on the structure of the contract, however, it can make sense to have its validity checked by a specialist lawyer for labor law.

Shift workers can do this for their health

Finally, it is important to address the health risks associated with working in alternating shifts. The constantly changing day and night rhythm can have a number of consequences. These range from increased blood lipid levels and hormonal disorders to a significant increase in the risk of strokes. In addition, there can be cardiovascular problems, high blood pressure and sleep disorders.

In addition to compliance with the legal requirements by the employer, employees working in alternating shifts can also personally contribute to mitigating the health consequences of shift work.

Light food: If you want to go straight to bed after work, you should eat light and easily digestible food between shift and sleep. Fatty and rich food is heavy on the stomach and can otherwise quickly lead to a sleepless night.

Avoid alcoholic and caffeinated drinks: Shift workers often indulge in a bottle of beer or a glass of wine after work in order to be able to sleep better after the shift. This is generally not advisable, because alcohol is a neurotoxin that prevents the body from falling into the regenerative deep sleep phases. Likewise, shift workers should avoid coffee and other caffeinated drinks in the last four hours before going to bed, because the stimulating effect is more likely to keep you from falling asleep quickly.

Adapt everyday life to the rhythm of working hours: Basically, it makes sense in the context of shift work to put the sleeping and waking phases beyond the shifts in such a way that the body finds a sufficient degree of relaxation. In order to get used to the changing work shifts, z. B. recommended going to bed a little later or earlier on the last working day of the shift, depending on which shift you are changing to.

Rituals help you fall asleep: Sleep rituals help you relax and help you fall asleep faster. This can be, for example, certain music or an audio book, or a piece of chocolate. After a short time, the body gets used to the ritual and switches off significantly faster due to the trained signal.

Switch off sources of interference: After a night shift, it makes sense to isolate yourself and systematically switch off sources of interference such as cell phones, landlines and doorbells so that you don't wake up in the middle of a deep sleep phase. In order to pretend it is night, the bedroom should be darkened and the room temperature should not exceed 19 degrees Celsius. By the way, it is recommended to wear sunglasses on the way home after a night shift so that the retina does not get too much sunlight and consequently cause problems when falling asleep.

By the way: Employees who work in alternating shifts can have their health checked every three years at the employer's expense. 50+ employees even annually. If this check-up shows that shift work has an unfavorable effect on health, an employee according to Section 6 of the Working Hours Act is even entitled to a job that is mainly performed during the day.


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