Shift scheduling for hospitals

Common hospital shift patterns

The usual pattern is three eight-hour shifts: 7 am to 3 pm, 3 pm to 11 pm and 11 pm to 7 am, each with a handover overlap at the nursing station. Some hospitals still run the 6-6-12 system of 8 am to 2 pm, 2 pm to 8 pm and a 12-hour night from 8 pm to 8 am. Under the OSH Code, ordinary daily work is capped at eight hours, with intervals, spread-over and weekly limits fixed by government notification, so if you still run 12-hour nights, check how your state treats the extra hours and pay overtime where it applies.

• Morning: rounds, medication, discharges and the heaviest workload
• Evening: admissions from OPD, visiting hours and handover to nights
• Night: fewer staff, casualty admissions and early morning samples
• General 9 am to 5 pm: OPD, administration and elective operation theatre lists

Worked example: staffing a 24-bed ward

A 24-bed medical ward needs 4 nurses in the morning, 3 in the evening and 2 at night. That is 9 nurse shifts a day, or 63 a week. Each nurse works 6 shifts a week with one weekly off, so the ward needs 63 divided by 6, which is 10.5 nurses. Round up to 11, then add one more for leave, training and sick calls, giving 12 on the ward's roll. Twelve nurses working 6 shifts each give 72 shifts a week against 63 needed, leaving 9 spare shifts. Nights come to 14 a week, which works out to a little over one night per nurse per week when shared evenly.

Night blocks and weekly offs

Spread nights evenly and in blocks. Many nursing offices schedule three to five consecutive nights followed by two rest days, so staff are not switching between day and night every other day. ZeniaHR rotation templates run cycles of up to 62 days and can be staggered per person, so twelve nurses on the same template start at different points and the ward stays covered. Weekly offs are part of the template, or set as a personal weekly off for a nurse with a fixed day. Women nurses may work night shifts with their consent and the safety conditions set by the government; keep the consent on file and read the night shift rules.

Swaps and last-minute gaps

Nurses swap duties constantly: a wedding at home, an exam, a child's school function. Allow it, with approval. In ZeniaHR the nurse asks a colleague to swap on the same day or across two dates, weekly offs included; the colleague accepts, then the ward sister and HR approve, and only then does the roster change. When someone calls in sick an hour before the night shift, the ward sister checks the day grid for a nurse on a weekly off or a float nurse from a quieter ward, and any double duty that follows goes through overtime approval.

How to set it up in ZeniaHR

1. Create shifts in the catalogue with codes such as M, E, N and G, their timings, breaks, full-day and half-day hours, and colours that match your ward roster sheet.
2. Flag the night shift as a night shift so punches after midnight are filed to the day the duty began.
3. Build rotation templates per ward type with night blocks and rest days, stagger them per nurse, and assign them in bulk for up to 92 days.
4. Set personal weekly offs for staff with a fixed day and keep rotating offs inside the templates.
5. Allow shift swaps, and tell ward sisters that the roster changes only after their approval and HR's final approval.
6. Check the day grid every morning for shifts below minimum cover and fill the gaps before the evening shift.

Read more about shifts and rosters in ZeniaHR.

Roles this applies to

Frequently asked questions