Nurses are consistently faced with mandatory overtime, which leads to high levels of distress and exhaustion. The realities of the healthcare sector require nurses to work long hours and dedicate extensive time to the profession. Mandatory overtime should be eliminated, as it affects nursing performance, creates dangers for patients and healthcare professionals, and incites issues with federal labor laws.
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Hospitals and medical facilities often struggle to meet staffing requirements to fulfill duties and remain compliant with regulations. It forces nursing staff, consisting of nursing assistants (CNAs) and nurses (RNs) to work extensive overtime. Nursing overtime is prevalent in the United States, with at least 60% of nurses surveyed work at least one type of overtime, and approximately 10% working unpaid hours (Wheatley, 2017). Mandatory overtime is when nurses are forced to work beyond the hours upon agreed upon contract, exceeding the legal working week of 40 hours per week. Although most nurses realize the need for them to work overtime and are glad to do so, utilizing this practice consistently is detrimental to the staff and non-sustainable, commonly leading to high levels of burnout and nurse turnover.
While there are benefits to working overtime, there are also significant negative aspects of working for nurses which affect their performance and quality of life. A study by Lobo, Ploeg, Fisher, Peachey, and Akhtar-Danesh (2018) conducted a large survey of nurses which encompassed their attitudes and self-reflection regarding working overtime. The findings state that “reasons for not working overtime were (1) feeling tired and tired of being at work (50%); (2) having established plans (71%); and (3) not receiving enough notice (61%)” (p. 47). Furthermore, many only worked overtime to help colleagues rather than for personal benefit. This suggests that nurses often feel forced into the practice and it affects their attitude and approach to care.
Another reason to eliminate overtime is the dangers to patients and medical staff that it creates. A meta-analysis using nationwide panel data conducted by Lu and Lu (2016) focused on determining how mandatory overtime affected the quality of service. They found that “…mandatory overtime in healthcare reduces the quality of services provided to patients by healthcare workers” (p. 3578). A decreased quality of care can present risks to patients as nurses are fatigued and face too many tasks, which could lead to human error, and in turn, adverse effects on the patient. This has profound long-term effects on the well-being of nurses, patient health, and the overall effectiveness of the healthcare system.
Mandatory overtime for nurses, however, remains legal under federal law as long as appropriate breaks are given between 12-hour shifts. A study by Kunaviktikul et al. (2015) examined the legal and organizational ramifications of mandatory overtime. They found that “…during the 2000s, several US states passed laws that are against mandatory overtime for nurses” (p. 3581). At least 19 states have made mandatory overtime illegal for nurses, with calls to apply this aspect to federal law. The concept of mandatory overtime was a temporary solution to a longstanding problem, but no significant changes have been made to the practice over the last decades.
It becomes evident that nursing overtime has significant negative effects on nursing performance and practice, thus suggesting that this approach should be eliminated in the healthcare sector. Consistent mandatory overtime leads to risks and dangers to both nurses and patients, while potentially violating labor regulations. Steps should be taken to address this issue to determine a sustainable solution.
Kunaviktikul, W., Wichaikhum, O., Nantsupawat, A., Nantsupawat, R., Chontawan, R., Klunklin, A., … Sirakamon, S. (2015). Nurses’ extended work hours: Patient, nurse, and organizational outcomes. International Nursing Review, 62(3), 386-393. Web.
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Lobo, V. M., Ploeg, J., Fisher, A., Peachey, G., & Akhtar-Danesh, N. (2018). Critical care nurses’ reasons for working or not working overtime. Critical Care Nurse, 38(6), 47-57. Web.
Lu, S. F., & Lu, L. X. (2017). Do mandatory overtime laws improve quality? Staffing decisions and operational flexibility of nursing homes. Management Science, 63(11), 3566-3585. Web.
Wheatley, C. (2017). Nursing overtime: Should it be regulated? Nursing Economics, 35(4), 213-217. Web.