Overtime And Fatigue

The Ohio house bill 346 also protects nurses by providing laws on staffing. HB 346 “requires hospitals to establish staffing plans, with meaningful input from direct patient care nurses, which are consistent with the principles of safe staffing developed by the American Nurses Association and other nationally recognized organizations” (Ohio Nurses Association, 2011). The American Nurses Association as well as other nursing organizations should continue to advocate for nurses to work towards decreasing nursing workload and preventing burnout.

Though nurses complain about having to work mandatory overtime, unfortunately, it is not a new problem to nursing. Mandatory overtime occurs when a nurse is demanded to work past scheduled hours. Mandatory overtime may happen because of a natural disaster, staffing turnover, or employee absences due to sickness. Some health care managers propose that mandatory overtime has caused

Mandatory overtime is a major problem for RNs and health care in general. In consequence of unequal RN staffing, organizations have adopted mandatory overtime often as a cost savings factor. The purpose of this paper is to voice nurses concerns about the health influences of long-term overtime and the quality of care that they provide.

Reasons for mandatory overtime varies from natural disaster to lack of staff. Many companies, organizations, and hospitals require mandatory overtime because of staffing issues. “Increasingly, however, nurses are reporting that mandatory overtime has become standard operating procedure instead of a last resort to short staffing. In fact, in some hospitals, mandatory overtime is routinely used in an effort to keep fewer people on the payroll, as well as to alleviate immediate shortage needs.” (Huston,

Whether or not mandatory overtime is required varies from facility to facility. Like many other issues, there are both pros and cons to this topic. Witkoski,S, Sloane, D, and Aiken L (2012) did a study and concluded that nurses who worked 10 or more hours a shift were more likely to experience burnout and were dissatisfied with their jobs with an intent on quitting. Burnout can affect the quality of care a nurse provides to patients. Burnout can be the cause of a nurse not noticing subtle changes of patients which could potentially lead to patient neglect. Although there are cons to working long shifts there are some pros. When nurses work 12hour shifts, they often meet or exceed their weekly hours over the course of a 3day work week. Since they would only be working a three-day work week, it provides nurses with a better work-life balance and flexibility (Witkoski,S, Sloane, D, and Aiken L 2012), giving nurses more time outside of their job to do whatever they would like. Getting this kind of flexibility is great for nurses like myself who are either back in school or have families to take care of, or just need a little more time to recover and

Working overtime is a prevalent practice among nurses that hospital management uses to deal with staff shortages. According to Manitoba Nurses Union (MNU), 34% of Manitoba nurses reported working overtime (2014, p. 4). Most overtime worked by nurses in Manitoba is voluntary, however, it is legal to mandate nurses to work overtime if required. Three in 10 overtime shifts worked by nurses in Manitoba are involuntary (MNU, 2010, p. 6). MNU defines mandatory overtime as a situation in which the nurse refuses the offered overtime and the employer orders the nurse to continue working after their assigned shift has ended (p. 7). Mandatory overtime is seen as an absolute, last possible resort for hospital managers, after all other options and possibilities have been exhausted (MNU, p. 6).

After all, hospitals and nursing facilities are required to have nurses around the clock, right? I totally understand this point of view. However, instead of mandating nurses to work overtime, have a back up agency to use to call on for help when shifts need covered. Some may argue that mandatory overtime is great because of the extra money being earned and incentives offered. Once a nurse is "burnt out", money doesn't mean much to him or her. They would rather go home to their families, sit down for dinner and have a goodnights sleep over any amount of money. Hospitals and nursing facilities argue that it cuts cost to mandate over time rather than hiring new employees. I agree with this statement to some extent. As long as mandatory overtime isn't being used often, it may cut some costs. Hospitals and nursing facilities have made this, over time, a standard of practice, so in the long run mandatory overtime is not saving any money. In reality, it is costing more. Nurses being paid time and a half for overtime, the increase in accidents from nursing errors, increase in sick days and more nurses quit so there is a need to hire new nurses. Whenever a new nurse is hired at a facility, that nurse needs to be trained. Each facility has their own protocol and the new nurse needs to be educated on that protocol, as well as simple things such as where supplies are kept, where

When nurses experience fatigue due to excessive overtime, effects that can occur are reduced decision making ability, reduced communication skills, increased forgetfulness, increased tendency of risk taking, reduced ability to handle stress on the job, decreased ability to do complex planning, and inability to recall details which can all danger patients wellbeing. Unfortunately even with all the

Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job dissatisfaction, which in effect decreases total patient care over all. When nurse staffing is inadequate, the ability to practice ethically becomes questionable. Time worked, overtime, and total hours per week have significant effect on errors. When nurses works long hours, the more likely errors will be made. He also argued that inadequate staffing not only affects their patients but also their loved ones, future and current nursing staff, and the hospitals in which they are employed. An unrealistic workload may result in chronic fatigue, poor sleep patterns, and absenteeism thus affecting the patients they take care of.

Within the recent years, hospitals and medical facilities have been experiencing nursing shortages that necessitate more nurses to be present to compensate for the care needed to be given. This requires nurses to be dealt with imperative extended work hours along with their normal shifts with no denial or excuse accepted. Working extra hours are accompanied with negative effects that have an impact on the nurse, coworkers, and patients. A major concern that occurs with overtime is that nurses become fatigued or burnout. Fatigue that is experienced is a result of sleep deprivation from working overtime that is associated with arduousness neurobehavioral functioning

Mandatory overtime has become an increasing problem for nurses who work in many hospital settings. Mandatory overtime is defined as additional hours added to a nurse’s current shift, making the nurse feel as if it’s a threat of being fired or disciplinary action will be taken in some form if they refuse to stay and work. Extensive overtime studies have established and confirmed that there are serious dangers to both the nurse and the patient being cared for in all types of healthcare settings.

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

Limited attention has been paid to the hours worked by nurses, or the effects of these hours on patient safety (Rogers, 2008). Even though most nurses favor 12- hour shifts and overtime, it is associated with difficulties staying awake during times of duty, reduced sleep times, and triple the risk of making an error (Rogers, 2008). The most significant risk of making an error occurred when nurses were scheduled to work 12.5 hours or more.

The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. (Trossman, 2009). Working longer hours in a high stress area will always increase the error rate. Designating an adequate number of RN positions to ensure nurses work an appropriate schedule without overtime and that their workload allows for breaks. Managerial staff must work to develop specific policies about the length of work times based on the setting, patient and provider needs. Those policies should limit nurses from working more than 12.5 consecutive hours. Provide education for all care providers on the hazards and causes of fatigue. Continue to document unsafe staffing conditions and work with others to change the current work culture so that it recognizes the effects of fatigue on patient safety, as well as the nurse. (Berger, et al. 2006)

Studies from different parts of the world made by different health organizations have showed that long working hours and pressured work lead to stress which affects the employees mentally and physically and leads indirectly to low productivity levels. Not only stress, but it can cause a lot more of health issues like extreme fatigue including sleepiness, poor concentration, and increased susceptibility to illness. These symptoms can a have a noticed effect on the general productivity of an organization.