The Issue Of Mandatory Overtime For Nurses And Why It Should Not Be Eliminated From Use By Hospital Management Essay

Over the last decades both public and private hospitals have been experiencing severe financial situations (Everhart, Neff, Al-Amin, Nogle, & Weech-Maldonado, 2013). The financial shortage is associated with delay or even lack of governmental sponsorship and competition from their rivals. Enacting the policy will mount financial pressure on these hospitals that are on cost-cutting strategies. The salaries and wages of nurses are dominating the costs of operation in the hospitals and therefore adding more staff to correct the understaffing will be like creating another problem (Goddard, 2003). Contrary, Empirical studies prove that adequate nurse staffing produces better outcomes for both the staffs and the patients (Donaldson & Shapiro, 2010). These do not mean that the financial performance of the health centers will be at stake. Quality is associated with profitability. Understaffing leads to increased workloads, fatigue and job dissatisfaction. These situations that can be corrected on the implementation of proper staffing policies (Everhart, Neff, Al-Amin, Nogle, & Weech-Maldonado, 2013). The policy aims at offering quality service, reasonable patient-doctor ratios, reducing high mortality rates, improving the health of patients through proper examination and disease diagnosis among other

In the past two decades, a lot of changes have been characterised in the healthcare working systems. One of these changes has been the assimilation of shift work systems and the flexibility in work schedules. The need for 24 hour care makes the healthcare professions to work with different shift systems such as 12 h, 8 h, 9 h or 10 hour shifts. However, the common shift work systems divide a 24-h day in two (12-h) or three (8-h) shifts. Nonetheless, this requires the staff to be adapted with the various forms of shift work schedules.

The case scenario portrayed Jackie, as a typical nurse who was conflicted and stressed out from both the demands of family and of the workplace environment. At home, she was pressured by her husband to take on extra overtime to supplement and augment the family’s income. Thus, in spite of feeling that her skills were not current, Jackie signed up with her previous hospital to be on the flexible staffing pool (Badzek, et al., 1998). As expected, “Jackie found the work extremely stressful. She rarely had the same unit and patient assignment” (Badzek, et al., 1998).

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.

The purpose of this paper is to discuss two things: the legislative process, and workplace issues, more specifically mandatory overtime. Once the legislative process is explained I will go into discussing the issue of mandatory overtime when it comes to registered nurses. Pros and cons of mandatory overtime will be viewed. Once that evidence is presented, I will continue to discuss my position and provide support for my stance. After I have done that, I will include a letter written to local legislators stating my position.

ANA rejects the adoption of overtime as a staffing solution and joints the Congress to establish national legislation to approach concerns about safe staffing and prohibition of mandatory overtime. ANA concludes that overtime is not a reasonable answer and has driven to various matters such as reduce patient satisfaction, an increase in adverse patient events, preventable medication, and medical errors and increased patient mortality. Besides, mandatory overtime reflects on job satisfaction, on nurse recruitment and retention, nurse fatigue and deficits in nurse’s work

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,

For some nurses, mandatory overtime can be an advantage due to financial instability but mostly mandatory overtime can cause fatigue, burnout, injuries, errors, inadequate sleep and deficits in performance. According to research working long hours which consists more than 40 hours a week or over 12 hours a day leads to an increased medication errors and patient mortality. The probability of making medication errors increases tremendously when nurses work longer than 12.5 hours a day. During surveys regarding reasons of overtime, 60 % of nurses stated that overtime was obligatory as part of their job, 29 % of nurses stated that they volunteered and 41% of nurses stated that they were “on call hours” (Bae, 2012)

Mandatory overtime in the field of nursing is described as forced overtime to maintain an adequate amount of staff present to meet the needs of the hospital. With a normal work schedule, a nurse usually works 12-hour shifts, usually three times a week. With the obligatory hours that are extended with overtime due to the continuation of nursing shortages, a nurse’s shift can be continued ranging from 12 to 16 hours, with very short notice. This mandatory action is related to putting not only nurses, but also patient’s health at risk. The advantages that accompany mandatory overtime are overshadowed by the disadvantages that surpass the benefits of working extended hours, therefore, mandatory overtime should not be allowed in the nursing work place.

Nurse staffing refers to the ratio of nurses to patients in a particular unit. The current global nursing shortage is simply wide spread and dangerous lace of skilled nurses who are needed to care for individual patients and the population as a while. A study on the nursing shortage by Linda Aiken of the University of Pennsylvania School of Nursing, fund that an estimated 20,000 people die each year, because they have checked into a hospital with overworked nurses. (The American Nurses Association, Inc., 2010).

The issue of healthcare personnel scarcity continues to be an ongoing challenge across the globe. Invariably, nurses are at the pinnacle in the delivery of quality care in any healthcare setting. The ever-increasing demands for care stem from a patient populace that is emergent, growing older and needing more care due to the escalating shift in their disease process. Hence, nurses are torn between balancing an overloaded schedule, working extra hours and maintaining astuteness and professionalism. This transcends to compromised patient care, nursing burnout makes it difficult for them to experience the rewards of caring for patients in the way they had expected; thereby, adding to the shortage of

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

Nurses provide excellent patient care, teach patients about health conditions, and give advice and support to patients and their families. Nurses have a variety of duties. They must monitor and record patient symptoms, take vital signs, watch patients diet and physical activity, supervise less skilled nurses, and order and interpret tests to access the condition of the patient. Nursing can be a wonderful, caring, and thoughtful job. However, to other nurses: nursing can be a difficult, tiring, and stressful job. Any job can be tough but nursing is emotionally and physically draining on a person. Nursing can be such a burdensome and demanding job sometimes because of the long hours, the exam to become a nurse, and dealing with other people.

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)