Mandatory Overtime And Its Effects On Patients

West, Ahern, Byrnes and Kwanten (2007) indicate that the new graduate nurses may have not worked full-time in the past; given that graduate nurses begin their career with a full-time job can lead to exhaustion. It was discovered that shift work leads to desynchronisation of physiologically determined circadian rhythms which has a major psychobiology effect and it is commonly perceived the effects of shift work contribute to graduate nurses attrition rate. The NGNs often have a high level of stress due to disturbed sleeping patterns, as they find to adaption to shift work or rotating work hours difficult. Eventually, it leads to feelings of lack of job satisfaction, exhaustion and spending of less time with their friends and family, which can eventually could lead to burnout (West et al., 2007).

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

Another cause of nurse fatigue is lack of adequate sleep. First, working 12 hour shifts means that nurses only have 12 hours to sleep and also conduct other activities of life outside the workplace, while other professionals have 16 or more hours for rest and social activities. This is the reason for the few hours of sleep recorded by nurses with some opting to not sleep at all but take short naps. These are

Mandatory overtime in health professions generally is likely high, although no reliable data regarding its extent are available. In the Institute for Workplace Studies (1999) report, health sector workers averaged a little over three hours of overtime per week - not particularly high. In a survey on mandatory overtime, the journal Nursing2000 reported that 36% said they never worked mandatory overtime. One quarter of the respondents worked mandatory overtime once or twice a month, while another quarter worked it once or twice a week. However, about 14% worked

Nurses spend most of their time taking care of their patients that they forget to be mindful of their own wellbeing. It is very important for nurses to take care of themselves because it is reflected through the care they provide to their patients. Sleep deprivation can increase the chances of a nurse miscalculating a dosage, which can be fatal to a patient’s life or injure themselves by forgetting proper body mechanics. Not having enough sleep and overworking themselves can be the cause for this simple mistake that could have been avoided through self-care. Having at least 8 hours a sleep a night is just one of the few ways a nurse can manage healthy living. A nurse’s work schedule can consists of mainly over

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

It appears that once you become a nurse, the world thinks you are immune from fatigue. I have worked with many nurses that work two jobs or pick up an immense amount of overtime. Sometimes these nurses appear to be in a daze and robotically performing their jobs. I worked with one nurse that would average four hours of sleep each day and drink highly caffeinated drinks all night in order to stay awake. But, nursing fatigue is not just from picking up an extra job or shift. Fatigue affects people like me that have worked rotating shifts for so long that my sleep schedule is basically non-existent. I rotate between nights and days every two weeks, which means I never feel like I have had enough sleep. Even when I worked straight nights,

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.

173). For many workers the schedule was an outlet for discontent; this is because many were forced to work six days a week, some weeks without a day off (Lynaugh, 2000). Nowadays, “60% of U.S. nurses surveyed work at least one type of overtime […] 54% work less than 12 hours a week overtime and 46% work 12 hours or more per week” (Wheatley, 2017, p.213). In addition, traditionally nurse’s shifts were eight hours long; however, in 1980’s -1990’s when structural changes in healthcare occurred and cost containment was put in, nurses started working 12-hour shifts. Because it was less expensive to work 12-hours shifts, instead of 8-hours, this became prevalent in most hospitals in the United States (Weathley, 2017).

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)