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Stop Requiring Nurses to Work Overtime

Alexandra Wilson Pecci, for HealthLeaders Media, January 31, 2012

When one of your nurses calls in sick, or if your organization is experiencing a staffing crunch, what do you do?

The answer is different for every organization, but here's one thing you probably shouldn't do: require mandatory overtime.

More states are restricting mandatory overtime in an effort to reduce nurse fatigue, which not only jeopardizes the health of patients, but of the nurses themselves. But according to Carol Brewer, PhD, RN, FAAN, professor at the School of Nursing, University at Buffalo, hospitals shouldn't wait for state laws before they do away with mandatory overtime requirements in their organizations.

That's because safety isn't the only problem that can stem from mandatory overtime; Brewer says mandatory overtime is a "dissatisfier" that can be a factor in high turnover rates.

"There is just simply no question that mandatory overtime is repugnant to most nurses," Brewer tells HealthLeaders. "Most nurses have families, many of them have children…you tell a nurse who has to pick up her child from the daycare that she has to work another eight hours? That's just devastating to people's personal lives."

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1 comments on "Stop Requiring Nurses to Work Overtime"


Chris Fox - Avantas (2/1/2012 at 9:45 AM)
In the article, Dr. Brewer mentions the use of auction systems for staff to fill open shifts. We recently conducted a research study (which will be published shortly) that exposes some of the dangers of reactive programs such these, namely: program abuse (e.g., 11th hour bartering), inefficiency, spiraling costs, and a sense of entitlement among nursing staff. With a reactive staffing approach, don't be surprised by these outcomes because "you get what you incent." Rather, proactive incentive shift management, where shifts are posted up to a month in advance and rates drop as shifts are picked up (and the severity of the need decreases), is a much more effective way of filling open shifts. This protocol promotes scheduling further in advance of the shifts and eliminates the last minute scheduling chaos that can be common on the unit level. This proactive assessment of patient volume is generated with the use of predictive analytics, and has proven that staff are willing to schedule early in the process with more than 75% of open shifts picked up more than two weeks ahead of the shift date. That being said, in our experience there are often two main issues that contribute to the use of mandatory overtime (in addition to the lack of accurate forecasts of patient volume). - A silo approach to staffing, where resources are not shared across the enterprise - The lack of right-sized sources of core and internal contingency staffing Getting a handle on these two elements have helped our clients realize tremendous reductions in overtime and agency usage, while positively impacting continuity of care, staff morale, and quality.