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Multiple Jobs Add to Nurse Fatigue

Alexandra Wilson Pecci, for HealthLeaders Media, January 28, 2014

For instance, Robert Wood Johnson Foundation research shows that even though state mandates are helping to curb mandatory nurse overtime, "regulations targeting hospital compliance overlook regulating nurses themselves, who can choose to increase their work hours (and fatigue) by working multiple jobs."

An 'Ethical Responsibility' to Consider Fatigue
An ANA position statement says that "Registered nurses should consider the impact that multiple jobs have on their level of fatigue and ability to practice safely" and that "all registered nurses have an ethical responsibility to carefully consider their level of fatigue [PDF] when deciding whether to accept any assignment extending beyond their regularly scheduled work day or week." (ANA is revising its position statement on nurse fatigue; the public comment period is open until February 10).

ANA spokesperson Adam Sachs tells me via email that: [The] "ANA does not know of any laws or regulations prohibiting nurses from working second jobs. We have heard anecdotes about employers requiring employees to fill out a form to notify them prior to taking a second job. There also may be organizations that prohibit nurses from taking second jobs by contract, but we can't verify that."

One nurse leader who's had experience with nurses working multiple jobs is Kathryn Hughes MSN, RN, program coordinator, nursing administration at University Medical Center in Las Vegas. She tells me via email that as a clinical manager, she often sees nurses who have multiple jobs, such as ones who have two full-time jobs; work per diem at several different locations; work full-time at one job and per diem elsewhere; or work as both a full-time nurse and a nursing instructor.

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5 comments on "Multiple Jobs Add to Nurse Fatigue"

Jennifer Fox (2/18/2014 at 10:18 PM)
If a nurse cannot live on the meager income received with just one job while going to school and supporting a family, then perhaps that is the wrong field to pursue in the first place. Many nurses are trying to move out of the quagmire of all work no pay that nursing offers. There are plenty of well paying jobs with regular raises, advancement and educational assistance that would not require a second income in order to live a far better existence. Informed school counselors could curb a lot of the problem of students going into a field that looks much greener and friendlier than it is. Since there is no chance of increasing pay, improving working conditions or staffing appropriately for safe patient care, nipping the problem in the bud seems reasonable.

Andrea Sehmel (2/5/2014 at 2:08 PM)
I would say that nurses could benefit from financial counseling; it's definitely not part of our education - it's assumed that we absorb it somewhere, and that's not necessarily the case. It's like cutting out salt for a hypertensive patient, though, it's a hard habit to change - the long-term effects are not sufficiently tangible now. Further, pay for nursing educators has to change - I took on a teaching position after a back injury made direct patient care an impossibility... with a 60% pay cut. State nurse professional organizations could offer financial counseling for nurses. State legislatures need to significantly improve educator pay, or face dire shortages.

Judy Sheehan (2/3/2014 at 4:46 PM)
I have noticed many nurses who work part time because that is what is available at their place of employment. If employers hire nurses as part-time employees to reduce expense and avoid the cost of benefits then you would expect nurses to hold more than one job. Nurses should be held accountable for practicing in any impaired state. It is understanding that fatigue causes impairment that must be incorporated into the nursing profession.