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Contract June 8, 2018

How to Handle Mandated Nurse Overtime

Nurses fill an important role in patient care, and the increasing need for qualified RNs has left some facilities short on trained medical staff. Mandated nurse overtime has been a common solution, but some say this puts an unfair burden on these caring professionals. Learn all about mandated nurse overtime, the benefits, and the drawbacks, and find out what you can do if you're affected by this growing trend.

What Is Mandated Nurse Overtime

Hospitals schedule nurses based on anticipated demand for different areas of the facility. Sometimes, a hospital is unable to hire enough staff to cover all shifts, unexpected events require additional staff for care or members of nursing staff are unable to work their shifts due to illness or family emergencies. This leaves the medical facility without the staff it needs to fulfill care obligations to patients. To avoid this scenario and ensure the hospital always has the nurses it needs, some states let medical facilities adopt mandated nurse overtime policies. Mandated overtime requires nurses to work overtime hours without their consent, letting the hospital take disciplinary action against RNs who refuse. Although not a new practice, this is a growing trend within the medical industry and has several pros and cons that are sparking debate.

The Pros Of Mandated Nurse Overtime

From the hospital's perspective, and sometimes the patients it cares for, mandated nurse overtime is an easy solution to staffing shortages. Requiring nurses to work overtime when needed ensures there is always the necessary number of RNs on hand without the inconvenience of hiring additional staff. This lets the hospital limit the nursing roster to the number needed to fill each full-time shift, benefiting those nurses by guaranteeing them full hours each week. For facilities in rural areas with a small applicant pool or those that can't afford to hire additional employees as a precaution, mandated overtime solves temporary staffing shortages so incoming patients can receive the care they need. Nurses who don't mind working long hours to collect the additional overtime pay can also benefit from this arrangement.

The Cons Of Mandated Nurse Overtime

On the other hand, many feel that mandated nurse overtime places an unfair burden on nurses who are already overworked. "When hospitals use mandated nurse overtime, it demonstrates a failure of the hospitals' HR management," says Dr. Kate Tulenko, CEO of Corvus Health. "Imagine after working a 12-hour shift being told you can't go home and take care of your children but instead have to work another 12-hour shift. That results in fatigued, dejected nurses taking care of hospitalized patients."

Making It Work

If mandated nurse overtime is a deal-breaker for you, there are a number of states that have adopted laws regulating this practice. Working in these states will protect your right to refuse overtime hours without risking your position or professional reputation. If you find yourself in a facility that uses mandated overtime and are unable to relocate or switch hospitals, you still have a few options that may improve your position over time. Write to your state legislators and ask that they address the issue or get involved with a union or local organization that is already advocating for change. You can also attempt to influence better practices at your facility.

Dr. Tulenko recommends hospitals keep "floater" nurses on staff who work shifts without an assigned ward. "When they come in for their shift, they are told which ward has a nurse shortage, and they go to that ward to care for the patients," she says. "Hospitals should also have a pool of PRN (pro re nata; Latin for 'as needed') nurses who can be called in to cover shifts if nurses call in sick, etc."

Whatever side of the debate you find yourself on, mandated nurse overtime is a common practice in many states, but many nurses and their unions are pushing back. While the practice can be beneficial for medical facilities, it can also cause harm to nurses and their patients. For now, it's important to keep the conversation alive and do what you can to protect yourself, and other nurses, from unfair policies.

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