Mandatory Overtime For Nurses: It’s Legal, But Is It Fair?

Here’s an all-too-common scene from just about any hospital in the country: a few nurses are out sick, someone else is taking time off and suddenly, a surge of inpatients places the burden on those nurses who are there.

Every medical facility has to deal with the occasional staffing shortage. Sometimes there just aren’t enough nurses on-hand, and we all know that nurses serve as the backbone of any well-run hospital.

So medical facilities turn to mandatory overtime.

How Mandatory Overtime Hurts Nurses & Patients

In most states, demanding that nurses work overtime to fill the gaps is very legal.

And as a makeshift solution to a temporary understaffing problem, mandatory overtime probably wouldn’t become its own source of difficulties. Many nurses are happy to work extra hours, even if they’re literally forced to do so, because more work means more money at higher pay.

But the US health system relies on mandatory overtime all the time, and it’s become a huge problem. Hospitals have learned that it’s easier, and cheaper, to run current employees ragged than look elsewhere for qualified candidates. Rather than spreading the stresses of providing care across a wide pool of talented workers, most medical facilities choose to concentrate them on an ever-narrowing group of nurses.

Is Overtime Really An Answer To Nursing Shortages?


Studies show that hospitals aren’t any more likely to enforce overtime shifts during nursing shortages, which is what you’d expect if employers were only making people work overtime during staffing droughts.

Surveying 1,000 RNs in North Carolina and West Virginia, a professor of nursing from SUNY Buffalo found that mandatory overtime wasn’t being used to control staff shortages. Instead, a pre-existing policy of mandatory overtime was causing nurse shortages.

How can this situation be anything other than stressful, exhausting and ultimately unfair? Although nurses rarely receive the praise they deserve, nursing is one of the hardest jobs in the world. It’s physically, emotionally and mentally demanding and with mandatory overtime, almost non-stop.

Ask any other worker to put in 12 hours at a time, day after day, and they’d crumble in an instant. But for some reason health care employers institute mandatory overtime as a fact of life, because it’s profitable to them. It’s no wonder that researchers at New York University found that 1 in 5 new nurses leave their first job before finishing their first year.

A Vicious Cycle, With Nurses Stuck In The Middle

This is the definition of a vicious cycle. Working too much leads to burnout and burnout means nurses quit. Nurses quitting means staffing shortages, and staffing shortages mean mandatory overtime.

At the center of it all are nurses, caught in the middle of a cycle they can’t control because mandatory overtime is perfectly lawful. This is exploitation, plain and simple. It needs to stop.

And there’s another problem that contributes to this vicious cycle. With increases in patients, hospitals actually become less efficient. So when real staffing shortages do pose a problem, health care employers have to shell out more money per patient, leaving less to hire new nurses.

Nurses Are Overworked & Underappreciated

A recent survey in the UK found that out of 4,000 nurses:

  • 56% said they spent too much time doing things that have nothing to do with nursing
  • 59% were too busy to provide the level of care they wanted to
  • 31% were looking for a new job

Not only are these hospitals working their nurses to the bone, they’re having them perform tasks that someone else (like Housekeeping!) should be doing. Rather than rely on the expertise of nurses, many facilities are treating valuable staff members as gofers and unskilled labor.

If that survey is any indication, nurses want to provide their patients with excellent care. But of course, they do; you wouldn’t go into nursing unless you thought you could truly help someone. It’s just that most hospitals aren’t letting nurses do the best job they can. Patients lose out, too. Study after study has shown that error rates increase, sometimes by 300%, when nurses are forced to work extra hours.

Even more insulting? Some hospitals report nurses who refuse to work overtime to their state licensing agency, saying they “abandoned their patients.”

Thing is, most nurses know when they’re too tired, too sore and too stressed to properly care for patients anymore. They know they need a break, and that not taking one could lead to a serious error. But when they raise their concerns with management, they’re punished for it.

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