Running Head: OVERTIME IN NURSING 1

Present Day Overtime in Nursing

Allison Bilbo

Professional Issues in Nursing

Dr. Crotty
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Present Day Overtime in Nursing

The state of Tennessee has no specific laws restricting or regulating mandatory overtime

for the nursing community. “In any situation in which a state legislature has not enacted laws to

cover important labor or employment issues, the federal Fair Labor Standards Act (FLSA) steps

in to provide citizen with labor guidelines.” (Deskin, 2016)With these guidelines nurses are

entitled to be paid for any overtime hours worked that span over the 40 hour work week, they are

entitled a thirty minute rest break when working more than 6 consecutive hours. Often you find

the average nursing shift has elongated from 8 hours, that it use to be, to approximately 12 hour

shifts. The timing of lunch/dinner breaks can span out throughout a shift. This can fluctuate

depending on the influx of patients, any emergent cases, or a shortage of nursing staff. What

good is a break after 10 hours if you were fatigued at 6 hours and needed a break? Of course

having this guarantee of getting paid what you work and getting a break provided sounds great, it

is burning out nurses all over the country and putting the quality of our healthcare system on the

line every shift this is allowed.

Trends in the medical field for nurses have been affected in congruence with many

factors. A main reason for the need of mandatory overtime is the overwhelming problem of

nursing shortage that the united states is facing. A change in requirements of nursing education

levels (from associates to bachelors degree) has made it more difficult to produce the correct

number of nurses needed for the field. Other factors that have affected the shortage are lack in

the numbers of instructors to produce teachings, pay factors, time and demand of schooling, are

all factors. A major factor that is starting to affect the medical workforce is that so many current

workers are on average 50 years old. These are the fellow people of the largest generation of our
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nation, known as the “baby boomers”. With over half of the workforce comprised of these

workers, they are starting to reach the age of needing more medical care visits. They are also

coming up on the age of retirement. When the shortage is already causing harm , if we lose half

of the workers it will be devastating.

Problems with mandatory overtime are that employers will sometimes demand a higher

quality of patient care without having the adequate nursing staff to obtain such goals. With an

overload of work, if the nurse manages to make it through the shift, they still have to document

everything that was performed throughout the shift. Some nurses have had to stay after there

scheduled end shift to complete these task. This is responsibility of a nurse that comes with the

job, but the matter in how it is presented with the staffing issues, it makes the job more difficult

and in time, fatigues the nurse out more. According to AJN article, “Under their professional

responsibilities as patients advocates, nurses have an obligation to complete all views alerts.”

(Wallis, 2016) Nurses are the patient advocates just like the employers should be advocated for

their employees.

It has been discussed that nurses will work overtime when asked for fear of losing their

jobs in retaliation. Tennessee is a right-to-work state. With that comes pros and cons in itself. It

has been labeled to those unfamiliar with the law, or overly worried about their job status, as

patient abandonment if the nurse refuses to take an extended or extra shift. Tennessee Board of

Nursing made a position statement clarifying grounds of patient abandonment. “Failure of a

licensed nurse to comply with a facility policy involving mandatory overtime, refusal to accept

an assignment or a nurse patient relationship and failure to notify the employing agency the

nurse will not appear to work is an employer-employee issue.” If the nurse feels that he/she is not
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able to continue working due to any reason he/she are able to refuse the extended shift and

responsibilities without the fear of retaliation.

The value of a nurse is based on multiple factors, the main factor being the quality of care

that is provided to patient from that nurse. The value of a nurses competency, judgement, and

abilities are affected on a downward spiral for every hour worked over a 40 hour work week.

“Nurses worked more than 39 hours per week, approximately 200 hours per year more than the

average American worker.” (Hurston 137) Is mandatory overtime of a overworked nurse worth

the value of the quality of care given. Are the goals and outcomes meeting the standards placed

by employer. These are questions that have peaked the interest of many researching the effects of

hours worked versus the quality of care given by said nurse. “Working more than 40 hours in the

average week was related to nurses’ perception regarding medication errors, falls with injuries,

and nosocomial infections after adjusting for nurse characteristics.” (Sung 2012)

I do not support mandatory overtime as a practice in the medical field. It should not be

used as a staffing resource, but for emergent situations. Respecting workers in a manner of not

having demands on overtime should be a more common gesture from employers. With that

respect should come workers who would support the employers and volunteer there time to help

in situations that cause for extra nurses and extra hours. Job morale would go up with the higher

level of satisfied and rested nurses. Chronic burnout of nurses would be lowered which can affect

the turnover of nurses and raise the retention as well. Ridding the nation of mandatory overtime

would, in turn, help the overwhelming fret of the nursing shortage that our nation is facing.
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References

Deskin. 2016, February, 11. Tennessee Overtime and Meal & Rest Break Laws for

Nurses. Retrieved February 9, 2017, from http://nursesovertime.com/tennessee-overtime-and-

meal-rest-break-laws-nurses

Wallis, Laura (2016, February, 14). VA Nurses’ Overtime Lawsuit Moves Forward.

American Journal of Nursing (116/2) Page 14.

Unknown. Tennessee Board of Nursing Position Statement. 1st ed. Nashville: TN Board

Nursing, 12 February 2012, Retrieved 9 February 2017, from

https://www.tn.gov/assets/entities/health/attachments/abandonment.pdf.

Huston, C. J. (2017). Professional issues in nursing: Challenges & opportunities. (4th

ed.) Philadelphia: Lippincott Williams & Wilkins.

Sung-Heui Bae (2012). Nursing Overtime: Why, How much, and Under what working

conditions. Nursing Economics March – April 2012 (30/2)