Working overtime for nurses has merits and demerits considering the working environment, risks, and benefits of the situation. A considerable number of nurses would prefer to work overtime to boost their salaries. However, doing so increases work stress and fatigue. It also increases the risks of poor service delivery and other hazardous risks and exposures in a hospital environment. But the nursing shortage crisis pushes hospital management and policymakers to adapt over time as the most feasible solution. Nurses have to work overtime to cater for the deficit. Also, nurses may derive some obligation from their ethical considerations to provide services to those in need even when the benefits are minimal. Mandatory overtime implies that the nurse has a responsibility to work an extra number of hours beyond contracted shifts. Thus, they have no choice over the matter and have to work the extra period. Mandatory overtime may imply the period that nurses spend during certain occasions like waiting for the next shift nurse or working an extra shift. Mandatory overtime does more harm than good as it leads to adverse patient outcomes including medicine errors, nurse fatigue, and burnout, as well as hospital-acquired infections.

Mandatory Overtime

Mandatory overtime is detrimental to healthcare service provision. According to Bae and Yoon (2014), banning necessary overtime policies improve nurses working conditions and quality of service. Working hours have a close relationship with burnout. Burnout and fatigue are the most common factors that lead to a lack of motivation and reduced effectiveness of nurses at work. Exhaustion is a form of psychological reaction that results from work-related stress. Generally, nurses work for more hours than the stipulated time in their contracts. The leading cause of the situation is the chronic shortage of nurses in different states and countries. The lack of professional nurses pushes organizations to offer overtime opportunities for nurses. Also, the low wage and remuneration for nurses push the nurses to work overtime as a means of boosting their income. However, working overtime is detrimental to the nursing profession and service delivery. According to Montgomery et al. (2015), workload and job demands can lead to emotional exhaustion. Increased emotional fatigue and job-related stresses increase the risk of burnout. By extension, burnout results in the reduction in major key performance indicators including nurses’ performance, patient safety, and patient satisfaction (Choi et al., 2018). Increasing nurses working hours should improve the productivity of the medical institution. However, the possibility of a burnout beats the essence of the decision. In other words, increasing the working hours reduces the effectiveness of the nurses.

Pros and Cons of Mandatory Overtime

Evaluation of the feasibility of increasing nurses’ working hours is usually a curative measure to combat the chronic shortage of nurses. The proponents of mandatory overtime for nurses base their argument on the idea that nurses should be able to work a few extra hours. They also use the boost in income as the main advantage or benefit of overtime to nurses. However, they tend to overlook the impact the decision has on nurses, patients, and medical institutions. Mandatory overtime implies a denial of rights for the nurses. Like any other citizen, nurses have rights and liberties. Mandatory overtime is an infringement on the rights of the nurses to work under the stipulated working hours a day or a week. It is also an infringement on the nurses’ ability to contract as individuals of sound mind. Overtime implies working beyond the time stipulated in the contract. In other words, mandatory overtime suggests forceful imprisonment and forced labor. The term mandatory means that the nurse has little or no say in the matter. The enforcement for compulsory overtime implies working without consent. It is a form of forced labor that many nurses may not agree to. However, federal law protects employers through the provision that employers can require employees to work overtime. Overtime lies under the Fair Labor Standards Act (FLSA), which describes the compensation criteria for over time.

However, forced overtime to have social impacts on the lives of the nurse that the employer cannot compensate with monetary compensation. It denies the nurses the possibility of having a work-life balance. Imposing forced overtime on nurses implies that they have to work during unplanned periods. The nurses may have used the time for other personal duties including family time and social interactions. Often, the employee has to choose between working overtime and job loss. The employee has no choice but to work the extended period. However, the employee has to trade between work and social life. In this case, the employer forces the employee to forfeit social life. Mandatory overtime reduces the nurses’ ability to find a balance between the work and other aspects of life. As a result, forced overtime subjects the nurse to psychological and emotional pressure. The nurse has to find a balance between work and other life factors. Hence, the nurse may spend a considerable amount of time and energy trying to strike a balance between the elements.

The two parties to mandatory overtime have opportunity costs resulting from the decision. Opportunity cost is the value of the factor that each party chooses to forego. The nurses have to renounce their social life factors to please the employer. They decide to either continue working or to leave the work by evaluating the value of their social lives against the value they derive from employment. Hence, mandatory overtime could be one of the contributors to chronic nurses’ shortage. Nurses that value their social life over an increased in income may opt to leave employment or simply the nursing profession. The employer also has opportunity costs arising from the situation. If a nurse chooses to vacate the position or the profession, the employer loses an employee. If the nurse chooses to stay, the nurse may suffer from the effects of losing the benefits of personal and social life. He or she may become depersonalized, unmotivated, negligent, or suffer from fatigue including compassionate fatigue. In such a situation, the employer is willing to give up the benefits of a motivated nurse. The employer is willing to forfeit patient satisfaction, safety, and the nurse’s quality of work. However, the employer must way the negative impact of mandatory overtime against its benefits. The employer must evaluate how mandatory overtime impacts the problem in question. The main puzzle is whether mandatory overtime resolves the nurses’ shortage or worsens the situation. However, most nurses will opt to stay and continue providing the services even though they may suffer from emotional and physical consequences. The nurses may make a choice based on the contribution the increased income has on their livelihoods. The nurses also have to evaluate their commitment to the profession and their ethical obligation.

Benefits of Mandatory Overtime

Mandatory overtime is probably the most feasible solution for the chronic shortage of nurses. The employer benefits from overtime by increasing the productivity of the medical institution. The nurses work for the stipulated amount of time and extra period. For the extra period, the employer has to need to employ another nurse to cover an extra shift. However, with the shortage of nurses, it may be difficult to acquire the services of an additional nurse. Hence, working overtime reduces the employers search for employees. Also, when nurses work overtime, the hospital meets its needs and requirements. For nurses, working overtime implies an extra source of income. Most nurses will gladly work overtime to boost their low salaries. For example, the Fair Labor Standards Act provides that the employer should pay the overtime employee an hour’s wage plus fifty percent. Hence, working overnight guarantees the nurses an extra source of income. The more overtime hours a nurse works the more extra income the nurse receives.

Negative effects of Mandatory Overtime

Though mandatory overtime may provide a feasible solution for the shortage of nurses, it also has some adverse impact on the performance of the hospital and nurses. Over time increase the level of mental and physical exhaustion among nurses. According to Montgomery et al. (2018), emotional and organizational demands may lead to reduced dedication. Mandatory overtime implies an increase in regulatory demands for nurses. Increasing demands and expectations may reduce the nurses’ commitment to their work. A combination of fatigue and emotional pressure increases the risk of burnout. Burnout has extensive adverse effects on nurses and their performance. According to Ribeiro et al. (2014), burnout may force nurses into emotional exhaustion and compassionate fatigue. According to Hall et al. (2016), one in every 20 prescriptions has errors and 70% of studies on burnout associate errors to staff burnout. Nurses that fail to cope with emotional exhaustion and compassionate fatigue may resolve to unconventional measures like drug use. Burnout may also result in reduced performance and quality of service (Salvagioni et al., 2017; Caruso, 2013). When nurses experience the effects of burnout, they are often unable to produce to their average level of quality. According to Bae and Yoon (2014), working long hours reduces alertness among nurses and impaired vigilance among other adverse effects on performance.

Mandatory overtime also affects satisfaction levels among nurses and patients. For nurses, working extended periods and losing their liberty to choose overtime hours reduces the level of job satisfaction (Stimpfel, Sloane, & Aiken, 2012). Dissatisfaction may also lead to lack of concentration and vigilance while at work. The impact nurses translate to the quality of services and eventually to the patients’ satisfaction. Demotivated nurses may not provide excellent care leading to lower satisfaction levels among patients. Quality of care and patient satisfaction are essential key performance indicators for a hospital. Hence, reduced quality of service and patient satisfaction contribute to poor performance.

Alternative for Mandatory Overtime

The best choice for mandatory overtime is the training and employment of more nursing staff. The goals of Healthy People 2020 include eliminating disparity and improving the health of all groups. Nurses also deserve a quality life, free of diseases, and free of injuries. However, mandatory overtime increases nurses’ risks to injury and reduces their health status. The Nursing Staffing for Patient Safety and Quality Care Act 2017 aims at resolving the staffing problem by establishing mandatory staffing plans for hospitals. Hospitals have to prepare and submit staffing plans to the Department of Health and Human Service. The bill also creates nurse to patient ratios in each unit. The depart will also cover incremental cost resulting from the ratio requirements. States also use laws that either allow the nurse to refuse mandatory overtime or limit the number of work hours. Currently, four states have passed laws that will enable nurses to resist compulsory overtime and work for only 12 hours (Bae & Yoon, 2014). These laws can help increase the number of nurses and reduce the need for mandatory overtime.

Conclusion

Mandatory overtime is a short-term solution that may lead to a long-term problem. To address the issue of nurses’ shortage, researchers should evaluate the effectiveness of flexible scheduled shifts for nurses. Flexibility in the schedule may increase motivation and collaboration between team members. As a result, flexibility can increase voluntary overtime and support. Flexibility also enables nurses to find work-life balance leading to an improved quality of service. Mandatory overtime does more harm than good because it leads to adverse patient outcomes including medicine errors, nurse fatigue and burnout, and hospital-acquired infections.

References

Bae, S. H., & Yoon, J. (2014).Impact of states’ nurse work hour regulations on overtime practices and work hours among registered nurses. Health Services Research, 49(5), 1638-58.

Caruso C. C. (2013).Negative impacts of shift work and long work hours. Rehabilitation nursing: The official journal of the Association of Rehabilitation Nurses, 39(1), 16-25.

Choi, B. S., Kim, J. S., Lee, D. W., Paik, J. W., Lee, B. C., Lee, J. W., Lee, H. S., … Lee, H. Y. (2018). Factors Associated with Emotional Exhaustion in South Korean Nurses: A Cross-Sectional Study. Psychiatry Investigation, 15(7), 670-676.

Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016). Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PloS one, 11(7), e0159015. doi:10.1371/journal.pone.0159015

Montgomery, A., Spânu, F., Băban, A., &Panagopoulou, E. (2015). Job demands, burnout, and engagement among nurses: A multi-level analysis of ORCAB data investigating the moderating effect of teamwork. Burnout Research, 2(2-3), 71-79.

Ribeiro, V. F., Filho, C. F., Valenti, V. E., Ferreira, M., de Abreu, L. C., de Carvalho, T. D., Xavier, V., de Oliveira Filho, J., Gregory, P., Leão, E. R., Francisco, N. G., … Ferreira, C. (2014). Prevalence of burnout syndrome in clinical nurses at a hospital of excellence. International Archives of Medicine, 7, 22. doi:10.1186/1755-7682-7-22

Salvagioni, D., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. M. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PloS One, 12(10), e0185781. doi:10.1371/journal.pone.0185781

Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs (Project Hope), 31(11), 2501.

Do you need high quality Custom Essay Writing Services?