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Nursing Overtime and Patient Safety

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Nursing Overtime and Adverse Effects
Blima Marcus
Hunter College

Abstract
This paper will explore the topic of nursing overtime and its effect on adverse events and errors in the workplace. The prevalence of mandatory and voluntary overtime is high. Nursing shortages combined with the aging baby boomer population means more work for health care workers, and nurses bear the brunt of this reality. There is some legislation in place to restrict mandatory overtime, but research suggests that overtime hours have not decreased since those policies were created. Furthermore, voluntary overtime is unregulated, with many nurses exceeding the recommended 40-hour workweek. Studies have shown that exceeding recommended hours results in workplace injuries to nurses, increased burnout and lower retention of nurses, and poorer outcomes for patients, including early readmission, medication errors, falls and nosocomial infections. More regulation may be necessary to reduce the hours worked by nurses. Advanced practice registered nurses are in a position to advocate for stricter policies in their facilities, and to implement strategies that would reduce overtime hours worked in their facilities, for example by increasing staffing. Nurse managers can ensure that their nurses doing overtime take the recommended breaks and do not exceed the recommended number of hours worked per week.

Nursing Overtime and Adverse Effects
Mandatory overtime is defined as employer-imposed work time in excess of one’s assigned schedule. Voluntary overtime is time worked at the employee’s discretion over and above that specified for a full-time employee. Both of these are utilized frequently by the health care sector, primarily in light of the nursing shortage. A study by Berney, Needleman and Kovner (2005) demonstrated that an average of 4.5% of total paid hours worked by registered nurses (RNs)

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