Nursing
Mandatory Overtime in Nursing: Implementations
Although mandatory overtime among nurses is not encouraged because of the perceived risk on job performance and patient management, the practice is still necessary particularly in health facilities where staffing is an issue. In situations where there are insufficient nurses, a mandatory overtime can be implemented. According to Rogoski et al., (2013) hospitals are typically understaffed particularly in neonatal ICUs by 32%, which is a ground for the implementation of overtime. In addition, high-acuity units particularly among infants require additional 0.39% of nurses. Implementing the mandate on overtime should begin by analyzing the current nurse to patient ratio. Each nursing unit is advised to have at least 4:1 nurse to patient ratio and any perceived variance of that ratio should be compensated by additional four hours on top of the 8-hour shift (Shekelle, 2013). In order to achieve the desired staffing ratio, the implementation should be backed by corresponding legislative policy.
The FLSA stipulates that overtime is permitted at a different standard other hand the 40 hour per week rule and the overtime can be imposed as necessary considering the scope of the nurses’ responsibilities (Huston, 2013). In addition, the ANA also asserts that nurses has the right to refuse provided the refusal to accept assignment is documented, but there is a legal risk in rejecting the assignment prior to acceptance, which includes but not limited to insubordination, patient abandonment, and violation of Code of Ethics for Nurses (ANA, 2009). In this regard, the implementation of the mandatory overtime should come with a policy statement, which implies the stated legislative mandate and ethical policy. In terms of resources to use in the implementation process, one of the most important tools is an effective manpower-scheduling tool that will plot the shift schedule. In addition, the patient turnover and ratio analysis would be used in order to anticipate the staffing requirement and adjustments.
References
ANA,. (2009). Patient Safety: Rights of Registered Nurses When Considering a Patient Assignment (1st ed.). ANA Board of Directors. Retrieved from http://nursingworld.org/rnrightsps
Huston, C. (2013). Professional issues in nursing (pp. 188-200). Baltimore, MD: Lippincott Williams & Wilkins.
Rogowski, J., Staiger, D., Patrick, T., Horbar, J., Kenny, M., & Lake, E. (2013). Nurse Staffing and NICU Infection Rates. JAMA Pediatrics, 167(5), 444. http://dx.doi.org/10.1001/jamapediatrics.2013.18
Shekelle, P. (2013). Nurse–Patient Ratios as a Patient Safety Strategy. Annals Of Internal Medicine,158(5_Part_2), 404. http://dx.doi.org/10.7326/0003-4819-158-5-201303051-00007
