Factors Associated with Nurse Paid Overtime and Mandatory Overtime in U.S. Hospitals

Tuesday, 14 July 2009

Sung-Heui Bae, PhD, MPH, RN
School of Nursing, The State University of New York at Buffalo, Buffalo, NY

Learning Objective 1: The learner will be able to identify the actual amount of paid overtime and mandatory overtime nurses work in the U.S. Hospitals

Learning Objective 2: The learner will be able to identify nurse demographic and employment characteristics associated with RNs’ paid overtime and mandatory overtime in the U.S. Hospitals.

Purpose: Nurses and their advocates have expressed concern about increasing use of overtime in hospitals. Currently, several states restrict nurse mandatory overtime. Nurse overtime has been found to threaten patient safety and lead to nurse injuries. Although several studies have been conducted to find factors associated with nurse overtime, we have little information about the actual amount of paid overtime and mandatory overtime nurses work in U.S. hospitals and which factors, including nurse demographic and employment characteristics, are associated with nurse overtime. Additionally there is little information about whether paid overtime and mandatory overtime are related to various factors. This study derived a framework to examine the association among nurse demographics, employment characteristics, and nurse overtime in U.S. hospitals and analyzed those associations.

Methods: This study used data from the 2004 National Sample Survey of Registered Nurses, consisting of 35,724 individual RNs in the United States. The data collection began in March 2004 and continued through November 2004. Dependent variables included nurse paid overtime and mandatory/unscheduled overtime. Nurses provided information about their demographic and employment characteristics. Differences in overtime hours across nurses with different demographic and employment characteristics were analyzed using ordinary least-squares regression of overtime on independent variables with sample weights.

Results: Full-time nurses worked an average of 7.5 hours of overtime per week, while part-time nurses worked an average of 5.6 hours of overtime. Further analyses will explore relationships among nurse demographics, employment characteristics, and nurse overtime.

Conclusion: Although we believe nurse overtime produces adverse effects, little empirical research has been conducted to explore nurse and employment characteristics associated with nurse paid overtime and mandatory overtime. This study contributes to our understanding of nurse overtime and provides managers with information about the underlying factors involved in the use of overtime in RNs.