Mandatory Overtime Regulations and Newly Licensed Registered Nurse Mandatory and Voluntary Overtime in U.S. Hospitals

Tuesday, 13 July 2010: 4:05 PM

Sung-Heui Bae, PhD, MPH, RN1
Carol S. Brewer, PhD, RN1
Christine Kovner, PhD, RN, FAAN2
1School of Nursing, University at Buffalo The State University of New York, Buffalo, NY
2College of Nursing, New York University, New York, NY

Learning Objective 1: The learner will be able to know how mandatory overtime regulations are related to newly licensed registered nurse mandatory and voluntary overtime.

Learning Objective 2: The learner will be able to identify incentives, workload, organizational citizenship, and nurse demographics associating with RNs’ overtime in the United States Hospitals.

Purpose: There is limited understanding of whether nurse mandatory overtime regulations can prevent nurse mandatory overtime practice. To retain newly licensed registered nurses (NLRNs), it is important to know whether these regulations influence nurse overtime practice. Therefore, this study examined mandatory overtime regulations and its associations with NLRNs’ mandatory and voluntary overtime.

Methods: The current study was a secondary analysis of wave 1 data from the NLRN study, including those who became a NLRN after August, 2004 and were employed in a nursing job in January, 2006. Dependent variables included a dichotomous variable (yes/no) for nurse mandatory and voluntary overtime and a continuous variable (overtime hours). Independent variables were mandatory overtime regulations including year the regulation started and level of regulations (restrict any mandatory overtime or only work hours). Covariates were incentives, workload, organizational citizenship behavior, and other nurse demographics. A two-part model was used to estimate the probability of incurring nurse overtime and the level of nurse overtime hours.

Results: Nurses working in states that started overtime regulations after 2003 or had high levels of regulations had lower probability of nurse overtime than those working in states without regulations. Quantitative workload reported was positively associated with the likelihood of nurse overtime. Nurses who reported higher levels of organizational citizenship behavior were less likely to work mandatory overtime and more likely to work voluntary overtime. Mandatory overtime regulations were not associated with levels of nurse overtime hours.

Conclusion: Higher levels of mandatory overtime regulations had a negative relationship with only mandatory overtime. This study provided insight into how mandatory overtime regulations were related to nurse overtime practice. Further research needs to investigate the levels of regulations and its impact on nurse mandatory overtime and institutions’ compliance with the regulations. Individual nurse behavior related to voluntary overtime needs to be assessed.