How Long and How Much Are Nurses Now Working Overtime within Which Conditions?

Thursday, July 14, 2011: 10:15 AM

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 how long and how much nurses are working overtime.

Learning Objective 2: The learner will be able to identify nurse work conditions associating with nurse overtime practice.


 Nurse overtime has been used in an attempt to control both chronic short-staffing and normal variations in patient census. Although nurse overtime has become an increasingly contentious issue in the U.S., these are limited information in which work conditions are associated with nurse overtime practice. Therefore, this study examined the nature and prevalence of nurse overtime and analyzed work conditions such as work schedule, patient census fluctuation, monetary reward, nurse shortages in nursing units, and use of temporary nurses.


 Data were collected from registered nurses (RNs) who work in hospitals as a staff nurse in North Carolina and West Virginia. A 500 random sampling of RNs in each of the two states was conducted. Using Dilman Tailored Design Method, multiple mailings to non-responders were sent between October and December 2010. The final sample consisted of 207 RNs with 28.7% response rates.


 148 nurses have worked overtime including mandatory, voluntary, and on-call hours.  While 51 (24.6%) RNs answered that overtime work is required as a part of job, 111 (53.6%) nurses worked overtime because of monetary reward. Sixty nurses (29%) answered when overtime is needed, they like to work it. More than half (59.9%) of the sample answered that they don’t want to let down the people they work with. Sixty seven (32.4%) worked overtime so that they can get all work done. Over 80% (175 RNs) of nurses perceived that patient census fluctuation in the unit is frequent.     


Although we believe that nurse overtime is used to fill in nursing shortages, little empirical research has been conducted to explore nurse and employment conditions associated with nurse overtime. This study contributes to our understanding of nurse overtime and provides managers with information about the underlying factors involved in nurse participation of overtime and work conditions.