You’ve just worked a long shift, putting your all into taking care of your patients. Your back hurts, your feet hurt, and your mind is something resembling mush. As you are charting your last note of the shift, you see your ward supervisor coming down the hall. She tells you they had three call offs for the next shift, and they couldn’t get anyone to come in. You are going to have to stay over because it would be unsafe for the next shift to proceed with so few nurses. It’s your turn. You have no choice.
Unfortunately this is a common scene in many facilities around the country. Some places still have mandatory overtime statutes despite the unions, and you may be asked to stay over even if you are exhausted. It is unfair to you and unfair to the patients. However, call offs and short staffing happen. Patients would be unsafe in low staffing situations, and this is why you find yourself having to work even after your shift is over. There are many facets to this situation, and they all have their place in the discussion about mandatory overtime.
Call Offs and Short Staffing
Call offs happen, and that can cause a gigantic problem for your ward. Some can’t be helped. Nurses get sick, and they don’t want to come in and compromise their patients. However, some nurses are merely burnt out, and they can’t even face the prospect of coming in for their shift. This is a problem that is much more prevalent than many people know. It is just too difficult, too anxiety producing to show up for the shift. Child care and family problems are other reasons people call off. No matter what, call offs are going to be a part of the nursing landscape, and this can lead to mandatory overtime.
Short staffing however, is a problem that should be fixable. Some facilities staff just barely enough nurses, and one call off is all it takes to make the shift unsafe. While it is often hard to find enough nurses to hire, some unscrupulous facilities keep the number of nurses down to save money. It isn’t a question of looking for nurses to hire, but a financial one. In this case the use of mandatory overtime to cover the purposely low staffing is reprehensible. It may be cheaper to pay a nurse overtime than to hire a full time person to cover the staffing. Either way, short staffing is a significant problem that can lead to a great deal of mandatory overtime.
Duty to the Patients
All nurses have a duty to patients to keep them safe, but does that mean to keep them safe at your own risk? If the next shift doesn’t have enough people to safely care for the patients, how much responsibility do you have in making sure they do? It is a difficult, sticky question, and the ethics of leaving a ward understaffed are muddied. When the problem arises, it doesn’t really matter whose fault it is. Whether it is call offs or understaffing by management, the problem still remains that the patients are potentially in danger. Nurses are sworn to prevent this. What is the solution?
It shouldn’t fall to a single nurse to take the responsibility of the safety of all patients on the ward. But whose responsibility is it when that time arises? Unfortunately the nurses have to work as a team, step up, and stay over as needed. It is a horrible inconvenience, could be unsafe for the nurse, and is imminently unfair, but there really is no other choice in the moment. Patient safety can be addressed on another day. Call offs and understaffing need to be addressed to avoid this situation, but when the time arises, what choice does a nurse have but to stay over?
Nurses work hard, and asking them to work more is almost cruel. Some nurses have children that need to be cared for. Some are just so tired they can’t possibly be safe for the patients anyway. In short, mandatory overtime is just a bad idea. There has to be some way to avoid this to help nurses care for themselves. Nurses spend so much time caring for others that it is only right and fair that something is done to limit their work to their shift.
One possible solution is the use of agency nurses. These are basically nurses that work with a separate entity and can be called in to fill in gaps. The problem with these nurses is that they are incredibly expensive. Not many facilities want to pay for the use of agency nurses when they can simply pay overtime to their own nurses that are forced to stay. Another possible solution is confronting management on the problem of short staffing. If necessary, become a whistleblower to help eradicate this problem and keep patients safe. Mandatory overtime, though it seems like it will keep patients safe, will not. Tired nurses are dangerous nurses, and they have a right to their own lives beyond the ward. Only when the culture of the profession changes, will mandatory overtime cease.
Lynda is a registered nurse with three years experience on a busy surgical floor in a city hospital. She graduated with an Associates degree in Nursing from Mercyhurst College Northeast in 2007 and lives in Erie, Pennsylvania in the United States. In her work, she took care of patients post operatively from open heart surgery, immediately post-operatively from gastric bypass, gastric banding surgery and post abdominal surgery. She also dealt with patient populations that experienced active chest pain, congestive heart failure, end stage renal disease, uncontrolled diabetes and a variety of other chronic, mental and surgical conditions. Her Website.