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Purpose: To assess nurse overtime in acute care general hospitals and the factors that influence overtime among various hospitals and in the same hospitals from year to year.
Methods: Staffing data from 1995 to 2000 from 193 acute general hospitals in New York State were used to examine hospital characteristics (size, location, RN unionization, hospital ownership, and teaching status) to determine whether they were associated with nurse overtime.
Results: The average weekly overtime RNs worked was 4.5% of total hours, varying from almost none to 16.6%. At mean overtime levels, nurses were working less overtime than the mean for manufacturing workers, but, at the extreme, nurses were working more than 6 hours overtime per week. Significant differences were observed in the use of overtime by hospital ownership and by union status. Nurses in government hospitals worked less overtime than did those in nongovernment hospitals. Nurses in unionized hospitals worked slightly more overtime than did nurses in nonunionized hospitals.
Conclusions: Hospitals varied dramatically in their overtime use. That some categories of hospitals (e.g., government-owned) used little overtime indicates that hospital management can find substitutes for overtime to meet fluctuating staffing needs. The finding that hospitals with similar characteristics varied greatly in their number of overtime hours also supported this conclusion.
JOURNAL OF NURSING SCHOLARSHIP, 2005; 37:2, 165-172. ©2005 SIGMA THETA TAU INTERNATIONAL.
[Key words: personnel staffing and scheduling, nurse overtime, hospital nurse staffing]
Both nurse shortages and increasing complaints about nurses working overtime are common in the United Kingdom, Canada, Germany, and the United States (Berliner & Ginzberg, 2002; Buerhaus, 2002; Finlayson, Dixon, Meadows, & Blair, 2002; Heitlinger, 2003; Muller-Mundt, 1997; World Health Organization, 2000). Although administrators report difficulty hiring nurses, nurses feel overworked and unable to provide good care for their patients and are consequently considering leaving their jobs (Advisory Commission, 1997; Aiken, Clarke, & Sloane, 2002; Geiger-Brown et al., 2004; Nicklin & McVeety, 2002; Wunderlich, Sloan, & Davis, 1996). Nurse overtime has become an increasingly contentious issue in the United States, generating strikes and leading to state and federal legislation to restrict mandatory overtime (Bloice, 2000; Foley, 2002; "National ban," 2000). If undesirable working conditions contribute to the nurse shortage, overtime is certainly part of the problem (Clarke et al., 2001; Geiger-Brown et...