Editor's
Note
Do the right
thing
Mandatory
overtime is a practice whose time has passed
Carol Bradley, MSN,
RN, California Editor
October
23, 2000
I am
convinced that creating a positive, rewarding work environment
where nurses feel empowered to govern their own practice,
valued and respected by a supportive administration, and
motivated to deliver excellent care and service at the bedside
is not an impossible goal. However, it requires strong,
principled leadership and a commitment to keeping our priorities
in the proper order.
If one
is concerned about the growing nursing shortage, medical
errors and the overall quality of work life in health care
today, it seems that mandatory overtime is an easy and obvious
place to begin to "do the right thing." Hospital,
nursing and human resource leadership should ensure that
this practice is abolished.
Mandatory
overtime comes in many forms. In one form, nurses are required
to work hours that extend beyond their normal shift despite
their objections. In another form, nurses are required to
commit to extra shifts within a given schedule cycle beyond
their normally scheduled hours. Despite policies that may
permit these actions, the frequency of mandatory overtime
within hospitals is a greatly debated subject. It is clearly
a major theme in union negotiations and legislative efforts
across the country.
Once
again, the failure to do the right thing may result in more
regulatory oversight. It also is unfortunate that the public
has been left with the impression that mandatory overtime
is a common, daily staffing strategy. I am not so sure that
is an accurate reflection of what is actually happening.
The
original intent of mandatory overtime – to address those rare
instances of natural disasters or unexpected emergency situations
that require extraordinary effort to ensure staff was available
to care for patients – has been long forgotten. In fact, during
the few natural disasters I have experienced, nurses came
out of the woodwork to help with the unexpected avalanche
of patients. Mandatory overtime never crossed anyone’s mind.
Today,
in those work environments where mandatory overtime has
become a frequent staffing strategy and is used in its strictest
form, it is demoralizing and abusive to nurses and other
staff, as well as unfair and unsafe to patients. It indicates
a lack of respect for employees as wellas a stunning ignorance
of the scientifically proven role of fatigue in performance
failures by an industry that insists it is focused on the
quality of care.
Most
important, a high price is paid when mandatory overtime
is employed, and that is the price of trust, respect and
loyalty, as well as the erosion of the critical relationship
between a nurse and the organization with whom she/he is
affiliated.
So,
if mandatory overtime is abolished, how do we respond to
chronic staffing shortages when not enough nurses are available
to care for patients?
My answer
is simple: Close beds and reduce services to the appropriate
level for which safe staffing exists. This is a practice
with which we should become comfortable and proficient because
it will be required more often. All one has to do is recognize
the severity of the nursing shortage in California.
Perhaps
the dramatic effect of closing beds and reducing services
will impress upon the powers that be the fundamental role
that nurses maintain within our delivery system process.
It also may inspire us as nurses to find new and creative
means of responding to our work environment challenges vs.
the old adversarial strategies that are still fostered by
some.
