One-Third of Surveyed Nurses Work Overtime

Chenjuan Ma, PhD

Health care provider burnout has developed into a known rampant trend among the profession. A survey conducted by the Mayo Clinic in 2014 reported that 54.4% of participating physicians had experienced at least 1 symptom of burnout and just 40.9% had satisfaction with their work-life balance (P < 0.001).

Another physician-based survey from network MDVIP last year reported that 76% of participants said they suffer from sleep loss due to stress, and 41% had contemplated quitting medicine due to stress. But a new study showed that doctors’ colleagues may be equally — if not more &mdash; burdened by workload.

According to a new study from researchers at New York University (NYU) Rory Meyers College of Nursing, one-third of surveyed nurses work past their scheduled work shift — which is commonly 12 hours. The end result could be detrimental to care provider collaboration and patient-based communication.

Using 2013 survey data results from the National Database of Nursing Quality Indicators which included responses from 24,013 nurses from 957 units in 168 US hospitals, researchers analyzed shift and collaboration patterns. Metrics were measured through the nurse-nurse interaction scale (RN-RN Scale) and nurse-physician interaction scale (RN-MD Scale), and shift patterns were gauged as averaged shift length, average overtime, and the proportion of nurses on a unit who had worked overtime.

Researchers found that, among the observed population, average nurse shift length was 11.88 hours across the 5 types of units measured (critical care, medical, medical-surgical, step-down, surgical). However, critical care and step-downs averaged 12.17-hour shifts, a slight but still significant increase from the other 3 units.

All nurses worked a mean 24 minutes longer than their scheduled shift, with 33% reporting having worked longer than initially scheduled. Another 35% of nurses said the amount of overtime needed from nurses in their unit had increased in the past year at that time.

Though there was no found significant relationship between average shift length and collaboration, researchers concluded that collaboration suffered in units with longer overtime shifts and more nurses working overtime. An hour of overtime was associated with a 0.17 decrease on the RN-RN scale and a 0.13 decrease on the RN-MD scale.

The 0.17 decrease in mean RN-RN scale score would suggest a unit’s rank would drop from the 50^th percentile among other units, to the 30^th percentile, according to researchers.

“One in 3 nurses reported working longer than scheduled,” Chenjuan Ma, PhD, an assistant professor at NYU Meyers and the study’s lead author, said in a statement. “This appears to be a chronic problem for nurses — one that extends an already long work day and appears to interfere with collaboration.”

The results indicate a need for limiting overtime work, as it directly affects nurses’ hours of wakefulness and inherently their work-time collaboration capability. The researchers advised fatigue management and education and communication training for care providers, noting that longer shifts have increasingly become the norm in a shrinking field of personnel.

“In practice, nurse managers should monitor the amount of overtime being worked on their unit and minimize the use of overtime,” Ma said.