Your supervisor is short-staffed for the next shift and asks you – quite politely, actually – to stay for a few more hours.

But you’re burned out. You’ve been working overtime for several days or even weeks in a row and your children greet you with blank stares as if asking “Who are you?” when you walk in the door. Your spouse is tired of being a “single parent” and has let you know so in no uncertain terms. Plus, you’re just tired and frazzled and need some time off!!

Can you turn down your supervisor’s request and still have a job to come back to the next day?

This depends on any applicable state laws and your facility’s policy.  Verify both.   A growing number of states are enacting laws to prohibit or restrict the use of mandatory overtime for nurses. To check your state’s status, contact your state board of nursing or the Office of the Attorney General in your state.

Your facility should base its policies on the state’s mandates, so if mandatory overtime is permitted under state law and facility policy, you agreed to abide by this expectation when you accepted employment.

If this is the case, you will need permission to turn down overtime.

Should  you say no?

Overtime can lead to a high-stress environment, which in turn leads to an increased risk of accidents, errors, chronic fatigue, errors and burnout. Fatigued nurses simply can’t provide high-quality, safe patient care.

Researchers have found, for example, that nurses know this.  The odds of nurses self-reporting errors are 3x higher after shifts lasting 12.5- hours or more. (Rogers, Hwang, Scott, Aiken & Dinges, 2004). Among critical care nurses, error reports almost doubled after 12.5-plus consecutive hours of work (Scott, Rogers, Hwang, & Zhang, 2006).

If you believe that mandatory overtime may be causing staff errors due to fatigue and burnout, before raising alarms with a risk management report, approach your manager with your concerns.  Suggest that you work together with supervisors and the facility’s owners to come up with long-term solutions regarding mandatory overtime that work for everyone.

Healthcare facilities understand the risks of overtime, but they also understand that there must be staff to cover patient needs.  Neither administrators nor nurses relish the idea of having mandatory overtime, and many facilities are already working with their staff towards solutions.

Many facilities encourage collaboration between all parties – facility administration, physicians, and nurses – to develop best practices that reward quality of care.  Doing so means everyone wins – nurses, facilities and (most importantly) patients.

Have you ever experienced the opportunity to work with an entire organization and staff to find a collaborative solution to an issue? We would love to hear about your experience!

Have you bookmarked our blog yet? What are you waiting for!? We blog each week with strategies that will help you and your facility do better by yourself and your patients/residents. If you have any comments or concerns, just give us a shout out!

NOTE:  A full-color, downloadable PDF is available.