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In all, a total of 5317 shifts were studied of which 2,057 shifts were for more than 12.5 hours. Within the 28-day period of the study two thirds of the nurses reported to have worked overtime 10 times or even more. There were a total of 199 reported errors and 213 'near errors' during the study period and the majority of the errors (58%) involved wrongful administration of medications. It was shown that overtime working increased the probability of committing at least a single error (or = 2.06, p =.0005) while the risk of making errors were even greater for shifts that extended for 12 hours and above (p =.005). It was found that there were not considerable differences in the error rate in terms of the age of the nurse or the hospital size. Thus commission of errors increases proportionately with the increase of the work time. [Rogers et.al] This study clearly shows the connection between mandatory overtime and error commission.
A statement from the International Council of Nurses reads, "the increasing amount of overtime threatens nurses' ability to provide safe and individualized care for patients." [MNA] a study by Akien et.al (2002) also attests that high patient nurse ratio affects the recovery of surgical patients. This comprehensive study involving 168 hospitals analyzed the surgical mortality rates in context of nurse patient ratio. The study showed that higher patient nurse ratio implied greater burnout and consequent job dissatisfaction. The risk of patient mortality increased by 7% for every additional patient under the care of a nurse. That is, as the nursing load increases there is an increased mortality rate. This study also showed that 43% of nurses who are supposedly overworked expressed a desire to quit the job within a one-year period. It is inferred from the study that an increase in the registered nurses would improve the outcome for the patients [Aiken et.al] So, imposing mandatory overtime not only affects the quality of health care delivered but also jeopardizes the health and career of the nurse. (Some serious errors may involve revoking the license) Nurses also have a legal liability for any discrepancies in the services they offer to the patients entrusted into their care.
Conclusion
There is a definite...
Overburdened and exhausted nurses present a clear threat to patient safety and seriously compromise hospital quality standards. Since numerous research studies have clearly illustrated a positive association between nursing errors and mandatory overtime it is high time that legislative measures are formulated and implemented throughout the nation to limit the working hours to the acceptable safety standards. There are strong reasons to believe that the prevailing nurse shortage may actually be the result of the dissatisfaction with the profession. Making overtime mandatory for nurses is not the rightful way to tackle the human resource crisis in the healthcare industry. Instead efforts must be directed at improving the working conditions for nurses and make nursing profession more attractive for our younger generation.
Bibliography
Linda H. Aiken et.al, "Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction," JAMA OCT 23/30 2002 VOL 288 no 16
http://www.pef.org/nurses/files/joc20547.pdf
Rogers, Ann E. Rogers et.al, "The Working Hours of Hospital Staff Nurses and Patient Safety," Health Affairs, Vol 23, Issue 4, 202-212
http://content.healthaffairs.org/cgi/content/full/23/4/202?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Rogers&andorexactfulltext=and&searchid=1102215041643_2218&stored_search=&FIRSTINDEX=0&resourcetype=1&journalcode=healthaff
Gorenberg, Bobbye, "Nurse retention: Is it Worth it?," Nursing Economics; 11/1/2003
4) Michigan Nurses Association, "The Costs of Mandatory
Overtime for Nurses," Accessed on December 4th 2004, http://www.minurses.org/spc/MandatoryOvertimeforNursesFinalReport.pdf
Robert Steinbrook, "Nursing in Crossfire," the New England Journal of medicine, Volume 346:1757-1766, May 30, 2002, M.D
http://content.nejm.org/cgi/content/full/346/22/1757?ijkey=67578611d2f36bf1fabb89e79334c2e23661f850&keytype2=tf_ipsecsha
CNA, "New Study Documenting Dangers of Forced Overtime for Nurses," Accessed on December 4th 2004, http://cna.igc.org/cna/press/7704.html
Bibliography
Linda H. Aiken et.al, "Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction," JAMA OCT 23/30 2002 VOL 288 no 16
http://www.pef.org/nurses/files/joc20547.pdf
Rogers, Ann E. Rogers et.al, "The Working Hours of Hospital Staff Nurses and Patient Safety," Health Affairs, Vol 23, Issue 4, 202-212
http://content.healthaffairs.org/cgi/content/full/23/4/202?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Rogers&andorexactfulltext=and&searchid=1102215041643_2218&stored_search=&FIRSTINDEX=0&resourcetype=1&journalcode=healthaff
Overtime for Nurses," Accessed on December 4th 2004, http://www.minurses.org/spc/MandatoryOvertimeforNursesFinalReport.pdf
http://content.nejm.org/cgi/content/full/346/22/1757?ijkey=67578611d2f36bf1fabb89e79334c2e23661f850&keytype2=tf_ipsecsha
CNA, "New Study Documenting Dangers of Forced Overtime for Nurses," Accessed on December 4th 2004, http://cna.igc.org/cna/press/7704.html
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