Nursing shortages exist all throughout the modern world. Worse yet, the nurses left, face the possibility of low pay and long hours. Mandatory overtime for example, is a common problem experienced in most countries. This essay focuses on the effects of mandatory overtime on the nursing profession through reviewing current literature. The literature offers ways mandatory overtime have influenced job outlook as well as job satisfaction for nurses and ways that may help reduce the need for it. Personal commentary highlights the effect of the issue first hand and creative solutions on how to counteract it. Nurses have difficult job duties. They set out to perform multiple job functions daily. Many times, they are overworked and experience continual and consistent stress. This can have and frequently does have a negative impact on the quality of care patients receive. What frequently turns out to be the main culprit in such a dilemma? Mandatory overtime.

Mandatory overtime takes on several faces. In general it is seen as voluntary overtime and "on-call hours." Nurses are not the only ones that experience this. Doctors do as well. However, nurses are hardly compensated for it and often work overtime unpaid. How can nursing overtime be defined? A 2013 article gives a clear definition. Nursing overtime is defined by four main attributes: "perception of choice or control over overtime hours worked; rewards or lack thereof; time off duty counts equally as much as time on duty; and disruption due to a lack of preparation. Antecedents of overtime arise from societal, organizational, and individual levels" (Lobo, Fisher, Ploeg, Peachey & Akhtar-Danesh, 2013, p. 2401). The results of nursing overtime may end up positive and negative depending on the benefits gained or not from the action. The consequences can affect the nurses themselves or the organizations and patients they care for if the nurses do not receive any benefit from performing overtime.

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Mandatory overtimes is not only a common problem seen throughout the modern world, but is also slowly becoming the norm. This is due to chronic understaffing. "Nurse overtime has been used to handle normal variations in patient census and to control chronic understaffing. By 2010, 16 states had regulations to limit nurse overtime" (Bae, Brewer & Kovner, 2012, p. 60). Although nurses should be given better work environments, or in the very least better pay to remedy the nursing shortage, efforts seem to be on the decline with more and more nurses working unpaid mandatory overtime. Even with the advent of work condition improvements and a growing awareness to improve nurse job satisfaction, government regulation may be the only thing that can change the rate at which mandatory overtime for nurses is implemented.

The results of the 2012 study highlighted a clear reduction in mandatory overtime in states the regulated it versus states that did not and the overall amount of hours nurses worked. Nurses working in states that instituted overtime regulations after 2003 or in states that restricted any type of mandatory overtime had a lower probability of experiencing mandatory overtime than those nurses working in states without regulations" (Bae, Brewer & Kovner, 2012, p. 60). Not only did nurses report a higher number of total hours worked per week in non-regulated states...

"Nurses' poor quality of sleep and fatigue are associated with working long hours, their quick return to work, and also shift work" (Bae, 2013, p. 59). It is clear nurses suffer from being overworked and mandatory overtime adds to this problem. It seen even in places close to home like the practice I work in.
In my current workplace, which is a multi-specialty medical group, management requirs doctors to work two late nights. Instead of the previous 7pm late night, it is now 9pm. Several nurses quit their job and now everyone there is required to do overtime. Management is slow on replacing nurses and other medical staff that left. This leaves a nursing shortage, forced overtime, and a stressful environment with low job satisfaction.

Low job satisfaction is prevalent in nursing because of the higher levels of stress experienced from longer hours. Overworked nurses may experience higher levels of stress, and increased fatigue that often negatively affect their performance while on duty. Patients witness this when they are being seen in a crowded hospital or clinic. It is evident in the practice I work in. The worst part of mandatory overtime is the variation nurses experience and what little is done to remedy it. Some nurses are paid for their overtime, other are not. Some work mandatory overtime in the form of "on-call hours" and are not recognized for the effort they put in daily, while others accept the longer work hours as the norm. This can lead to low job satisfaction and exacerbate an already growing nurse shortage.

Figures from a 2013 study show that at least 15% of nurses work what is labeled as mandatory overtime, while the rest are categorized as voluntary overtime, or "on-call hours." "From our sample, 15.6% of RNs worked mandatory overtime (either paid or unpaid) while 34.1% worked voluntary overtime (either paid or unpaid) in a typical week. About 32% of RNs worked on-call hours (either paid or unpaid)" (Bae, 2013, p. 63). Those that worked unpaid mandatory overtime experienced a frequent and high rate of job satisfaction. This of course affected the way they treated patients.

There are however, ways that the government is intervening. Regulations exist for some states to help reduce the rate at which nurses are forced to work overtime. Still, some literature points to the nursing shortage worsening in states that are regulated. "Those nurses working in states with regulations cared for more patients per shift and experienced more chronic nursing shortages on their nursing units than those working in states without regulation" (Bae, 2012, p. 205). Creative solutions must then be formed to combat the problem. Some simple solutions are nurse-physician relations and workgroup cohesion.

We explored direct and indirect influences of physical work environment on job satisfaction in a nationally representative sample of 1,141 early-career registered nurses. In the fully specified model, physical work environment had a non-significant direct effect on job satisfaction. The path analysis used to test multiple indirect effects showed that physical work environment had a positive indirect effect (p?