Legal Implications of Mandatory OvertimeLegal Implications of Mandatory Overtime
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Although mostly a workplace and safety issue, there are legal implications to mandatory overtime. Due to nursing shortages, hospitals have increasingly forced nurses to work overtime (ANA, 2011). The ANA conducted a survey of almost 220,000 RNs from 13,000 nursing units in over 550 hospitals. The survey produced a 70% report rate and the results indicated that:
■ 54% of nurses in adult medical units and emergency rooms revealed that they do not have sufficient time with patients;
■ The amount of overtime has increased during the past year with 43% of all RNs working extra hours because the unit is short staffed or busy; and
■ Inadequate staffing affected unit admissions, transfers, and discharges more than 20% of the time (ANA, 2011).
Overtime causes physical and mental fatigue, increased stress, and decreased concentration. Sub- sequently, these conditions lead to medical errors such as failure to assess appropriately, report, docu- ment, and administer medications safely. This prac- tice of overtime ignores other responsibilities nurses
have outside of their professional lives, which affects their mood, motivation, and productivity (Bae, Brewer, & Kovner, 2011).
Forced overtime causes already fatigued nurses to deliver nursing care that may be less than optimum, which in turn may lead to negligence and malpractice. This can result in the nurse losing his or her license and perhaps even facing a wrongful death suit due to an error in judgment. Needleman, Buerhaus, Pankratz, Liebson, Stevens, and Harris (2011) found that patient mortality increased by 2% on nursing units that had nurses working shifts 8 hours or more over their scheduled time due to registered nurse short staffing issues. Many states have implemented legislation restricting manda- tory overtime for nurses. It is important for nurses to know and understand the laws of their particular state dealing with this issue.
Nurses practice under state or provincial (Canada) nurse practice acts, which state that nurses are held accountable for the safety and welfare of their clients. Once a nurse accepts an assignment for the client, that nurse becomes liable under his or her license.
Licensure
Licensure is defined by the National Council of State Boards of Nursing as “the process by which boards of nursing grant permission to an indi- vidual to engage in nursing practice after determin- ing that the applicant has attained the competency necessary to perform a unique scope of practice. Licensure is necessary when the regulated activi- ties are complex, require specialized knowledge and skill and independent decision making.” (NCSBN, 2012). Licenses are given by a govern- ment agency to allow an individual to engage in a professional practice and use a specific title. State boards of nursing issue nursing licenses, thus limit- ing practice to a specific jurisdiction (Blais & Hayes, 2011).
Licensure can be mandatory or permissive. Permissive licensure is a voluntary arrangement whereby an individual chooses to become licensed to demonstrate competence. However, the license is not required to practice. Mandatory licensure requires a nurse to be licensed in order to practice. In the United States and Canada, licensure is mandatory.
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