Your Failure to Plan Doesn’t Constitute an Emergency On My Part: Mandatory Overtime

 When we think of mandatory – or forced – overtime, our minds might go back to the day before labor unions, when people in factories were steadily working hour after hour, day after day, in unsafe and unpleasant conditions. But mandatory overtime is not a thing of the past for some nurses in Canada. It’s a reality.

No one argues that units must be staffed – there must be a certain number of nurses to maintain a safe level of patient care. But what happens when there is no staff to cover the next shift?

At first, supervisors usually ask for volunteers who would like to work overtime. But what does the hospital do when no nurse steps forward? If they can’t call for outside help (private agencies), their only option may be to pressure nurses into working another shift or, to bluntly tell nurses that they must stay. This is mandatory overtime, although they may not use those words.

While the administrators are solving their staffing problems, they are causing a whole host of problems for their nurses who need or want to go home – they may have daycare issues, classes to attend, senior relatives to care for, important appointments to keep, or they may need to get some much needed sleep.

If nurses refuse to work overtime, they may be threatened with “abandoning their patients.” However, according to the Canadian Federation of Nurses in their position statement on mandatory overtime, this is not true. The union says, ”It is important [to know] that refusing duty to care is not [to be] confused with client abandonment, which occurs when a nurse leaves before the end of a scheduled shift, or being unavailable during a scheduled shift for a period of time that compromises patient/resident/client care.” So, by saying that you can’t/won’t work an extra shift, you cannot be told you are abandoning your patients. But that is on paper. Our conscience may say otherwise.

Research has shown that tired workers make more mistakes. Tired workers have more accidents going home. They are unhappier overall, and their health may suffer over the long-term. In fact, a 2015 review study, published in the Lancet, looked at people who consistently worked more than the usual 40-hour workweek. The researchers found several studies that concluded that these workers are at a higher risk of stroke.

This problem must be addressed, particularly as patients who are in the hospital are sicker than they ever were before. They need more eyes on them, more procedures done with them, and more split second decisions made. Their nurses must be on the ball and refreshed, not tired and frustrated because they are at work against their will.

The union’s position paper goes on to say, “With the exception of disaster situations, or emergency circumstances (where the Code of Ethics outlines the duty to provide care), nurses unions feel that there are no circumstances whereby employers should mandate employees to work overtime. Mismanagement of human resources and chronic unfilled vacancies do not constitute emergency conditions or grounds for ordering mandatory overtime. Additionally, the right to refuse duty to care may also be applied during an emergency situation when ability to provide safe care is compromised by unreasonable expectations, lack of resources or ongoing threats to personal well-being.”

In other words, your failure to plan ahead of time doesn’t constitute an emergency on my part.

What do you think hospitals should do if there is no one available when a nurse’s shift is over?