Mandatory Overtime for Nurses: What Are the Pros and Cons?

• Mandatory overtime originated from the Fair Labor Standards Act (FLSA) of 1938.
• Although it is a great way for facilities to ensure their staffing levels are consistent, mandatory overtime for nurses comes at a cost.
• Want to learn more? Keep reading!

What is Mandatory Overtime? What Does It Mean for Nurses?

Mandatory overtime is when an employer forces an employee to work beyond the hours agreed upon in his or her contract, and it is extremely common in nursing as well as other healthcare professions.  

As with most full-time careers, nurses typically agree to work 30-40 hours per week when hired. Unfortunately, extreme staffing shortages and high turnover rates have resulted in administrators asking for more.  

Per the Fair Labor Standards Act (FLSA) of 1938, full-time employees are expected to work at least 40 hours per week; there is no maximum amount of time set. This allows employers in states with no legislation against mandatory overtime to force employees to work more than 40 hours per week for whatever reason.  

And yes, an employee can face consequences or be fired for not complying. 

The Pros and Cons of Mandatory Overtime for Nurses

Pros

As previously mentioned, the ongoing staffing shortages, high turnover rates, and nursing burnout have become detrimental to healthcare systems nationwide.  

Nurses are leaving the profession faster than they are joining it, and without them, patient care quality will crumble.  

Mandatory overtime serves as a short-term fix to keep nurses in the facility shift-to-shift, which appears as only beneficial to administrators. 

However, there is a positive side for nurses; if they are looking to make extra money, that is.  

Although a nurse cannot pick and choose when an employer requires them to work overtime, they will be paid more than their average hourly wage. Usually, it is time and a half.   

Cons

From a nurse’s perspective, it is evident that there are several downsides to mandatory overtime.  

For example, there is an increased chance of a provider making a mistake, which can put patients and their health at risk.  

Following, by enforcing overtime, workplace morale decreases, and the probability of nursing burnout increases. Additionally, a nurse’s safety, physical health, and wellbeing may also be put at risk if required to work more than 40 hours per week. 

The American Journal of Nursing (AJN) outlines that due to the potential health risks for both patients and providers that mandatory overtime should only be implemented temporarily and during the most emergent situations. 

Despite the need for more working nurses, there are several outlets that hospital administrators can pursue instead of mandatory overtime in order to address the detrimental staffing deficits, Bradley University highlights the following: 

• Strategic planning 
• Improving working conditions 
• Using travel nurses 

What State-Specific Legislation Addresses Mandatory Overtime for Nurses?

California

Employees are not required to work more than 12 hours in a 24-hour period unless there are emergent circumstances. 

Connecticut

Unless they are finishing a procedure or are in an emergency-like scenario, no employee is required to work past their scheduled shift.  

Hawaii

Overtime is voluntary; however, shifts cannot exceed 14 hours.  

Illinois

Employees cannot exceed four hours over a scheduled shift; there are no exceptions to this. If the employee finishes a 12-hour shift, they must have at least an eight-hour resting period before returning to work.

Maine

Employees may only be required to work overtime during emergencies; however, they are required to have a 10-hour resting period following the overtime shift.  

Maryland

The only exception to this ban is if the employee’s skills are needed in the event of an emergency. 

Massachusetts

No shift can exceed 12 hours. The only exception is if no alternative employee is available, and a patient’s life is at risk.  

Minnesota

Emergency situations and an inability to find an alternate employee in said circumstances are the only exceptions to this ban.

Missouri

Overtime might be required if an emergency arises, and the facility has made a ‘reasonable effort’ to find coverage but failed to do so.  

New Hampshire

No shift can exceed 12 hours in a single shift unless an emergency arises; they must receive an 8-hour resting period immediately after.  

New Jersey

Employees are not required to work overtime. The only exception is in unforeseeable emergency circumstances. 

New York

Employees are not required to work overtime unless they are assisting in an emergency or finishing a procedure. 

Oregon

Employees cannot exceed four hours past their scheduled shift. Overtime is only required in unforeseeable emergencies.  

Pennsylvania

Employees are only required to work overtime in situations declared as emergent by a federal, state, or municipal authority. 

Rhode Island

Employees are only required to work overtime in scenarios declared as ‘catastrophic events’ by a state authority.

Texas

Employees are not required to work overtime. There are no known exceptions.  

Washington

Employees are not required to work overtime. There are no known exceptions. 

West Virginia

Employees cannot exceed 16 hours in a single shift, and those who work 12 hours or more must receive an eight-hour rest period immediately after the shift.  

Please note that this information was obtained from all of these states’ legislation may contain exceptions, and that they all vary.  

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