Study: State Caps on Mandatory Overtime for Nurses Seem to Work

Jan 30, 2012, 12:57 PM

A recent study from the Robert Wood Johnson Foundation-funded RN Work Project takes a close look at state rules capping nurses’ mandatory overtime hours. As of 2010, 16 states had imposed such caps, with the goal of avoiding errors caused by long hours and insufficient rest between shifts.

The study concludes that the laws seem to be working. “It’s important to policy-makers to understand the impact of the remedies they devise for particular problems,” says study co-author Sung-Heui Bae, PhD, MPH, RN. “What we learned in this study is that it’s working. The tool is effective. Other states with similar objectives can follow suit and expect similar results.”

“The purpose of capping mandatory overtime is to make hospitals safer for patients and nurses,” says co-author Carol Brewer, PhD, RN, FAAN. “Nurses routinely work long shifts, often as long as 12 hours straight. These laws were intended to prevent hospitals from piling mandatory overtime on top of such shifts—a practice that research shows can increase the likelihood of mistakes. The laws seem to be accomplishing their objective.”

Brewer is a professor, and Bae is an assistant professor, at the School of Nursing, University at Buffalo. Brewer directs the RN Work Project, together with Christine Kovner, PhD, RN, FAAN, professor at the College of Nursing, New York University. Kovner is also a co-author of the study.

The trio identified 16 states with laws or regulations restricting mandatory overtime hours for nurses as of 2010—Arkansas, California, Connecticut, Illinois, Maryland, Minnesota, Missouri, New Jersey, New Hampshire, New York, Oregon, Pennsylvania, Rhode Island, Texas, Washington and West Virginia. To find out whether the rules had actually affected the workplace, the researchers examined newly licensed RNs’ self-reported mandatory and voluntary overtime hours, as well as their total work hours.

They found that in the states with rules governing mandatory overtime, the newly licensed nurses were 59 percent less likely to work mandatory overtime than their colleagues in unregulated states. In addition, in the states regulating overtime, newly licensed nurses worked an average of 50 fewer minutes per week than their colleagues in states without overtime regulations.

The researchers were particularly interested in finding out if caps on mandatory overtime might lead to increased voluntary overtime, thus defeating, to at least some degree, the purpose of the restrictions. But the data demonstrated no relationship between mandatory and voluntary overtime hours.

Read more about the RN Work Project.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.