Tuesday, 11 November 2014

Nurses' overtime and patient care

Roger Watson, Editor-in-Chief

Nursing work is hard enough with physical and psychological demands and long and often unsocial hours. Nursing shortages and often poor salaries mean that overtime working is often a feature of many nurses' lives. It appears that there is little rigorous research into the extent to which working overtime influences patient care, according to a recent paper from Canada by Lobo et al. (2014) titled Integrative review: an evaluation of the methods used to explore the relationship between overtime and patient outcomes.

The paper reports on nine articles related to how nursing overtime affects patient outcomes. As with many such studies, the review showed methodological weaknesses in the area related to defining overtime and working out what effect confounding variables had on the measurement of outcomes. The findings of the studies, therefore, need to be interpreted cautiously. Nevertheless, there was some evidence to show that nurses' overtime was related to such things as infection rates, deaths from pneumonia and medication errors.

If there is any truth in these findings, these phenomena are surely worth investigating further; if upheld, they would certainly strengthen the argument for a better resourced nursing workforce. In the words of the authors: 'additional funding and attention needs to be directed at this topic area to mitigate the negative patient outcomes that may be a result of the use of nursing overtime.'

Lobo v, Fisher A, Peachey G, Ploeg J, Akhtar-Danesh N (2014) Integrative review: an evaluation of the methods used to explore the relationship between overtime and patient outcomes Journal of Advanced Nursing doi: 10.1111/jan.12523

1 comment:

  1. Timely. This flags a number of things - firstly terminology. Overtime is generally used to refer to extra hours sanctioned and paid for, usually at a higher than normal rate. This is not the only means whereby nurses hours rise: excess hours also accrue unpaid, with the (often unfulfilled) expectation of 'time in lieu'. This nurses can expend extra energy and time with or without any recompense - and often without even acknowledgement. There is little examination of the effect of this - but even less has its effect on the health of nurses themselves been considered. It is time we did so.