NURS 438 Trends And Issues In Nursing And Health Systems
Question
Topic Mandatory overtime
The purpose of this assignment is to:
Issues are often value laden; issues in health care and in nursing are no different. Concerns about the state of our health care system and the state of nursing in Canada have been discussed at length within the media, government, and nursing organizations. While it is often difficult to differentiate fact from fiction and opinion, public opinion is often influenced by what is written in the popular press or on the Internet.
Expectations
Find three articles on the same issue/topic.
Your second article must be from a scholarly periodical either print version [e.g. The Canadian Nurse] or retrieved from a database [e.g. AU Library, CINAHL, Medline, etc.].
The third article must be from a Web site that is not merely a Web version of a print source. The articles should represent a range of views; in other words, these articles should not all agree.
Respond to the three articles by:
- Comparing the authors’ credibility, documentation, and support for claims;
- Evaluating any disagreements or agreements between the authors; and
- Articulating your own position on their ideas or issues. This means more than just stating your opinion; you must also explain it.
- Describe how your personal and professional values influence your views on this issue.
Answer
Literature review on mandatory overtime for nurses
Introduction
Mandatory overtime in Canada has become a norm in a bid to address the shortage of nurses and increased numbers of patients. This refers to working beyond the stipulated working time which varies in different provinces in Canada. In this essay, I’m going to address the mandatory overtime in nursing according to various media. The three articles raise the issue on mandatory overtime for nurses, the various effects it has and why hospital administrations are opposed to the ban of mandatory overtime. I personally don’t support mandatory overtime and there are several effects on the nurse emotionally, physically and health-wise.
Article by the canada broadcasting corporation
This article is sourced from the Canadian Broadcasting Corporation online article (CBC.Ca ,2010). The nurses in Montreal’s Maisonneuve-Rosemont Hospital are not comfortable with the mandatory overtime hours. The first issue addressed states that it has affected their productivity and has resulted in a decreased nursing satisfaction. The author states that the nurses now work for an eighteen-hour shift up from sixteen-hour shift due to a shortage of nurses.
The union representative states that the nurses are exhausted and suffering burn out due to the long working hours. The second issue is patient care jeopardized since the nurses can’t function optimally due to the heavy workload. An example is some of the nurses working in the intensive care unit have resigned due to the unfavourable conditions leaving the unit without nursing staff. The hospital seeks to address the issue of nursing shortage while it endorses various solutions to ensure the intensive care unit is covered.
Journal on critical care nurses regarding overtime
The second article is a periodical which addresses the perceptions of critical care nurses on the outcomes due to working overtime (Lobo, Ploeg, Fisher, Peachey, & Akhtar-Danish, (2017). The first issue addressed is the nurse describe the physical effects of mandatory overtime such as fatigue and inability to focus and concentrate. This leads to decreased patient centered care. The second issue is that patient safety is jeopardized since the nurses are exhausted and are unable to provide the best care. However, the article also states the advantages of mandatory overtime to nurses being financial gain as they were making more money for their extra work.
The author states the need for the administration and nursing managers to evaluate the need for mandatory overtime for nurses and ensure evaluation for staffing practices in the various hospitals.
Article by canadian nurses protective society
The third article is from the Canadian Nurses Protective Society website which states that during the nursing shortage and the nurse is working overtime he/she should uphold the standards of practice within the territory (Elaine Borg,2016). The nurse who declines to work overtime is charged with patient abandonment which appears as professional misconduct.
The other issue that the article addresses when the nurse is confronted with a difficult situation where they have been requested to work mandatory overtime, they should work then seek help later. The nurse is required to report the issue of nursing shortage to the management and ensure their complaints are addressed. The author also states for example when there is a lawsuit regarding negligence the nursing shortage should be considered.
My response
The first article written by the Canadian Broadcasting Corporation focuses on the nursing fraternity facing difficulties due to mandatory overtime and pointing out the nurse’s exhaustion due to long working hours. The second article focuses on the view of critical care nurses who state that although patient care is jeopardized by long nursing shifts, the nurse gets the advantage of increased monetary funds. The third article written by Canadian Nurses Protective Society states that when the nurse is working overtime, they are required to ensure they maintain professional standards and look for alternative channels to address their complaints on mandatory overtime. There is the credibility of authors in addressing the mandatory overtime for nurses as a trending issue.
Evaluation on agreements between the authors
The three articles have three similarities they highlight the effects of the nurses working on mandatory overtime in terms of exhaustion and decreased productivity. The overtime requires the nurses to work beyond their working hours which leads to increased fatigue. According to Boamah, Read& Spence Laschinger, (2017), mandatory overtime has been associated with nurse burnout and increased medical errors which translate to patient mortality.
The articles also state the major cause of nurses participating in mandatory overtime is due to nursing shortages in Canadian hospitals while there is increased patient admission. Some hospitals are reluctant to employ new staff due to increased costs compared to paying the nurses working on overtime. According to Murphy et.al (2012), the nursing shortage in Canada is expected to rise to 20,000 by 2022.
Evaluation on disagreements between the authors
While the first article by Canadian Broadcasting Corporation emphasizes the total ban the mandatory overtime the third article by the Canadian Nurses Protective Society states that the nurse is responsible during the overtime. That their actions regarding declining the mandatory overtime may be regarded as professional misconduct. The first article mainly focuses on the wellbeing of the nurse and the patient outcomes regarding nurse who works overtime while the third article mainly focuses on the responsibility of the nurse during the mandatory overtime.
The second journal on critical care nurses focuses on the fatigue experienced by nurses during the mandatory overtime but differs with the first article by the Canadian Broadcasting Corporation in that the nurses benefit financially from the mandatory overtime. It also states that states that when nurses are working overtime the patient’s care is jeopardized. Kunaviktikul et.al (2015) states that medical errors are largely attributed to health workers fatigue and inability to concentrate.
My position welfare of nurses
My opinion regarding the fatigue and exhaustion encountered by nurses should not be allowed and there should be a policy in the Canadian Nurse Association protecting nurses from mandatory overtime. According to the International Labor Organization, the stipulated working hours are forty hours a week. Extending this period not only violated the rights of the nurse but also affects their emotional and mental well-being. Dembe (2016) states that long working hours for nurses results in chronic illnesses, depression and musculoskeletal disorders.
Nurses are the primary health care providers and a priority sector in the healthcare system. Forcing ill and fatigued nurses to work not only jeopardises the patient centered care but also increases the chances of lawsuits against negligence. The hospitals should not sacrifice the nurses due to the shortage of nurses.
FInancial benefit due to mandatory overtime
Nurses just like other professionals depend on their careers to earn a living and meet their basic needs. The second article states that the nurses benefit from mandatory overtime since there is a monetary gain. However, I disagree with this because there is compromise being made which may prove fatal to the nurse, the patient and the organization. Johnstone (2015) states that nursing is guided by ethics and principles such as the principle of doing no harm. Therefore the patient should be the first priority while providing nursing care. Their safety comes first and they should not be knowingly placed in harm as the nurse aims at earning more. Flagg (2015) states that when the nurse’s workload is heavy the patient is no longer the focus of care.
Professional misconduct
The third article states that when the nurse declines the mandatory overtime it is regarded as professional misconduct. The nurse should accept the overtime and find alternative ways to address the nursing shortage. I disagree with this in all aspects. The nurse is autonomous and has the right to respectfully turn down the extra shift if they are not willing. The contract signed during the employment period should be followed to the latter. According to van Oostveen Mathijssen & Vermeulen(2015), the study shows that nurses feel like they lack the authority to address the nursing shortage. So the author’s option for the nurse to address the shortage is difficult for the nurses. The Canadian Nurse Association should clearly look into this aspect while considering the nursing shortage in Canada.
Personal&professional values.
My personal values such as integrity and accountability influence my views on mandatory overtime in that the hospitals and organizations should be open to their nursing staff regarding the nursing shortage and on what is being done about it. Overworking the nurses in a bid to meet the demands not only yields negative results in terms of performance but also affects the health of the nurses. I also believe that there should be mutual respect between the nurses and the management and when the mandatory overtime is implemented it creates conflict leading to disharmony and disrespect in the hospital environment.
Justice is another value I highly identify with and believe that there should be justice for all parties. The nurses should receive their justice in terms of ensuring a favourable working environment and working hours. The patient should receive holistic care from the nurses and the hospital should produce optimal patient results.
My professional values include human dignity and this heavily influences my stand since the nurse is a human being who deserves to be treated with respect at all times. This means their needs are considered when the protocol at the hospital is put in place. Shahriari, Mohammadi, Abbaszadeh & Bahrami (2013) state that nursing values are also guided by ethics.
Conclusion
Mandatory overtime is a contentious issue in nursing. However, the nurse’s welfare should always be considered. The paper has reviewed various articles, their similarities and differences and I have also given my stand regarding mandatory overtime. Nursing should be protected since it’s a key factor in the provision of healthcare.
Refernces
Boamah, S. A., Read, E. A., & Spence Laschinger, H. K. (2017). Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time?lagged study. Journal of advanced nursing, 73(5), 1182-1195.
CBC.Ca(2010,February 26).Nurses protest against mandatory overtime.CBC News.Retrieved from https://www.cbc.ca/news/canada/montreal/nurses-protest-against-mandatory-overtime-1.967043
Dembe, A. E. (2016). Long working hours: The scientific basis for concern. Members-only Library, 8(2).
Elaine Borg(2016,June 14).Professional liability during shortage.Canadian Nurses Protective Society.Retrieved from https://www.cnps.ca/index.php?page=91
Flagg, A. J. (2015). The role of patient-centered care in nursing. Nursing Clinics, 50(1), 75-86.
Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences.
Kunaviktikul, W., Wichaikhum, O., Nantsupawat, A., Nantsupawat, R., Chontawan, R., Klunklin, A., … & Akkadechanunt, T. (2015). Nurses’ extended work hours: patient, nurse and organizational outcomes. International nursing review, 62(3), 386-393.
Lobo, V. M., Ploeg, J., Fisher, A., Peachey, G., & Akhtar-Danesh, N. (2017). Critical care nurses’ perceptions of the outcomes of working overtime in Canada. Nursing outlook, 65(4), 400-410.
Murphy, G. T., Birch, S., MacKenzie, A., Alder, R., Lethbridge, L., & Little, L. (2012). Eliminating the shortage of registered nurses in Canada: an exercise in applied needs-based planning. Health policy, 105(2-3), 192-202.
Shahriari, M., Mohammadi, E., Abbaszadeh, A., & Bahrami, M. (2013). Nursing ethical values and definitions: A literature review. Iranian journal of nursing and midwifery research, 18(1), 1.
van Oostveen, C. J., Mathijssen, E., & Vermeulen, H. (2015). Nurse staffing issues are just the tip of the iceberg: A qualitative study about nurses’ perceptions of nurse staffing. International journal of nursing studies, 52(8), 1300-1309.
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