Nurses who work longer than their scheduled shifts don't collaborate as well with other nurses or physicians, according to new research.
Even one hour of nurse overtime can negatively affect collaboration between nurses and physicians. The study, published Thursday in the Journal of Nursing Administration, found that overtime among nurses was relatively common. About one-third of nurses reported working longer than they were scheduled. Additionally, about 35% of nurses felt the demand for overtime has increased on their units.
Collaboration among clinicians is often cited as a critical component to high-quality patient care, and nurses are key players on such teams. Research shows that patients have better health outcomes when they are treated in hospitals with nurses who collaborate with other providers.
"It's been well-documented for many years that nurses' shifts don't end when they are scheduled to end, but it's interesting to note that this is a chronic problem," said Amy Witkoski Stimpfel, co-author of the study and assistant professor at NYU Rory Meyers College of Nursing. "These findings suggest there is a negative impact on collaboration, and we've seen in previous work that overtime leads to patient safety and quality issues, so this (study) is expanding the scope of the repercussions of overtime."
Overtime likely leads to breakdowns in collaboration because nurses are fatigued, which causes "deterioration" in cognitive and behavioral functioning, the study said. Nurses are typically scheduled to work 12-hour shifts at hospitals.
Managers can use technology to reduce overtime by predicting how many nurses a unit needs based on patient case loads, said Chenjuan Ma, lead author of the study and assistant professor at NYU Meyers.
Although Ma noted that sometimes overtime is inevitable, such as when a nurse calls off unexpectedly, the findings could also be applied to other clinicians. "Working overtime is a common theme across disciplines," she said.
The study used 2013 survey data from Press Ganey's National Database of Nursing Quality Indicators to reach its findings. The analysis included 24,013 nurses in 957 units at 168 U.S. hospitals.