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Study finds overtime impedes nurse collaboration


We’ve all heard about how nurses that work overtime struggle with burnout and make more errors, but a new study suggests that overtime makes it harder to collaborate with peers and physicians as well.

A New York University study examined the National Database of Nursing Quality Indicators’ data from 2013, which included 24,000 nurses working at 168 different hospitals. A third of participants reported working overtime, and researchers compared the quality of service with the amount of overtime.

The team discovered that for each hour of overtime that a nurse worked, collaboration with other nurses and doctors on their unit worsened. They also found that units with longer overtime shifts and more nurses working overtime correlated with decreased overall collaboration.

For the research team, these results came as no surprise. The long hours, additional fatigue, and loss of sleep are a major factor that undermines nurses’ ability to work together and communicate clearly, study co-author Amy Witkoski Stimpfel, RN, Ph.D. said in a recent interview. Since so much of nurses’ work is critical to patient safety, any missteps during handoffs or physician interactions negatively impacts patient outcomes.

So what can leadership do? Stimfel suggests that leaders can work within nurses’ circadian rhythms by scheduling nap or coffee breaks that can help keep energy up, and standardize handoff procedures to mitigate some of the inherent risks. Chenjuan Ma, Ph.D., the study’s other co-author, suggests using scheduling technology that can help leaders monitor schedules and hours more effectively, and scheduling managers alongside overworked nurses during peak windows to support staff during the most difficult times.

For more tips on how to help nurses cope with burnout and fatigue, check out the following articles from the Strategies for Nurse Managers Reading Room:

Preventing nurse fatigue
Stop requiring nurses to work overtime
Combating depression in nurses