A concept analysis of nursing overtime

Area of Science:

• Nursing
• Healthcare Management
• Organizational Behavior

Background:

• Hospital restructuring due to economic constraints has led to increased reliance on nurse overtime.
• Nurse staffing, the largest organizational expense, is often targeted through alternative strategies like overtime.
• Nursing overtime is a poorly defined and broadly applied concept requiring analysis.

Purpose of the Study:

• To conduct a concept analysis of nursing overtime.
• To clarify the multifaceted nature of nursing overtime.
• To inform the development of appropriate staffing strategies and rigorous research.

Main Methods:

• Concept analysis utilizing Walker and Avant's methodology.
• Comprehensive literature search including electronic databases, grey literature, and policy documents (1993-2012).
• Analysis of approximately 65 documents meeting inclusion criteria.

Main Results:

• Nursing overtime is characterized by four attributes: perceived choice/control, rewards/lack thereof, equitable value of time off duty, and disruption from lack of preparation.
• Antecedents of overtime span societal, organizational, and individual levels.
• Consequences of overtime are both positive and negative, impacting organizations, nurses, and patients.

Conclusions:

• This concept analysis provides a clearer definition of nursing overtime.
• Recommendations are made to advance nursing research, practice, and policies related to overtime.
• A nursing-specific middle-range theory for understanding and studying overtime was proposed.