Mandatory Overtime

This position statement was updated and combined with a Workplace Advocacy Position Statement on 11/7/2012.


  • Overtime should be offered on a voluntary basis and after all other attempts to provide adequate staffing has failed.
  • The medical-surgical nurse should not be required to work beyond the individual nurse's physical and mental capacity.
  • Health care facilities should have a system in place to assess patient care needs and assign staff without the use of mandatory overtime. Mandatory overtime should not be used to provide adequate staffing as a solution to chronic understaffing.
  • The medical-surgical nurse should serve on committees that address the impact of inadequate staffing levels on patient safety, nursing errors and patient outcomes.
  • The medical-surgical nurse has a responsibility to report unsafe staffing conditions or inappropriate staffing without fear of retribution and retaliation.


Mandatory overtime is an issue faced by many medical-surgical nurses across the nation. Mandatory overtime is seen by some as a solution to the nursing shortage, cost-cutting layoffs, and redesign of health care organizations. Many states have enacted or are considering laws prohibiting mandatory overtime.


The Institute of Medicine (1999) found the likelihood of making an error increases when a health care worker works more than 12 hours and is fatigued. The medical-surgical nurse has the right and responsibility to provide safe patient care within one's physical and mental abilities.


Mandatory overtime (or forced overtime) occurs when employers require an employee to work more than 40 hours per week, even if the employee does not want to work the additional hours.


American Nurses Association (2009). Mandatory overtime. Retrieved January 29, 2010 from

Academy of Medical-Surgical Nurses. (2007). Scope and standards of medical-surgical nursing practice.  Pittman, NJ: Author.

American Nurses Association (2006). Assuring patient safety: The employer's role in promoting healthy nursing work hours for registered nurses in all roles and settings. Retrieved September 19, 2009, from

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (1999). To err is human: Building a safer health system. Washington, DC: National Academy Press.

Trinkoff, A., Geiger-Brown, J., Brady, B., Lipscomb, J., Muntaner, C.  (2006).  How long and how much are nurses now working?: Too long, too much, and without enough rest between shifts. American Journal of Nursing, 106(4), 60-71.