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Impact of Mandatory Overtime on Recruitment and Retention
It should come as no surprise that both nurses and hospital administrators recognize mandatory overtime as a leading cause of turnover among nurses. JCAHO President Dennis O'Leary notes that 22 percent of nurses who leave direct care work do so in search of "more regular hours."247 He warns, "Health care organizations face competition from employers who offer nurses the chance to work a regular business week. No nights. No weekends. No mandatory overtime. One major source of nurse overwork and dissatisfaction is overtime."248
By contrast, those hospitals that have succeeded in boosting their recruitment and retention rates have almost universally shunned the practice of mandatory overtime. When the American Organization of Nurse Executives asked human resource directors and chief nurses to identify "the most effective methods of recruitment and retention," they specifically identified "low or no mandatory overtime" as one of their most effective policies.249 In a survey of New York area hospitals, administrators likewise reported that policies barring mandatory overtime "were judged most effective" among retention strategies.250 In the original magnet hospitals, interviews with both staff nurses and nursing directors across the country did not produce even a single mention of the use of mandatory overtime; it appears to have been a foreign practice.251 Among the current magnet hospitals participating in the University of Oregon LERC survey, 17 out of 21 maintained a complete ban on mandatory overtime, and the others restricted it to limited needs, such as snow days. Several human resource directors commented specifically on the importance of banning this practice as part of the hospital's recruitment strategy. "The other hospitals in the area have mandatory overtime," explained one executive, "so [not using it] helps us in recruiting. No one thinks mandatory overtime is a good idea."252 At St. Mary's Hospital and Medical Center, where the vacancy rate is just 3 percent, the human resources director went even further, explaining that "no mandatory overtime is our promise to the staff."253
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