Competing Needs
The previous discussion highlighted the problem of employee absenteeism and turnover and the extent to which they impact the healthcare organization. As the analysis concluded, high rates of employee turnover and absenteeism are crippling to the success of clinical settings and the entire healthcare sector. To tackle the problem, it is important to identify and address the underlying needs contributing to the escalation of the issues. The United States medical sector is highly demanding; most of the times, employees are compelled to work overtime with unsatisfactory pay. This aspect brings out two aspects of competing needs leading to the identified healthcare stressor; high stressing work environment with little or no appropriate compensation.
Mandatory overtime is an issue of great concern, especially in nursing practice. According to Bae and Fabry (2014), because of unexpected census peaks, unfilled vacancies, leaves, and the likes, nurses and some employees in healthcare organizations are forced to work beyond the hours stipulated in employment contracts. According to the laws of the United States, over time constitutes working more than 40 hours a week (Bae & Fabry, 2014). Although some nursing professionals may not mind working for longer hours, for many, it implies interfering with their free time and thereby affecting their chances of realizing a healthy work-life balance. Furthermore, employees in the organization have cited that the vicious cycle of mandatory cycle makes nurses overly fatigued, thereby causing absentia or nurses quitting their jobs.
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Amid mandatory overtime, compensation for the nursing profession is not attractive. A survey conducted by Kunaviktikul et al. (2015) on the status of compensation rates for mandated overtime for nurses and other healthcare professionals reveals a flat rate, which is also highly demanding. Nearly 80 percent of surveyed nurses demonstrated dissatisfaction with the amount they are paid for being forced to work beyond the agreed time. It is a similar situation with the organization I work for. The two elements are competing in the sense that while the hospital expects nurses to deliver up to required standards; nurses, on the other hand, feel they are not treated right in terms of compensation for their forced inputs.
Organizational Policy Influencing Absenteeism or Employee Turnover
To address the problem of unfilled vacancies, census peaks, and overall shortages, the organization, as well as others in the sector, enact policies compelling nurses and other healthcare professionals like physicians into forced overtime. The policy serves the purpose of defining overtime, hours involved, and compensation (on hourly rates) for the extra time on the job. According to the policy, work begins on Monday morning all through to Sunday night. Normal work shifts begin from 9 a.m. to 5 p.m. covering the eight hours agreed upon by the employment contract. In addition to the normal shifts, the policy outlines two additional shifts that cover the overtime tasks.
The second shift begins from 5 p.m. and ends at 1 a.m. with a special shift starting from 1 a.m. to when the normal shift starts. In other words, the organization works around the clock and expects some employees, especially nurses, to be available at any given time from Monday to Sunday. Mandatory overtime applies to the second work shift with the special shift being arrived at through arrangements established by the hospital and individual nurses. Although the compensation rates are higher (1.5 times) than the normal working hours, the management expects that staff in the demanding departments must show up more than the standard hours when required.
Critique of the Policy
The purpose of mandatory overtime policy is to keep healthcare processes ongoing without interruptions. From this, the positive aspect associated with the organizational policy is increased productivity for the hospital and more earnings for members of the organization (Bae, Kelly, Brewer, & Spencer, 2014). These are also some of the strengths associated with the policy. For instance, when employees are required to work in excess of standard time, clinical centers get the benefit of an increased level of productivity. More work is done at longer hours which means nurses and doctors attend to more patients at a greater rate. For individual employees, it means more money. This is also the reason why some practicing professionals have no problem or are enthusiastic about mandatory overtime.
The problem with mandatory overtime is the burnout it causes to nurses. The main issue that is causing an outcry from members of the organization is that the policy imposes forced overtime. In a way, this is seen as an unethical organizational practice. As Kunaviktikul et al. (2015) explain when staff members do not have a choice but to work for many hours, sometimes twice their standard working time, it becomes an issue of ethics and the fact that this is not yet illegal is beyond explanation. This creates a stress-inducing environment, of which as pointed out in previous analysis, contributes to high rates of turnover and absenteeism. Additionally, mandatory overtime policy means the increased cost for the organization. Having staff work in excess of normal time with remuneration at higher rates means escalating costs, which cut into profits.
Recommendable Changes
Addressing the identified competing needs to ensure a balance is arrived at is not an easy task. In as much as it is important to create a friendly working environment for the staff members, it is also important to fulfill the healthcare needs of all patients, which are sometimes increasing. Mandatory overtime might be justifiable for some healthcare practitioners who are concerned about achieving the set goals and objectives of the sector (Griffiths et al., 2014). At the same time, it is an issue of violation of ethical principles, especially for those who carry the weight of the policy. The ideal solution here, therefore, is to find a way to get healthcare processes ongoing without necessarily having to force anyone to work.
Fixing the problem of forced overtime to find an effective alternative, of which, in this case, is voluntary overtime. Healthcare professionals know when they are too exhausted to work overtime in an effective and safe manner. On that note, why not find a way to obtain their consent on whether to work overtime or not. This is the only solution to break the remorseless cycle of mandatory overtime and at the same time, making sure the needs of the organization are met. Voluntary overtime allows employees to gauge their fatigue levels before accepting or turning down a request to work in excess hours. Lu and Lu (2016) suggest that this prevents risks associated with forcing an employee to work when fatigued. Further, the authors explain that long working hours, and its impact on patient care is not distinguishable between voluntary and mandatory care except for mandated overtime, the risk of patient harm increased.
References
Bae, S. H., & Fabry, D., (2014). Assessing the relationships between nurse work hours/overtime and nurse and patient outcomes: a systematic literature review. Nursing Outlook , 62 (2), 138-156.
Bae, S. H., Kelly, M., Brewer, C. S., & Spencer, A. (2014). Analysis of nurse staffing and patient outcomes using comprehensive nurse staffing characteristics in acute care nursing units. Journal of Nursing Care Quality , 29 (4), 318-326.
Griffiths, P., Dall’Ora, C., Simon, M., Ball, J., Lindqvist, R., Rafferty, A. M., ... & Aiken, L. H. (2014). Nurses’ shift length and overtime working in 12 European countries: the association with perceived quality of care and patient safety. Medical care , 52 (11), 975.
Kunaviktikul, W., Wichaikhum, O., Nantsupawat, A., Nantsupawat, R., Chontawan, R., Klunklin, A., ... & Akkadechanunt, T. (2015). Nurses' extended work hours: patient, nurse, and organizational outcomes. International nursing review , 62 (3), 386-393.
Lu, S. F., & Lu, L. X. (2016). Do mandatory overtime laws improve quality? Staffing decisions and operational flexibility of nursing homes. Management Science , 63 (11), 3566-3585.
