Working overtime can make it harder for nurses to collaborate with physicians and other nurses, according to a new study.
Researchers at New York University examined 2013 data from the National Database of Nursing Quality Indicators that included more than 24,000 nurses at 168 hospitals. One in three nurses in the study reported working overtime.
The study team found that for each overtime hour a nurse worked, collaboration with other nurses and doctors on a ward worsened. They also found collaboration was worse in units with longer overtime shifts and more nurses working overtime.
Amy Witkoski Stimpfel, R.N., Ph.D., an assistant professor at NYU Rory Meyers School of Nursing and one of the study's co-authors, told FierceHealthcare that the additional fatigue and sleep loss that extra hours cause can impact performance and nurses' mood, making collaboration harder.
"That could be one factor that's really starting to undermine their ability to work together and collaborate," Stimpfel said.
Chenjuan Ma, Ph.D., an assistant professor at NYU's Meyers School and the study's other author, told FierceHealthcare that the study highlights one way that providers can improve collaboration, which is especially important as collaborative, team-based care can improve outcomes and boost safety.
If nurses can't collaborate effectively with one another, for example, that can impact handoffs and other potential pressure points where patient safety is at risk, she said. The results also reflect trends that exist beyond hospital-based doctors and nurses, she said.
"Although this [study] is focused on physicians and nurses, I think the implication may be beyond that, and it can expand to other healthcare providers, or even outside of the healthcare discipline," Ma said.
There's a lot that providers can do to support nurses and ease the stress of long hours or overtime, Stimpfel said. Working within nurses' circadian rhythms to schedule naps or coffee breaks can keep their energy up, she said, and standardized handoffs at the end of shifts can mitigate some of the risks inherent in the process.
Ma said that providers should be taking advantage of scheduling tech that allows them to monitor schedules and hours more effectively. There is also room for providers to re-examine how they schedule managers, who can provide support to overworked nurses in peak windows, she said.
"This is something that's modifiable in the work environment," Stimpfel said.