ArticleClinical Practice: GlobalCritical care nurses' perceptions of the outcomes of working overtime in Canada

•This qualitative study was able to illuminate the direction of the effect of overtime on critical care nursing sick time as the additional hours and pace were perceived to result in injury and illness.•Overtime situations may be particularly harmful to wholly dependent critical care patients when nurses are more hurried and less patient centered.•At the policy level, there is a need for institutional accountability for the hours that nurses are working, and these should be reasonably limited to safeguard nurse and patient well-being.•There are both positive and negative consequences to overtime work, but critical care nurses valued the option to work it.

BackgroundNursing overtime is being integrated into the normal landscape of practice to ensure optimal staffing levels and addresses variations in patient volume and acuity. This is particularly true in critical care where fluctuations in either are difficult to predict.PurposeThe goal of this study was to explore critical care nurses' perceptions of the outcomes of working overtime.MethodsSally Thorne's interpretive description guided the collection and analysis of data. Participants were recruited from 11 different critical care units within three large teaching hospitals in Southern Ontario, Canada. A total of 28 full- and part-time registered nurses who had worked in an intensive care unit for at least one year took part in this study. Data were collected through semistructured, audio-recorded, individual interviews that took place in rooms adjacent to participants' critical care units. Template analysis facilitated the determination and abstraction of themes using NVivo for Mac 10.1.1.FindingsMajor themes highlighting the perceived outcomes of overtime included (a) physical effects, (b) impact on patient-centered care, (c) balancing family and work, (d) financial gain, and € safety is jeopardized.ConclusionsNursing managers and institutions need to be accountable for staffing practices they institute, and nurses themselves may require further education regarding healthy work-life balance. There are both negative and positive consequences of nursing overtime for nurses and patients, but nurses at large valued the option to work it.