A Guide to Mandatory Overtime for Nurses

You get your schedule for the month and immediately notice that you are scheduled for four, not three, 12-hour shifts per week. You ask your manager if there was a mistake, and they reply, “Everyone will be working mandatory overtime for the next few months.”

You wonder: How is this possible? Is mandatory overtime for nurses even legal? What happens if I refuse — will I be fired?

While this is an imaginary situation, your curiosity about overtime for nurses may be very real. In this article, we’ll discuss what qualifies as mandatory overtime, explore the pros and cons, and provide a state-by-state breakdown of laws prohibiting mandatory overtime.

What Is Mandatory Overtime in Nursing?

Mandatory overtime occurs when an employee is required to work beyond their regular, agreed-upon work hours. This is not limited to those working 40-hour work weeks. It can also apply to part-time workers and those expected to work more than the scheduled hours in one shift.

For example, if a nurse is hired part time and agrees to work two 12-hour shifts per week, working a 14-hour shift could qualify as overtime. However, under federal law and the laws of many states, those hours would not be paid at the overtime rate because, for this nurse, it does not exceed 40 hours in a week.

How Is Overtime Compensated?

Employers are generally required to pay overtime at one-and-a-half times an employee’s normal pay rate under the federal Fair Labor Standards Act (FLSA). This pay rate kicks in after 40 hours of work in a week.

However, the law allows for some exemptions — like being paid on a salary basis and possessing advanced knowledge in science — that could make some nurses ineligible for overtime pay under the FLSA, although they could still be eligible for overtime pay under state law. Facilities can still, and often do, offer their nurses overtime pay — this just means it may not always be federally required.

Mandatory Overtime Laws by State

There are 18 states that have enacted laws regarding mandatory overtime for nurses. Learn about your state’s labor laws to get a better understanding of your rights.

1. Alaska

Mandatory overtime: Illegal (Alaska Statutes Sections 18.20.400 – 18.20.499), but there are several exceptions to include unforeseen emergency situations. Applies to nurses hired for full-time and part-time. On-call is allowed.

Maximum legal shift: 14 consecutive hours.

2. California

Mandatory overtime: Illegal (Department of Industrial Relations, Wage Order 4-2001 Section 11040), with exceptions for emergencies. However, nurses may not be forced to work more than 72 hours in a week.

Maximum legal shift: 12-hour shift. Working more than 12 hours in a day must be paid at double the employee’s base rate.

3. Connecticut

Mandatory overtime: Illegal (Connecticut General Statutes, Title 19a, Chapter 368v, Section 19a-490l), but there are exceptions which include emergencies, when critical care nurses are waiting for their replacement nurse, and for completing surgical procedures.

Maximum legal shift: No more than their predetermined, regularly scheduled hours.

4. Illinois

Mandatory overtime: Illegal (210 Illinois Compiled Statutes, Section 85/10.9), with exceptions for unforeseen emergencies where overtime is needed as a last resort. Overtime cannot exceed 4 hours beyond the predetermined shift.

Maximum legal shift: 12 consecutive hours. Must have at least 8 consecutive hours off duty afterwards.

5. Maine

Mandatory overtime: Illegal (Maine Revised Statutes, Title 26, Chapter 7, Section 603), with some exceptions. For example, nurses can be disciplined for refusing overtime in an unforeseen emergency when patient safety is at risk and overtime is needed as a last resort to ensure patient safety.

Maximum legal shift: 12 consecutive hours. Must have at least 10 consecutive hours off duty afterwards.

6. Maryland

Mandatory overtime: Illegal (Maryland Labor and Employment Statutes, Section 3-421), with some exceptions, such as situations where overtime is needed for emergencies, completing a treatment or procedure, or when there’s no replacement nurse available. The prohibition also does not apply to nurses working in community-based care or those who agreed to on-call rotations.

Maximum legal shift: No more than their predetermined, regularly scheduled hours.

7. Massachusetts

Mandatory overtime: Illegal (Massachusetts General Laws, Title 16, Chapter 111, Section 226), with exceptions for emergencies when there is no reasonable alternative.

Maximum legal shift: 16 consecutive hours in a 24-hour period. Must have at least 8 hours off duty afterwards.

8. Minnesota

Mandatory overtime: Illegal (Minnesota Statutes, Chapter 181, Section 181.275), but with exceptions for emergencies. It also does not apply to nursing facilities, intermediate care facilities for persons with developmental disabilities, a licensed boarding care facility, or a housing with services establishment.

Maximum legal shift: 12 consecutive hours.

9. Missouri

Mandatory overtime: Illegal (Missouri Code of State Regulations, Title 19, Division 30, Section 30-30.020, Paragraphs [1][C][9][A]-[F]), with exceptions for any “unexpected nurse staffing shortage” that puts patient safety at substantial risk, but reasonable efforts must be made to obtain safe staffing before overtime can be required.

Maximum legal shift: Nurses required to work more than 12 consecutive hours must be given the option to have at least 10 consecutive hours of uninterrupted off-duty time.

10. New Hampshire

Mandatory overtime: Illegal (New Hampshire Statutes, Title 23, Chapter 275, Section 275:67), with exceptions for completing surgery, public health emergencies, when a replacement nurse is unavailable in a critical care unit or in a home health care setting, and when a collective bargaining agreement includes overtime.

Maximum legal shift: 12 consecutive hours. Must have at least 8 consecutive hours off duty afterwards.

11. New Jersey

Mandatory overtime: Illegal (New Jersey Administrative Code, Section 8:43E-8.5), with exceptions for unforeseeable emergencies where overtime is required as a last resort, but this exception does not apply to situations where overtime is used to fill vacancies resulting from chronic short staffing. Employers may not use on-call time as a substitute for mandatory overtime.

Maximum legal shift: May not exceed the regular, predetermined shift.

12. New York

Mandatory overtime: Illegal (New York Labor Code, Article 5, Title 1, Section 167), with exceptions for emergencies, natural or healthcare disasters, and completing a surgical procedure.

Maximum legal shift: May not exceed the regular, predetermined work hours.

13. Oregon

Mandatory overtime: Illegal (Oregon Revised Statutes, Title 36, Chapter 441, Section 441.166), with exceptions for emergencies, infectious disease epidemic, or an unforeseen event making the replacement nurse unavailable.

Maximum legal shift: No more than the regular, predetermined shift, 12 consecutive hours in a 24-hour period, or 48 hours in a hospital-defined work week. Must have at least 10 consecutive hours off duty after the 12th hour worked.

14. Pennsylvania

Mandatory overtime: Illegal (2008 Act 102), with exceptions for unforeseen emergencies, for completion of procedures already in process, and for last-minute absences when a replacement nurse is unavailable. Employers may not use on-call time as a substitute for mandatory overtime.

Maximum legal shift: Nurses required to work more than 12 consecutive hours must have 10 consecutive hours off duty afterwards.

15. Rhode Island

Mandatory overtime: Illegal (Rhode Island General Laws, Title 23, Section 23-17.20-3), with exceptions for unexpected emergencies where overtime is a last resort and not used to fill vacancies from chronic short staffing.

Maximum legal shift: May not exceed 12 consecutive hours.

16. Texas

Mandatory overtime: Illegal (Texas Health and Safety Code, Title 4, Chapter 258, Section 258.003), with exceptions for disasters, unforeseen emergencies, and completing a procedure. Employers may not use on-call time as a substitute for mandatory overtime.

Maximum legal shift: May not exceed the predetermined shift.

17. Washington

Mandatory overtime: Illegal (Revised Code of Washington, Title 49, Chapter 49.28, Section 49.28.140), with exceptions for unforeseen emergencies, prescheduled on-call shifts, completing a procedure, and when a replacement nurse is unavailable.

Maximum legal shift: No more than 12 hours in a 24-hour period. May not exceed 80 hours in a consecutive 14-day period.

18. West Virginia

Mandatory overtime: Illegal (West Virginia Code, Chapter 21, Article 5F, Section 3), with exceptions for unforeseen emergencies, prescheduled on-call shifts (employers may not use on-call time as a substitute for mandatory overtime), and completing a procedure.

Maximum legal shift: No more than 16 hours in a 24-hour period. Nurses working more than 12 consecutive hours must have 8 consecutive hours off duty after their shift.

Can Nurses Be Forced to Work Overtime?

The short answer is yes, but the context is important. Remember this varies from state to state, and most states don’t have laws making mandatory overtime for nurses illegal. In those states, nurses could be required to work overtime.

Can nurses not be required to work overtime? Some states have enacted laws that make it illegal. Yet even in states where mandatory overtime is prohibited, there may be exceptions. Common exceptions include:

• Unforeseeable emergencies
• Catastrophic events
• Completing patient care that’s in progress
• Nursing replacement is unavailable

Can I Be Fired If I Refuse Overtime?

If mandatory overtime for healthcare workers is legal in your state, you are an “at will” employee, and your employer follows the applicable laws and regulations, you could be fired for refusing overtime.

However, some states have nursing labor laws that prevent employers from firing nurses who refuse to work overtime. In these situations, refusing to work beyond your previously agreed-upon shift requirements will not put your job at risk.

Pros and Cons of Mandatory Overtime for Nurses

You may wonder just how mandatory overtime affects nurses (and their patients). The good news is that there are some pros — though there appear to be more cons.

Pros:

• Extra pay: Overtime is typically compensated at 1.5 times the base pay.
• Staffing solution: While temporary, it can fill an unexpected nursing coverage gap.

Cons:

• Increased errors: Errors are three times more likely when a nurse works more than a 12-hour shift.
• Patient dissatisfaction: Nursing shifts greater than 13 hours are linked with an increase in patient dissatisfaction.
• Decreased morale: Higher nursing burnout, increased staff turnover, and emotional/mental exhaustion can result from mandatory overtime.
• Detrimental health effects: Overworked nurses may experience poor sleep, stress, fatigue, and a higher likelihood of needle stick injuries.

How to Get The Schedule You Want

Are you working more than you’d like? Let’s face it — even if your employer isn’t requiring mandatory overtime for nurses, you might not enjoy your shift requirements. Luckily, IntelyCare can help. Search today to find a job that better suits your lifestyle.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.