How does mandatory OT work?

Nurses General Nursing


We don't have mandatory overtime where I work. But I'm curious as to how the "rules" go about Mandatory OT.

Does it mean that they can call you in on your days off and you aren't allowed to refuse? Or does it just mean that you can't refuse to stay for overtime after a regularly scheduled shift? Is there a limit of how long they can make you stay, or not? Can you be fired for refusing to come in on your days off? What about just not answering the phone?

I could stay an extra four hours after my regular twelve (and have done so voluntarily). But only if I don't have to come back the next day! More than that I would refuse, because I would be too exhausted. Does mandatory OT mean that I would not be allowed to plead exhaustion and go home?

How rampant is mandatory OT in various regions? It sounds positively inhumane!


951 Posts

Specializes in Hospice, Critical Care.

I suppose the "rules" vary by institution. In our facility, mandatory overtime does happen but it is infrequent. There is a staffing book that the house supervisor refers to when someone has to be mandatoried. (You cannot be called in from home; you have to already be in the facility. I know we make calls ASKING people to come in but you cannot be MANDATORIED if you're at home.) The supervisor has staffing sheets from all the units. She checks the staffing book to see if anyone currently at work has been mandated, and if so, when. If someone's name is on the list as having been previously mandated, it is not their "turn." They will go by unit first and ASK. They will consider it a "mandatory" if someone says, yes they can stay--that way, their name gets in the book and it won't happen to them again soon. If not, then they will require someone to stay--based on who's turn it is, etc. You cannot be mandated to work more than a total of 16 hours in a row; hence, if you normally work a 12-hour shift, you can only be mandated for 4 more hours.

Last week we had a snow storm and a nurse couldn't make it in; another nurse was mandated from 7A to 11A until we could get a nurse in. That's all the mandatoring my 374-bed hospital has done in the last month. Not too bad. Would be nice if it didn't happen at all but...ah, well.

OC_An Khe

1,018 Posts

Specializes in Critical Care,Recovery, ED.

It does depend upon individuals policies of the employer and by state law. There are facilities that can mandate you to come in from home on your day off, or don't provide you with relief at the end of your scheduled shift. Most RN don't mind MOT in a truly emergent situation but many facilities are using it as a means of staffing the hospital as opposed to hiring the necessary FTE's or PRN's to adequately staff their facility. This is a conscious choice by administrators as some facilities run well with out using this abusive policy. Count yourself lucky that you work in an institution that doesn't disrepect its staff in this manner.


152 Posts

When my facility had mandatory OT we had to work one extra shift per pay period. We work 12's but he extra shift could be an 8. That got old very rapidly but we had to do it for a year.


2,709 Posts

It doesnt.

But the employers dont want to hear about it because it still costs less than hiring hiring more staff or using supplemental temps like agencies.

So, while the nurse is getting ready to give report & planning to get home in time to cook her kids dinner, or meet the shcool bus, or just go to sleep, she gets a call from the supervisor who tells her that somebody called in sick, or agency cancelled their shift, or no one signed up for overtime, or the nurse that resigned hasnt been replaced, or they just dont have enough staff, so she must work the next shift too.

If the nurse says she cant because she has responsibilities at home, she is usually told that if she cares about her job, she will make other arrangements. If she says shes too tired to work another shift, she is usually told to do the best she can. If she says shes leaving at the end of her shift and refuses to be forced to work overtime, she is usually told that she will face termination, be reported to the BON for "abandoning" her pts, and possibly risk losing her license.

NicuGal, MSN, RN

2,743 Posts

Specializes in NICU, PICU, PACU.

You can not be "charged" with abandonment if you do not accept the assignment in the first place. We just say.."I respectfully decline".

We had one person that was terminated for refusal and she got a lawyer and had her job back pretty quickly. You do not have to stay for manadatory OT, especially if you have no child care.

We try to only mandate in 4 hour blocks if we have to do it, but it doesn't seem fair that some people get a 16 hour day and others get a 12 hour day. You also can not be mandated if you are on extra or OT for that day where I work.

Specializes in Trauma acute surgery, surgical ICU, PACU.

Are people getting paid just their normal wage when they get mandated to stay, or do they actually get time and a half?

In canada, these things are governed by LAW - there seem to be a lot less legal protections for workers in the USA...

Trauma Columnist

traumaRUs, MSN, APRN

97 Articles; 21,237 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

How absolutely horrid. However, I see it soon in the ER where I work, because of staffing issues. Not sure how it will work, but right now we can't get enough staff to voluntarily stay for double-time plus bonus, so see it coming.

Specializes in Trauma acute surgery, surgical ICU, PACU.

In our union-dominated cushy little world up here, we use the tactic of work-to-rule before we go on strike. That means a)only doing things that are nursing functions (although contracts often add on "and other duties as needed..." clauses to get out of that one), and b)only working our EFT's - nobody picks up beyond their contracted hours of work. If we all quit picking up extra shifts, we'd close the hospital, I'm sure...

I guess all that stuff wouldn't work in Mandatory Overtime Management Rules the World land... it is a scary concept.


2,709 Posts

We had one person that was terminated for refusal and she got a lawyer and had her job back pretty quickly. You do not have to stay for manadatory OT, especially if you have no child care.>>

All true but the nurse being mandated already has an assignment because shes been there all shift. Also, you cannot be charged with abandonment if there are other nurses on the floor that you can turn your pts over to & leave but the threat still intimidates too many nurses & most dont want to go the distance with the fall-out for leaving at the end of the shift. They dont want to deal with the fight against any disciplinary action if they leave, so they stay under protest.

In my hospital, we filed a class action on the hospitals use of mandatory ot & are taking the hospital to arbitration because mandatory ot language is in our contract for emergencies only - not sick calls or cancelled agencies - but real emergencies like the attack on the WTC - which by the way was the one day in which NO mandatory ot was called for in this entire city - everybody volunteered.

canoehead, BSN, RN

6,856 Posts

Specializes in ER.

About that list for MOT- is the supervisor on the list? She is a nurse too and if it is an "emergency" should be called on in her turn to help.


2,709 Posts

It doesnt have to come. The hospital should look at the reasons WHY nobody wants to work there & fix that. Do some research. Take a poll of the staff. Evaluate the results. Present it to the hospital & demand that they make changes that will make working in that dept more attractive & also help to hire enough staff. Mandatory ot is not the cure for people not wanting to work in the unit. But it is a big reason why they wont be able to hold to the staff they do have because people will not put up with it for long.

There has to be a REASON why people dont want to work there. Instead of looking at that, the hospitals all just say "oh well we cant find nurses - you have to stay another shift". Most hospitals have no monetary disincentive to using Mandatory ot. Even at the time-&-a-half ot pay required by law, its still less expensive in the long run than hiring more staff or using agency. And less expensive than making improvements that will attract nurses.

Then its a vicious cycle - the hospital misuses mandatory ot for staffing, the nurses get sick, tired, burnt out, leave the job, the word gets out locally, other nurses avoid that facility, the hospital cant attract staff, they dont have enough nurses, and so they call MORE mandatory ot, then....... the nurses who are still left there get sick, tired, burnt out, leave the job, the word gets out locally, other nurses avoid that facility, and so on...........

Its the hospital taking the easy way out at our & our families expense. And is driving nurses out of and away from the profession. Penny wise and pound foolish management.

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