Working Extra Hours Guidelines On Fitness To Practise And The Provision Of Safe Competent Ethical Nursing Care

Across Alberta, registrants in direct care, management, and other roles face increased requests and requirements to work extra hours. Extra hours may take the form of planned or unplanned overtime, mandatory overtime, staying on after the end of a shift, or working extra shifts on scheduled days off or during vacation time. The following guidelines for registrants outline key factors for consideration in making decisions about requesting, requiring, or working extra hours. The guidelines aim to ensure the provision of safe, competent, and ethical nursing care.

The impact of fatigue arising from working extra hours on patient safety may include

• reduction of skillful anticipation and patient safety;
• diminished judgment, degraded decision-making, slowed reaction time and lack of concentration;
• increased clinical errors and failure to rescue;
• absenteeism;
• increased falling asleep when driving home; and
• interpersonal consequences, including decreased quality of interaction with colleagues 
  and clients.

These guidelines are grounded in the Practice Standards for Registrants (College of Registered Nurses of Alberta [CRNA], 2023) and the Code of Ethics for Registered Nurses (Canadian Nurses Association [CNA], 2017).