Understanding Mandatory Overtime for Nurses: Which States Enforce Mandatory Overtime?

January 20, 2022 , Modified on April 27, 2022 · 4 Min Read

Reviewed by Angelique Geehan

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How many hours can a nurse work straight through? The answer depends on the state in which you work. Read on for information about nursing labor laws.

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Understanding Mandatory Overtime for Nurses: Which States Enforce Mandatory Overtime?
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Hospitals and clinics have implemented mandatory overtime policies to help ease nursing staff shortages. While effective at achieving its goal, mandatory overtime for nurses can be detrimental to the quality of patient care and lead to stress and burnout among nurses.

If you are a current or aspiring nurse researching mandatory overtime laws, keep reading for information about mandatory overtime for nurses and its impacts, applicable state laws, and tips on avoiding burnout.

What Is Mandatory Overtime in Nursing?

Mandatory overtime laws were established to ensure that workers received compensation for hours that exceeded the standard 40-hour work week. The federal Fair Labor Standards Act (FLSA) requires employees to be paid 1.5 times their regular hourly pay rate for any additional hours worked. States have enacted their own laws but, if the pay rate is lower than the federal standard, the employee is paid according to the federal law.

Federal regulations require Medicare-certified hospitals to ensure that "adequate numbers" of nurses are staffed to provide patient care "as needed." This vague regulatory language has led to state-enacted legislation regarding nurse staffing levels, including those mandating specific nurse-to-patient ratios. A nationwide nurse shortage has created situations where hospitals and clinics impose mandatory overtime to meet these legislative requirements.

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Mandatory Overtime Laws By State

Currently, 18 states have enacted laws or regulations applicable to nurses that either prohibit or limit mandatory overtime for nurses: Alaska, California, Connecticut, Illinois, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Texas, Washington, and West Virginia.

Alaska

Mandatory Overtime: Illegal
Maximum Shift: 14 consecutive hours

California

Mandatory Overtime: Prohibited
Maximum Shift: 12 hours in a 24-hour period
Exceptions: Emergency

Connecticut

Mandatory Overtime: Legal
Maximum Shift: Nurses cannot be forced to work beyond scheduled shift
Exceptions: Emergency, procedure completion

Illinois

Mandatory Overtime: Illegal
Maximum Shift: No longer than four hours beyond scheduled shift; eight hours of rest required after 12 consecutive hours
Exceptions: Emergency

Maine

Mandatory Overtime: Illegal
Maximum Shift: Ten hours off required after eight consecutive hours
Exceptions: Emergency

Maryland

Mandatory Overtime: Illegal
Maximum Shift: Scheduled shift
Exceptions: Emergency, critical skills

Massachusetts

Mandatory Overtime: Illegal
Maximum Shift: 12 hours
Exceptions: Emergency

Minnesota

Mandatory Overtime: Illegal
Maximum Shift: 12 hours
Exceptions: Emergency, inadequate replacement staff

Missouri

Mandatory Overtime: Prohibited for licensed practical nurses
Maximum Shift: Scheduled shift
Exceptions: Patient's safety at risk

New Hampshire

Mandatory Overtime: Illegal
Maximum Shift: 12 hours; eight hours off required after working over 12 hours
Exceptions: Emergency, procedure completion

New Jersey

Mandatory Overtime: Illegal in hospitals and nursing homes
Maximum Shift: Scheduled shift

New York

Mandatory Overtime: Illegal
Maximum Shift: Scheduled shift
Exceptions: Emergency, procedure completion

Oregon

Mandatory Overtime: Illegal
Maximum Shift: 48 hours per week; 12 hours per day
Exceptions: Emergency

Pennsylvania

Mandatory Overtime: Illegal
Maximum Shift: Scheduled shift
Exceptions: Emergency

Rhode Island

Mandatory Overtime: Illegal
Maximum Shift: 12 hours
Exceptions: Emergency

Texas

Mandatory Overtime: Illegal
Maximum Shift: Scheduled shift

Washington

Mandatory Overtime: Illegal
Maximum Shift: Scheduled shift

West Virginia

Mandatory Overtime: Illegal
Maximum Shift: 16 hours; eight hours of rest required after 12 hours or longer

The Impacts of Mandatory Overtime

While mandatory overtime can offer a solution to the nursing shortages, it does so with costs that negatively impact nurses and patient care. In some situations, such as temporary staff shortages, mandatory overtime benefits nurses who desire extra working hours and time-and-a-half pay rates, while it can be detrimental to nurses who do not have the ability to accommodate those scheduling demands easily.

However, chronic or ongoing mandatory overtime takes a toll on nurses and, ultimately, their patients. Nurses who work longer than 12-hour shifts on a regular basis or without enough time off between shifts become fatigued, which can lead to mistakes. They also may feel resentful or dejected, which can lead to subpar patient care.

Burnout is a common result for nurses who must work long hours.

How Nurses Can Avoid Burnout from Mandatory Overtime

Refuse overtime: In states where mandatory overtime is illegal or prohibited, nurses can refuse to work beyond their scheduled shifts unless an exception, such as an emergency, exists. These states include: California, Connecticut, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Rhode Island, Texas, Washington, and West Virginia. Join a nurses' union to advocate for better working conditions: A nurses' union, such as National Nurses United, uses the power of collective bargaining and sponsors legislation at the federal and state levels to advocate for nurses' rights and improved patient safety and outcomes. Practice self-care: Learning how to take care of your mental health and well-being by managing your stress levels can help during challenging times. Strategies that can alleviate negative stress include maintaining a routine, eating healthy foods, exercising, spending time outdoors, and setting boundaries. Support systems like friends and family, or even a therapist, can also help. Build connections: Joining an organization like the American Nurses Association (ANA) offers benefits and support through its mentorship program, online community, and local networking opportunities.The ANA also advocates for nurses at the federal and state legislative levels and welcomes member involvement on issues important to nursing and healthcare.

Mandatory Overtime for Nurses FAQs


What states have mandatory overtime for nurses?

Currently, 32 states impose mandatory overtime with the goal of ensuring optimal staffing levels that meet patient care demands:

  • Alabama
  • Arizona
  • Arkansas
  • Colorado
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Michigan
  • Mississippi
  • Montana
  • Nebraska
  • Nevada
  • New Mexico
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • South Carolina
  • South Dakota
  • Tennessee
  • Utah
  • Vermont
  • Virginia
  • Wisconsin
  • Wyoming

Can healthcare workers be forced to work overtime?

Healthcare workers in states that have not enacted legislation making mandatory overtime illegal or prohibited can be forced to work overtime. Employers in these states must comply with the FLSA, which designates 40 hours per week as the minimum for full-time employees, not the maximum. But employees who work in excess of 40 hours a week must be compensated with time-and-a-half pay.

Can I be fired for refusing to work overtime?

In states where mandatory overtime is legal, you can be fired for refusing to work overtime if you are an "at-will" employee and your employer follows the laws and regulations in your state. "At-will" employees can be fired for any reason at any time unless the reason is discriminatory or retaliatory.

But if you work in states with nursing labor laws that address mandatory overtime—such as California, Connecticut, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Rhode Island, Texas, Washington, and West Virginia—you cannot be fired for refusing to work overtime.

How does mandatory overtime affect nurses?

Mandatory overtime for nurses can alleviate nursing shortages and bolster shrinking bank accounts, but it can also have negative effects. Nurses forced to work long hours over extended periods of time suffer from burnout, which leads to emotional, mental, and physical exhaustion. Burnout can also lead to a condition known as "compassion fatigue," where nurses experience the inability to empathize with their patients.

Reviewed by:

Angelique Geehan works to support and repair the connections people have with themselves and their families, communities, and cultural practices. A queer, Asian, gender binary-nonconforming parent, Geehan founded Interchange, a consulting group that offers anti-oppression support. She organizes as part of several groups, including the National Perinatal Association's Health Equity Workgroup, the Health and Healing Justice Committee of the National Queer and Trans Asian and Pacific Islander Alliance, QTPOC+ Family Circle, and Batalá Houston.

Angelique Geehan is a paid member of the Red Ventures Education freelance review network. Learn more about our review partners.

NurseJournal.org is an advertising-supported site. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site.

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