March 7, 2021

The Editor Speaks: Nurses’ overtime has escalated dangerously

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Colin WilsonwebI do not normally refer to letters in another media house publication that are anonymous. However, there are exceptions.

This is one of the exceptions.

A letter published on CNS on Sat 5th May draws attention to the extended work shifts and overtime that the writer claims has escalated as hospitals in Cayman cope with a shortage of registered nurses (RNs).

The writer states:

“Logbooks completed by 393 Cayman Islands hospital staff nurses revealed that participants usually worked longer than scheduled and that approximately 40 percent of the 5,317 work shifts they logged exceeded twelve hours.”

The writer then points to safety concerns.

“Little is known, however, about the prevalence of these extended work periods and their effects on patient safety.

“The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. Both errors and near errors are more likely to occur when hospital staff nurses work twelve or more hours at a stretch.

“Several trends in hospital use and staffing patterns have converged to create potentially hazardous conditions for patient safety. High patient acuity levels, coupled with rapid admission and discharge cycles and a shortage of nurses, pose serious challenges for the delivery of safe and effective nursing care for hospitalized patients. While systematic national data on trends in the number of hours worked per day by nurses are lacking, anecdotal reports suggest that hospital staff nurses are working longer hours with few breaks and often little time for recovery between shifts.

“Scheduled shifts may be eight, twelve, or even sixteen hours long and may not follow the traditional pattern of day, evening, and night shifts. Although twelve-hour shifts usually start at 7pm and end at 7am, some start at 3am and end at 3pm. Nurses working on specialized units such as surgery, dialysis, and intensive care are often required to be available to work extra hours (on call), in addition to working their regularly scheduled shifts. Twenty-four-hour shifts are becoming more common, particularly in emergency rooms and on units where nurses self-schedule.”

The whole letter can be seen at:

There are only a few comments and that does surprise me. However, one is said to be from “someone who works in the HSA at the GT hospital”.

This person endorses the letter and says, “I can tell you that I’ve worked 48 hour shifts before; and for people in professions such as mine (Emergency Room), working more than 12-16 hour shifts is dangerous. Productivity falls, attention span is decreased, forgetfullness increases – these are not issues we want to deal with while a patient’s life may be on the line.

Both this writer and the letter writer want some action from the Members of the Legislative Assembly and I hope they have viewed this letter.

The letter writer suggests the government should pass bills “prohibiting mandatory overtime for nurses, doctors, paramedics and EMTs. No measure, either proposed or enacted, addresses how long nurses, doctors and paramedics may work voluntarily. The Health Ministry recommends that voluntary overtime also be limited”.

Having recently come out of hospital I can testify how the nurses and doctors there treated me with exemplary care but it was obvious their workload was very demanding.

When one is dealing with human lives the present situation, even in these times of austerity, cannot be allowed to continue.

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