Overtime Hours for Registered Nurses (RNs) Working in Erebor, Eriador,

Gondor, Harad, Rohan, and the Shire Regions

1. What’s overtime and why is it a challenging to study

In nursing practice, starting on time can be easily achieved, however, finishing on

time is notoriously impossible due to issues such as shortage of staff, long
procedures, availability of incentives to work overtime, etc. This ends up forcing
many RNs to work overtime to keep the health facilities running. Although this
can be more beneficial to the patients, they are often documented retrospectively,
by the nurse who worked overtime, and sometimes relying on their memory, or in
some centers where technology is well adopted, they can track the time
electronically with RNs checkins and check-outs.

Understanding the cause or reasons for overtime by just looking on the total
hours accumulated per region is not very informative. Without additional
administrative information like department size, workload, as well as the
seasonality factors or infirmation about RNs, the type of patients or procedures
they are working on during those overtime hours, it’s challenging to determine the
exact reasons behind changes in overtime and possibly comme up with an
intervention that’s likely to work(1).

2. Analysis of the data discussing any notable trends in overtime over

the available time periods

At Erebor, as Fig.1 below shows, the newly generated series of the duration of
each overtime period was plotted with their own y axis on the right, and overtine
hours with their y axis on the left from 2017 till 2022. Due to limited time for
analysis, seasonality and other possible biases in time series analysis weren’t
addressed in either time series (overtime hours and duration). But as the figure
shows, as soon as the recording of overtime was introduced in 2017, it quickly
picked to around 14000 hours per quarter, slightly reduced in Q1 2020 to pick
again before falling again in 2022. The duration of period for recording overtime
was sinusoidal across the period.

Fig.1 Overtime hours and their duration series from 2017-2022 at Erebor

At Eriador, as Fig.2 below shows, the newly generated series of the duration of
each overtime period was plotted with their own y axis on the right, and overtine
hours with their y axis on the left from 2017 till 2019. Due to limited time for
analysis, seasonality and other possible biases in time series analysis weren’t
addressed in either time series (overtime hours and duration). But as the figure
shows, as soon as the recording of overtime was introduced in 2017, it quickly
picked to around 6000 hours per quarter and has been up and down till Q3 2019,
marked with deep falls and sudden increases close to 10000. The duration of
period of overtime recording was sinusoidal across the period.

Fig.2 Overtime hours and their duration series from 2017-2019 at Eriador

At Gondor, as Fig.3 below shows, the newly generated series of the duration of
each overtime period was plotted with their own y axis on the right, and overtine
hours with their y axis on the left from 2017 till 2021. Due to limited time for
analysis, seasonality and other possible biases in time series analysis weren’t
addressed in either time series (overtime hours and duration). But as the figure
shows, as soon as the recording of overtime was introduced in 2017, it quickly
picked to around 18000 hours per quarter, but kept reducing till Q1 2020 to pick
up again to 190000 hours, from which it started falling till the end of data
collection. The duration of period for recording overtime was sinusoidal across
the period.

Fig.3 Overtime hours and their duration series from 2017-2021 at Gondor

At Harad, as Fig.4 below shows, the newly generated series of the duration of
each overtime period was plotted with their own y axis on the right, and overtine
hours with their y axis on the left from 2017 till 2019. Due to limited time for
analysis, seasonality and other possible biases in time series analysis weren’t
addressed in either time series (overtime hours and duration). But as the figure
shows, as soon as the recording of overtime was introduced in 2017, it slowly
picked to around 4000 hours per quarter and has been up and down till Q3 2019,
marked with deep lows and highs. The duration of period of overtime recording
was sinusoidal across the period.

Fig.4 Overtime hours and their duration series from 2017-2021 at Harad

At Rohan, as Fig.5 below shows, the newly generated series of the duration of
each overtime period was plotted with their own y axis on the right, and overtine
hours with their y axis on the left from 2017 till 2021. Due to limited time for
analysis, seasonality and other possible biases in time series analysis weren’t
addressed in either time series (overtime hours and duration). But as the figure
shows, as soon as the recording of overtime was introduced in 2017, it slowly
picked to around 14000 hours per quarter and has been up and down till Q3
2021, marked with deep lows and highs, ranging overall between 4000 and
145000 hours. The duration of period of overtime recording was sinusoidal
across the period.

Fig.5 Overtime hours and their duration series from 2017-2021 at Rohan

At the Shire, as Fig.6 below shows, the newly generated series of the duration of
each overtime period was plotted with their own y axis on the right, and overtine
hours with their y axis on the left from 2017 till 2021. Due to limited time for
analysis, seasonality and other possible biases in time series analysis weren’t
addressed in either time series (overtime hours and duration). But as the figure
shows, as soon as the recording of overtime was introduced in 2017, it has been
slowly picking up to around 8000 hours per quarter and has been up and down
till Q3 2021. There was a marked drop in Q1 2020, however, overtime hours
increased again to arrive near 140000 hours in Q4 20of the same year, and then
slowly decreasing. The overall range of overtime hours was between as low as
500 and 140000 hours. The duration of period of overtime recording was
sinusoidal across the period.

3. Recommendations:
Overall, there was major changes in overtime hours per each site since the time
it was introduced. Some sites had major changes, possibly resulting from
relevant factors that are worth evaluating while others had relatively stable
overtime hours across the whole period, with just minimal changes that could be
attributed to seasonality in further analysis.

We would love to have more information on how those data was recorded,
basically by who and using what. Additionally, we would love to add columns of
staff that was available duing each period, if relevant, the number of patients or
relevant cases that were also avalable, because they could help to understand
the reason for the picks and lows observed. Lastly, we would love to have
information on any changes in the policy or hiring procedures, weather or other
drivers of population health that could be associated with the changes in data, or
anything you suscept to have influenced the overtime hours(2). With all that
information, we can thoroughly evaluate the contributors and facilitating factors,
and help you with insights that could help address this problem or overtime
hours(3).

4. References:

1. Bae SH. Nurse Staffing, Work Hours, Mandatory Overtime, and Turnover in Acute Care
Hospitals Affect Nurse Job Satisfaction, Intent to Leave, and Burnout: A Cross-Sectional
Study. Int J Public Health. 2024 Apr 30;69:1607068.
2. Lobo VM, Ploeg J, Fisher A, Peachey G, Akhtar-Danesh N. Critical Care Nurses’ Reasons for
Working or Not Working Overtime. Crit Care Nurse. 2018 Dec;38(6):47–57.
3. kjohnson. CareerStaff Unlimited. 2024 [cited 2024 Nov 5]. Rising Nursing Overtime: 7
Strategies to Reduce It. Available from:
[Link]
ategies/