Overtime in healthcare is an important issue because it has implications for the safety of
both patients and healthcare workers. Whereas resident physicians have limits on the total
number of hours they work, such limits do not exist for nurses. Legislation related to nurses
has thus far focused on banning or limiting mandatory overtime, without addressing
voluntary overtime that can also have negative impacts on safety. This may be due, in part,
to an assumption that a nurse who is fatigued will not voluntarily work beyond what is
required. However, it can be difficult for individuals to recognize the effect of fatigue on
their practice (Arnedt, Owens, Crouch, Stahl, & Carskadon, 2005).