According to a new study, nurses who have just gotten their licenses often work overtime, and some have second jobs. This work pattern hasn’t changed much over the decades despite changes in healthcare, including the passage of the Affordable Care Act.

The good news is that most new nurses are working the shifts and the schedules they prefer, and mandatory overtime, while common, has not increased over the years.

New nurses generally worked an average of 39.4 hours a week, mostly in the 12-hour daytime shifts. It seems that nurses work 12-hour shifts at a rate similar to more experienced nurses, which has been measured in other research.

In the new study, Amy Witkoski Stimpfel, an assistant professor at New York University in New York, and colleagues looked at 4,500 nurses who were licensed in 13 states and the District of Columbia in either 2004-2005, 2007-2008, 2010-2011, and 2014-2015. The nurses were sent a mailed survey asking about demographics, education, work attributes, and attitudes and were given a $5 incentive to complete the survey.

What Does the Research Show?

About 46% of the newly licensed nurses worked voluntary overtime, an average of about three hours per week. Some — 12%— had to work mandatory overtime, but the average was less than one hour per week. Another 12% had a second job, according to the report in the Journal of Advanced Nursing.

Although the researchers didn’t specifically look at outcomes, long work hours have been linked to problems in patient care, such as medication errors, as well as for nurses themselves. For example, burnout and occupational hazards, like needle-stick injuries, are more common with long work hours. Some hospitals may rely on mandatory overtime to skirt issues with inadequate staffing, which can put both nurses and patients at risk.

What Does This Mean for Healthcare Providers?

Eighteen states have laws restricting mandatory overtime for nurses. For example, New York State passed a law in 2009 prohibiting mandatory overtime for nurses. However, the state also outlined scenarios when hospitals could be allowed to do this, such as in the case of a “patient care emergency,” so check your state’s specific laws.

“Nurse managers, policymakers, and researchers should pay attention to new nurses’ schedules and shift preferences and guard against mandatory overtime hours,” the authors concluded.