If the staffing level is lower than optimal then the employees in that operation have to work additional hours or extra shifts to keep the positions filled. These hours may be added on by:
- Holding employees over for additional hours at the end of their shift (i.e. effectively increasing the actual shift length and reducing off-duty rest hours between shifts).
- Calling employees in early for additional hours at the beginning of their shift (i.e. increasing the actual shift length and reducing off-duty rest hours before the shift).
- Scheduling employees to work on their days off to cover open shifts (thereby increasing the number of consecutive workdays and/or reducing the number of consecutive days off)
- Short notice call-in to cover vacant positions (creating the potential to miss or compromise a planned sleep period and thus start the shift unrested and/or less fit for duty).
- Having employees work double or even triple shifts (increasing actual shift length and reducing off-duty rest hours after the shift).
As a result, the amount of overtime worked by employees will be significantly increased, and the additional hours and days worked will make the published shift schedule a work of fiction. Up to a point, overtime is often welcomed, if not desired by many employees, as an understandable way to increase their paychecks. Some employees will volunteer for all of the overtime they can get, which buffers those who don’t want the extra hours. This also makes life easier for their supervisors. However, from every scientific and operational perspective, any significant understaffing, especially when there is uneven distribution of overtime, will affect both acute and chronic fatigue levels, and can represent a high-risk occupational health and safety exposure.
This white paper does not advocate a goal of zero overtime. After all, when distributed and managed efficiently, overtime provides a measure of operational flexibility and it gives people a chance to earn additional pay. Instead the objective of the white paper is to educate managers at 24-hour operations on the causes and consequences of understaffing, and to help them address staffing