Work hour constraints in the German nursing workforce: A quarter of a century in review

Background: Work hour constraints (WHC), or the mismatch between desired and actual worktime, can negatively affect work productivity, job satisfaction, worker health and job fluctuations. Objectives: This study analyzes the WHC trends in the German nursing market between 1990 and 2015. Methods: Using data from 25 waves (1990-1995 and 1997-2015) of the German Socio-Economic Panel, the contractual, actual, and desired worktime among a representative sample of German nurses (N = 6493) were analyzed. The trends in over/underemployment for full and part-time nurses and the modalities/trends in overtime compensation were analyzed. A Blinder-Oaxaca decomposition was used to explain changes in worktime. Results: Although German nurses' actual and contractual work hours decreased substantially between 1990 and 2015, their desired work hours remained stable (31 h/week), precipitating a persistent gap between actual and desired work hours and an ongoing reliance on overtime. For full-time nurses, the actual work hours consistently exceeded the contracted ones by 3-6 hours. For part-time nurses, the actual and desired work hours have remained very similar, indicating ability to control workforce participation. Conclusions: WHC remained persistently high over the quarter century studied, with overemployment affecting nearly half of the nursing workforce. Overemployment, resulting primarily from overtime, was high among full-time nurses. Study findings could guide the formulation of programs to optimize German nursing workforce participation. (C) 2018 Elsevier B.V. All rights reserved.