The B.C. Nurses Union says a chronic nursing shortage is reaching critical levels with many nurses facing unreasonable work demands, and patients potentially paying the price.

Numbers released by Vancouver Coastal Health show how one nurse worked 1,449 overtime hours in 2014 — an average of 30 extra hours per week — earning almost $125,000 in overtime wages.

BCNU President Gayle Duteil says "excessive amounts of overtime" have become the norm.

"The reality is that 16-hour shifts are frequently worked," said  Duteil. "I did hear of two 20-hour shifts worked last week. We would much prefer nurses come to work well rested and able to provide safe and high quality care."

"I would go so far as to say the health care system depends on it," she added.

The top overtime earner in the Fraser Health District racked up an extra 1,200 hours last year — an average of 25 overtime hours per week — and took home an additional $98,308 in wages.

Interactive | Top 3 nurse overtime earners

But the Vancouver Coastal Health authority maintains most of that overtime is optional.

In an e-mail, Anna Marie D'Angelo, the senior media relations officer with VCH stated, "Those top overtime earners work at multiple hospital sites and choose to work all that overtime. In the vast majority of cases, overtime is an option."

Vancouver Coastal Health claims the average overtime per year per RN is 51.5 hours.

Tasleen Juma, Senior Consultant of Public Affairs for Fraser Health pointed out in an email, "A cap on the total number of hours nurses work is not possible because it would contravene the BCNU agreement."

Fatigue policy

Both Fraser Health and Vancouver Coastal Health have a "fatigue policy" aimed at limiting the number of consecutive shifts that can be worked in a period of time, however D'Angelo admits the policy is not always followed. 

 "A review of high overtime nurses did indicate that some did work shifts that were greater than our fatigue policy." she wrote.

Last year nurses worked over a million overtime hours combined between the two health authorities, at a cost of more than $73 million.

Duteil blames understaffing on the health authorities poor forecasting and claims they're taking advantage of nurse loyalty.

"Nurses work on a unit as a team and so it's important they don't leave their colleagues short," said Duteil. "They'll be texting each other pleading, 'it's hell on wheels in here, can you please come in?'".  

"And they do. Nurses care for their patients, but they also care for each other." 

However, in a statement the B.C. Ministry of Health claims nursing overtime hours have actually decreased nine per cent between 2012 and 2014.

The debate over overtime hours is occurring as the nurses union prepares to bargain its next collective agreement.

The nurses' contract expired in March of 2014 and preliminary discussions around a new one are just beginning.