Policies,Administrative,UWHC,Department Specific,Nursing Administrative,Personnel

Clinical Overload Nurse (4.34)

Clinical Overload Nurse (4.34) - Policies, Administrative, UWHC, Department Specific, Nursing Administrative, Personnel


Policy Title: Nursing & Patient Care Services Clinical Overload Appointment Process
Policy Number: 4.34
Effective Date: October 24, 2017


As of October 24, 2017, this administrative policy applies to the operations and staff of legacy UWHC. Effective July 1, 2015, the legacy
operations and staff of UWHC and UWMF were integrated into the University of Wisconsin Hospitals and Clinics Authority (UWHCA).
All administrative policies are being transitioned to apply UWHCA-wide, but until future revision to this policy #4.34, it applies only to the
operations and staff of legacy UWHC.


To establish a systematic procedure for the employment and scheduling of exempt (salaried) staff who are willing to
work additional hours within their clinical specialty beyond their permanent appointment during times of critical
staffing shortage. This procedure applies to exempt staff who are registered nurses at UW Health who will work extra
hours beyond their permanent appointment to assist in providing direct patient care.


Critical Staffing Shortage: A period when replacement staff are not able to report for duty for the next shift or there is
increased patient need because of unforeseen circumstances (e.g., act of terrorism, natural, external or internal
disaster, an acute disease epidemic, declared weather emergency, high staff vacancy rates and/or high patient
occupancy, high volume of last minute staff sick calls and/or no-shows etc.). The shortage must not be caused by
inattention or lack of reasonable contingency planning.


During times of critical staffing shortage, exempt registered nurses may work extra hours providing direct patient care
if all reasonable efforts have been made (e.g., float pool, expansion, per diem) to meet staffing needs. At no time will
Nursing allow the performance of this additional work without prior approval of the employee's direct manager/director
and the Director of Nursing Operations Support. Clinical overload shifts will be scheduled in accordance with Policy
4.61 (Scheduling of Work) and Policy 9.80 Limits on Hours Worked. The employee with the clinical appointment is
responsible for ensuring they will not exceed their limits on hours worked between their regular position and the
clinical overload position prior to requesting the shift. Requests to work future clinical overload shifts will be denied if
an employee is found to be non-compliant with Policy 9.80-Limits on Hours Worked or Policy 4.61-Scheduling of


A. Exempt registered nurses who may be interested in working clinical overload within their clinical speciality area must
complete approved for an exempt temporary appointment called Clinical Overload. The Clinical Overload
Appointment Application can be downloaded from U-Connect.
i. The Clinical Overload applicant must obtain the signature of the employee’s direct manager/director and the
Director of Nursing Operations Support. When the Clinical Overload Appointment Application is completed
and all signatures are obtained, the applicant must return the document to the designated contact on the
Clinical Overload Appointment Application.
B. The designated contact person in the Nursing Resource Center will review that the Clinical Overload Application is
completed correctly and completely. Additionally, they will ensure that the Clinical Overload Competency Contract is
filled out and signed by the Nursing Education Specialist, Clinical Nurse Specialist, Unit/Department
Supervisor/Manager and the employee before he/she initiates the approval and appointment entry process with
C. Following confirmation of the applicant’s appointment entry into PeopleSoft, the designated Nursing Resource Center
contact person will notify the applicant that their Clinical Overload position has been activated and they can begin to
pick up shifts as a Clinical Overload RN. The contact person will e-mail the Clinical Overload RN directions on proper
/out procedures, which are essential to the payroll process.
D. Shifts or portions of shifts worked by a Clinical Overload RN cannot be processed by payroll unless the employee has
an active Clinical Overload RN staff appointment in PeopleSoft. An employee with proper approval and an active
appointment will receive payment for extra shifts worked by clocking in and out on the assigned unit using the
authorized UW Health time and attendance system
E. The Clinical Overload RN will be compensated at an hourly rate and will not be paid time and a half for work
performed on holidays.
F. Approval to work as a Clinical Overload RN expires at the end of every fiscal year (June 30) regardless of the date

Policy Title: Nursing & Patient Care Services Clinical Overload Appointment Process
Policy Number: 4.34
Effective Date: October 24, 2017


approval was obtained. To renew a Clinical Overload appointment, the interested employee must fill out a new
Clinical Overload Appointment Application and initiate the appropriate approval process again.
G. Qualification to work Clinical Overload requires that the employee demonstrate to a clinical team comprised of a
Manager/Supervisor, Nursing Education Specialist and Clinical Nurse Specialist (provided each area/unit has each of
these roles) that they have completed all current competencies and compliances required for their speciality area(s)
prior to approval. In addition, the employee must also agree to the clinical team that they will complete and maintain
all ongoing required education, competencies and compliances and minimum number of hours worked to maintain
competencies for the area(s) they are qualified to work in for the duration of their one (1) year Clinical Overload RN


A. Clinical Overload Competency Contract
B. Clinical Overload Policy 4.34 FAQ
C. Clinical Overload Appointment Application


Author: Director, Nursing Operations Support
Reviewers: Director, Nursing Finance and Staffing Effectiveness; Nurse Manager(s), UH Inpatient Float Pool
Nursing Administrative Policy & Procedure Committee Approval: September 18, 2017

UW Health is a cohesive, united and integrated academic medical enterprise comprised of several entities. This
policy applies to facilities and programs operated by the University of Wisconsin Hospitals and Clinics and the
University of Wisconsin Medical Foundation, Inc., and to clinical facilities and programs administered by the
University of Wisconsin School of Medicine and Public Health. Each entity is responsible for enforcement of this
policy in relation to the facilities and programs that it operates.


Beth Houlahan DNP, RN, CENP
Senior Vice President, Chief Nurse Executive


Nursing Administrative Policy #4.61 – Scheduling of Work
UW Health Administrative Policy #9.80 – Limits on Hours Worked


Version: Revision
Last Full Review: September 18, 2017
Next Revision Due: September 2020