Nurse Overtime Pay in 2026: 8/80 Rule, Mandatory OT & Calculator

Do Nurses Get Overtime Pay?

Yes — most RNs, LPNs, CNAs, and other healthcare workers are non-exempt and entitled to overtime under the Fair Labor Standards Act. The myth that "salaried nurses don't get overtime" is wrong: the FLSA's learned professional exemption generally applies only to those required to hold an advanced/specialized degree, and most staff nurses are paid hourly or as non-exempt salaried workers.

This 2026 guide covers the special 8/80 rule for hospitals, mandatory overtime bans, on-call pay, and how to calculate it correctly.

The Hospital "8/80" Overtime Rule (FLSA Section 7(j))

Hospitals and residential care facilities may opt into an alternative 14-day overtime schedule:

• Overtime is owed for any hours over 8 in a workday OR over 80 in a 14-day period (whichever yields more)
• Must be a written agreement with the employee
• Cannot be used to *reduce* what the standard 40-hour rule would pay

Example — A nurse on the 8/80 schedule works seven 12-hour shifts (84 hours) over 14 days:

• Daily OT: (12 − 8) × 7 days = 28 hours of OT
• Weekly comparison: 84 − 80 = 4 hours over the 80-hour cap
• The employer must pay the greater = 28 hours at 1.5× the regular rate

Skip the math — run your shifts through the Overtime Pay Calculator.

States That Restrict Mandatory Overtime for Nurses (2026)

The following states prohibit hospitals from forcing nurses to work past their scheduled shift (genuine emergencies excepted):

Alaska · California · Connecticut · Illinois · Maryland · Massachusetts · Minnesota · New Hampshire · New Jersey · New York · Ohio · Oregon · Pennsylvania · Rhode Island · Texas · Washington · West Virginia + Washington D.C.

A nurse who refuses mandatory OT in these states cannot be fired, disciplined, or reported to the nursing board for the refusal alone. See our full Mandatory Overtime by State guide.

Is On-Call Time Paid?

It depends on how restrictive the on-call is:

| Situation | Counts as work time? |

|---|---|

| Required to stay on hospital grounds | ✅ Yes — pay full rate, counts toward OT |

| Required to respond within ~10–20 minutes | ✅ Usually yes |

| Free to be at home, must answer pager within 30+ min | ⚠️ Time spent *responding* is paid; idle time often isn't |

| Truly free to use time as you wish, occasional callbacks | ❌ Only actual callback hours are paid |

When on-call time counts, add it to your weekly total to determine overtime liability.

Shift Differentials and the Regular Rate

Night, weekend, and charge-nurse differentials must be rolled into your regular rate before calculating the 0.5× overtime premium.

Example — RN earns $35/hr base + $4 night diff for 36 of 48 hours worked:

• Total straight-time pay: (12 × $35) + (36 × $39) = $420 + $1,404 = $1,824
• Regular rate: $1,824 ÷ 48 = $38.00
• Overtime premium owed: 8 × ($38 × 0.5) = $152 (in addition to the straight-time already paid)

Many hospitals get this wrong — see How Bonuses Affect Overtime Pay for the same rule applied to bonuses.

Are Travel and Per-Diem Nurses Eligible?

Yes — travel nurses are typically non-exempt W-2 employees of their staffing agency and earn overtime. Stipends and per-diems for housing/meals are excluded from the regular rate only when they're true business-expense reimbursements (not disguised wages). Agencies that label half your pay as "per-diem" to dodge overtime are violating the FLSA.

Common Healthcare Wage Violations

• Auto-deducted meal breaks when nurses actually worked through breaks
• Failing to pay for pre-shift handoff or charting time
• Not paying overtime on shift differentials
• Misclassifying salaried RNs as exempt without meeting the duties test
• Forcing mandatory OT in states where it's banned

FAQ

Are nurse practitioners exempt from overtime?

Most NPs are exempt under the learned professional exemption (master's degree required, advanced clinical judgment). Verify with your state and contract.

Do CNAs get overtime?

Yes — CNAs are non-exempt and earn time and a half over 40 hours per week (or under the 8/80 rule if their hospital uses it).

Does my state require double time for nurses?

Only California does (over 12 hrs/day, or over 8 on the 7th consecutive day). Use the California Overtime Pay Calculator.

Can I be fired for refusing mandatory overtime?

Not in the 17 jurisdictions listed above. In other states, yes — unless an ADA, FMLA, or pregnancy accommodation applies.

Does the 2026 No Tax on Overtime deduction apply to nurses?

Yes — qualifying overtime premium pay (the 0.5× or 1.0× extra above regular rate) up to $12,500 is deductible on your federal return. Read the No Tax on Overtime Guide.