You worked four twelves last week, two of them nights, and picked up an extra shift for a bonus. Your paycheck is higher than usual, but is it right? The pay statement lists a base rate, a night differential, an overtime line and an incentive, and none of the numbers seem to multiply out to what you expected.
Most nurses learn how their pay works only when something looks wrong. That is a shame, because the rules are knowable, and a few of them catch out payroll systems as well as nurses. The most important one, that shift differentials and many bonuses must be built into your overtime rate, is set by federal law, not by your employer's preference.
This guide explains each part of a typical hourly nurse's pay under the federal Fair Labor Standards Act (FLSA), as described by the US Department of Labor, with a worked example. It is general information, not legal or financial advice. Your employer's policies, any employment contract or collective agreement, and the specific facts of your job all matter.
The FLSA's overtime rules apply to nonexempt employees. Whether you are exempt depends on how you are paid as well as on what you do.
The Department of Labor's Fact Sheet #17N on nurses sets it out. Registered nurses generally meet the duties test for the learned professional exemption, but only if they are paid on a salary basis of at least $684 per week. Registered nurses who are paid by the hour should receive overtime pay. Licensed practical and vocational nurses generally do not qualify as exempt learned professionals, whatever their experience, and are entitled to overtime.
The salary figure has a recent history. The Department issued a rule in 2024 raising the threshold, but on November 15, 2024 a federal court in the Eastern District of Texas vacated it, and the Department says it is enforcing the 2019 level of $684 per week. Most staff nurses in Texas hospitals are paid hourly, so the rest of this guide assumes you are nonexempt.
Your base rate is your agreed hourly wage. Overtime under the FLSA is calculated per workweek: a fixed, regularly recurring period of 168 hours, seven consecutive 24-hour periods, set by your employer. Under the standard rule, a nonexempt employee must be paid at least one and one-half times their regular rate for every hour worked over 40 in that workweek.
Two consequences surprise nurses. The FLSA does not require overtime simply because a shift ran past 8 or 12 hours; the trigger is the weekly total. And each workweek stands alone, so 48 hours one week and 32 the next is 8 hours of overtime, not an average of 40. Texas has no separate state overtime law, so for most nurses the federal rule is the one that applies.
Hours you are paid for but do not work, such as paid time off or a paid holiday you did not work, are not hours worked under the FLSA, so they generally do not count toward the 40. Your employer's policy may be more generous.
Hospitals and residential care facilities have an alternative under Section 7(j) of the FLSA. The Department of Labor's Fact Sheet #54 explains the 8 and 80 system: by prior agreement or understanding with employees, before the work is done, the employer may use a fixed 14-day work period instead of the 40-hour workweek. Overtime is then due for hours over 8 in any workday and over 80 in the 14-day period.
The system suits eight-hour schedules that are uneven from week to week. It works badly with twelve-hour shifts, because every twelve would generate four hours of daily overtime, which is why most units with twelve-hour shifts use the standard workweek. Fact Sheet #54 also says an employer cannot use both systems for the same employee, and the 14-day period must be fixed and regularly recurring.
No federal law requires an employer to pay a night, weekend or charge differential. Whether you get one, and how much, is up to your employer or your contract. But once it is paid, it changes your overtime.
Overtime is one and one-half times your regular rate, not your base rate. Fact Sheet #54 says the regular rate is total remuneration for employment in the workweek divided by total hours worked, and it lists shift differentials and nondiscretionary bonuses, such as attendance, retention or performance bonuses, as pay that must be included. Discretionary bonuses, holiday, vacation and sick pay, gifts and certain benefit contributions may be excluded.
Here is how that works in an illustrative week. A nurse earns a $40 base rate and works four twelve-hour shifts, 48 hours, two of them nights with a $4 per hour night differential.
| Step | Calculation | Amount |
|---|---|---|
| Straight time for all hours | 48 hours x $40 | $1,920 |
| Night differential | 24 night hours x $4 | $96 |
| Regular rate | $2,016 / 48 hours | $42.00 |
| Overtime premium | 8 hours x half of $42.00 | $168 |
| Total for the week | $1,920 + $96 + $168 | $2,184 |
If the overtime were calculated on the $40 base rate instead, the premium would be $160, $8 short for this week. Small per week, it adds up over a year, and the gap grows with bigger differentials and bonuses. A pick-up incentive or retention bonus that is promised in advance is usually nondiscretionary, so it belongs in the regular rate for the week or period it covers.
Whether on-call time counts as hours worked depends on how restricted you are. Federal regulation 29 CFR 785.17 says an employee who must remain on call on the employer's premises, or so close that they cannot use the time effectively for their own purposes, is working. An employee who only has to leave word where they can be reached is not working while on call. Many procedural and surgical nurses take call from home with a required response time, and whether that is restrictive enough to count depends on the facts.
Two points are clearer. Time actually worked when you are called in is hours worked and counts toward overtime. And under 29 CFR 778.223, an on-call payment (for example, a fixed amount per hour or per shift of availability) must be included in the regular rate even when the on-call hours themselves are not hours worked.
The Department of Labor is direct: the FLSA does not require payment for time not worked, such as vacations or holidays. Holiday premiums, whether time and a half for working Thanksgiving or a paid day off, come from your employer's policy or contract.
Holiday premiums interact with overtime in a specific way. Department of Labor rules allow a premium paid for holiday work at a rate of at least one and one-half times the normal rate to be left out of the regular rate and credited toward overtime owed for that week. In practice, a properly designed holiday premium usually means you are not paid twice for the same hours, so read your policy to see how your employer applies it.
The FLSA does not require meal or rest breaks. Under Department of Labor rules, short breaks of about 5 to 20 minutes count as hours worked, while a bona fide meal period, ordinarily 30 minutes or more, is unpaid only if you are completely relieved of duty. If your system auto-deducts a meal break you did not get, because you stayed with your patients or kept your phone, ask how to cancel the deduction.
Texas adds a nurse-specific protection. Texas Health and Safety Code Chapter 258 says a hospital may not require a nurse to work mandatory overtime, that a nurse may refuse it, and that a hospital may not use on-call time as a substitute for mandatory overtime. There are exceptions, including declared disasters and emergencies and unforeseeable emergencies where the hospital has first tried other staffing options, and the chapter prohibits retaliation against a nurse who refuses mandatory overtime as it allows.
Long shifts and extra hours have a cost beyond pay. Our article on fatigue in healthcare workers explains why, and our guide to per diem and part-time routes compares other ways to structure your hours.
If something does not add up, start with payroll or human resources and ask how the figure was calculated; most errors are system settings, not bad faith. If that does not resolve it, the US Department of Labor's Wage and Hour Division takes confidential complaints about overtime (1-866-487-9243). For unpaid wages, the Texas Workforce Commission accepts wage claims under the Texas Payday Law, and a claim must be filed within 180 days of the date the wages were due. FLSA back-wage claims are generally limited to two years, or three for willful violations, so do not wait.
Do nurses get overtime for working a 12-hour shift? Not automatically. Under the standard FLSA rule, overtime is due for hours over 40 in the workweek, not for long shifts. The exception is the 8 and 80 system, where overtime is due for hours over 8 in a workday, which is why units with 12-hour shifts rarely use it. Your employer's policy may pay daily overtime anyway.
Does my night differential count toward overtime? Yes. The US Department of Labor's Fact Sheet #54 lists shift differentials among the pay that must be included in the regular rate, so your overtime rate should be one and one-half times a rate that includes the differential, not just your base rate.
Is holiday pay required by law? No. The Department of Labor says the FLSA does not require payment for time not worked, such as holidays. Holiday premiums come from your employer's policy or contract, and a premium for holiday work of at least time and a half can be credited toward overtime owed that week.
Do I get paid for being on call at home? It depends on how restricted you are. Under 29 CFR 785.17, on-call time on the premises, or so restricted you cannot use it for yourself, is working time; simply leaving word where you can be reached is not. Time worked after being called in is always hours worked, and any on-call payment must be included in your regular rate.
Can a Texas hospital force me to work mandatory overtime? Generally no. Texas Health and Safety Code Chapter 258 says a hospital may not require a nurse to work mandatory overtime and a nurse may refuse, with exceptions for declared disasters and emergencies and certain unforeseeable emergencies. Hospitals may not retaliate against a nurse who refuses as the chapter allows.
Understanding your pay is one part of a sustainable career; the other is feeling confident in the work itself. Wahero's courses include the self-care and work-home balance course for nurses juggling heavy schedules, and our live training offers small-group sessions and mentorship. Nurse leaders who want to talk about training for their teams can contact us.
Educational content only
This material is published by Wahero Health Institute for professional education and is not individual medical advice, a care protocol, or a substitute for clinical judgment. Always follow your facility's policies, your state's nurse practice act, and your own scope of practice, and confirm medication doses against a current authoritative reference before administration. See our Terms of Use.
