I used to work in a hospital laundry (where we were understaffed, of course), and I spent my lunch hour talking with nurses. Many were actually NAs and had to work second shifts at different hospitals to make a living wage. So even if the hospitals are reporting normal shifts, the personnel are actually working up to twice as many hours.

A friend of mine had to become his wife's driver, because after working double shifts across two hospitals, she could barely keep her eyes open.

There you have it: she was working agency at a secondary hospital. That is due to a decision of her agency or herself; it has nothing to do with hospital administration or nursing in general.

Many hospitals are based across multiple locations, so it's not necessarily agency work.

I do. Nurse midwives, and other mid-level providers are often subject to similar hours and work schedules.

Nurses cannot leave until relieved. My mom routinely had 12 hour shifts extended when she worked in NYC.

And at considerably worse pay with no overtime, asumming nursing is the same everywhere.