Is it legal for a nurse to work 24 hours straight? - page 2
Im so upset. I need some opinions and to vent............... I work in home health and I have a client that has 24 hour nursing care. I was scheduled yesterday to work 7a-7p. At 4pm my patient... Read More
1Oct 28, '11 by systolyIn my state, leaving or staying past the end of the scheduled shift is not a nursing issue, but an employment issue. My BON doesn't care to get involved in these issues. However, your shift ended at 7p and you're still with the pt at 10p which means you effectively accepted another shift (again, this is the way it works in my state). I believe what happened is you took care of everyone else and as a reward you got burned. That's not on you.
2Oct 28, '11 by Purple_Scrubs, BSNThis infuriates me for you, OP. So, what, if you were scheduled the next day, and no one showed up to relieve you, you would have to work 36 hours? Then what if no one showed up again? 48? When does it stop? The supervisor should have relieved you himself if no one could be found. I would be looking for another position ASAP with a company that does not put their employees in this position.
I think there should be laws that prevent nurses from abandoning patients, but there should also be some protection for the nurse. When you show up for a shift, you should not be signing your life away in the event a replacement does not show up for the next shift. Dramatic, yes, but we can see what can happen when there are bad management practices...the nurse is the one to have to take up the slack.
2Oct 28, '11 by Esme12, ASN, BSN, RN Senior ModeratorIn the state of New Jersey most adult employees could technically be required to work 24 hours a day, 7 days a week, 365 days a year. Of course that is physically impossible; however, there is nothing in either Federal or NJ law (or the law of many other states) that puts a limit on how many hours in a row you can be required to work. Federal and NJ law requires breaks depending on consecutive hours worked. All either Federal or state law (in your state) cares about is that you are paid appropriately for whatever hours you work.
There are only a very few states that have a weekly hours limit. NO state has a daily limit. Seven states require rest breaks; twenty two states require meal breaks for some or all employees; seven states require one day off out of every seven. Some states are on more than one list; NJ is on none of them.
New Jersey has some newer legislation specific for healthcare workers.
The requirement that an employee of a health care facility accept work in excess of an agreed to, predetermined and regularly scheduled daily work shift, not to exceed 40 hours per week, except in the case of an unforeseeable emergent circumstance when the overtime is required only as a last resort and is not used to fill vacancies resulting from chronic short staffing and the employer has exhausted reasonable efforts to obtain staffing, is declared to be contrary to public policy and any such requirement contained in any contract, agreement or understanding executed or renewed after the effective date of this act shall be void.
34:11-56a34. Health care facility employee work shift determined; exceptions voluntary
(a) Notwithstanding any provision of law to the contrary, no health care facility shall require an employee to accept work in excess of an agreed to, predetermined and regularly scheduled daily work shift, not to exceed 40 hours per week.
"Reasonable efforts" means that the employer shall: a. seek persons who volunteer to work extra time from all available qualified staff who are working at the time of the unforeseeable emergent circumstance; b. contact all qualified employees who have made themselves available to work extra time; c. seek the use of per diem staff; and d. seek personnel from a contracted temporary agency when such staff is permitted by law or regulation.
"Unforeseeable emergent circumstance" means an unpredictable or unavoidable occurrence at unscheduled intervals relating to health care delivery that requires immediate action.
But I would check with the BON as it is usually stated there how many hours are legal for nurses to work. Even the federal labor laws fail to address this issue but are trying to change the laws for "involuntary" or "mandated" OT. The Fair Labor Standards Act of 1938 (FLSA), which regulates overtime, currently imposes no limits on overtime hours, nor does it prohibit dismissal or any other sanction for declining overtime work. Rather, the FLSA merely requires that payroll employees (who are not "exempt" from the overtime requirements of the FLSA) be paid an overtime premium of at least one-half of regular rate of pay for each hour worked over 40 during a work week with no provision to the max amount of hours to be worked consecutively.
I looked at the BON site and couldn't find it addressed but I have to ger the kids of the bus so I have to go.....I hope this helps.
4Oct 28, '11 by caliotter3When I have accompanied my patient to the hospital, the next assigned nurse reported to the hospital and took report from me and assumed care of the patient. There was no reason for this not to have occurred in this particular case. There is something wrong with the reasoning of the staffing coordinator. You need a serious talk with your Director of Patient Care Services.
3Oct 28, '11 by GHGoonetteWait, wait...there's another thing I'd like to know, OP; if the patient was at the hospital, under the care of hospital nurses, why were you required to stay there? And in such a case, why weren't the parents, or at least one of them, present with their child? Then at least you could have gone home at 4pm and got some rest before being asked to go back to care for the child after discharge.
2Oct 28, '11 by Meriwhen, ASN, BSN, RN Senior ModeratorLegal to work 24 hours in a row? Depends on your state's BON as well as the state's labor laws.
Ethical? Big grey area.
Personally, I wouldn't have done it because I know I would not have been capable of practicing safely. Just because it would be legal for me to work 24 hours doesn't mean I wouldn't be putting my license at risk by doing so.
1Oct 28, '11 by CapeCodMermaid, RNWe got cited at one SNF for having CNAs work 60 hrs a week. They picked up double shifts frequently....never did more than 16 at any one time, but we got cited anyway. I was on duty as the building supervisor for close to 40 hours straight during a huge blizzard. Not fun.
0Oct 28, '11 by healthstarWorking 24hours straight, without any sleep = big room for errors ( your body needs to rest)
4Oct 28, '11 by dudette10, BSN, RNHe also said if the patient was released I was to call him so he could call the next nurse (who was on standby) to come in and take over.
I'm wondering if he told her "standby" expecting your patient to be admitted. When your patient wasn't admitted, that's when the trouble began.
Some places have this problem if no policies are set for employer call-offs. When things happen where a called-off nurse is needed back at the facility or assignment, the nurses who were initially called-off can't be found because there is no on-call policy and/or compensation incentive to answer the phone.
1Oct 28, '11 by beckster_01, BSN, RNQuote from GHGoonetteI don't work in an ED or in Peds, but I can only imagine what it would be like if I got an admission that was 1:1 nursing care at HOME, and the home care nurse left! That's not safe either...Wait, wait...there's another thing I'd like to know, OP; if the patient was at the hospital, under the care of hospital nurses, why were you required to stay there?
0Oct 28, '11 by Esme12, ASN, BSN, RN Senior ModeratorI had to dash so to continue.....YOur supervisor should NOT have canceled the on comming nurse. She should have reported to the hospital. Although there are no laws per-se.....it is deemed unsafe by many standars of care and in a court of law you may be held liable.
I would have a face to face discussion with the DON to discuss company policy and to make it clear that this will not happen again. I am sure there is a legal loophole here somewhere that this cannot be done but I would make it clear that you wil not do this again unless a disaster has been called. I'm not even sure if the regulations are different for home care.........If they continue this kind of behavior...I'd look for another position.
I found the ANA's position with state laws...http://nursingworld.org/MainMenuCate...yOvertime.aspx
2Oct 28, '11 by nerdtonurse?1) I'd be willing to bet that the next nurse had already called out, that's why he told the OP to stay.
2) There have been volumes of studies that state working more than 11 hours dramatically increases the risk for error and employee injury. I wouldn't even do 16 unless we were having a disaster.
3) Your boss will probably throw "So you were going to abandon your patient?" at you. That's why you call your BON before you talk with him, so that when he brings this up, you tell him you discussed "unsafe working conditions" and "illegally mandated amount of continuous hours" right back at him.
And you really need to go find another job if you can. He's a snake.
1Oct 28, '11 by Double-Helix, BSNQuote from ColleenRN2BUnless the patient is admitted to the hospital, the home health company still has responsibility for the patient. That's the law. If your child is admitted to the hospital, you might leave them alone in the room, but I certainly hope you wouldn't leave them alone in a doctor's office, walk-in clinic, or an ER just because another nurse was there! Her supervisor was correct on this. What in the world was the ER nurse supposed to do with the child once he was able to be discharged and no one was there with him?You would have been leaving him with a nurse----at the hospital!!! Sounds like your supervisor is a real piece of work....
Quote from MeriwhenI agree that it's not safe and shouldn't be done. However, it doesn't look like the OP had any choice. If she had refused to work and had left, she would have been guilty of patient abandonment. That would put your license at risk even more than working 24 hours straight.Personally, I wouldn't have done it because I know I would not have been capable of practicing safely. Just because it would be legal for me to work 24 hours doesn't mean I wouldn't be putting my license at risk by doing so.
Quote from nerdtonurse?Good thought, but I highly, highly doubt that a representative from the BON would have been available at 10pm to discuss this issue with the OP. I also think that, had the OP just left the patient, she legally could have been sued for abandonment, regardless of the circumstances.1) 3) Your boss will probably throw "So you were going to abandon your patient?" at you. That's why you call your BON before you talk with him, so that when he brings this up, you tell him you discussed "unsafe working conditions" and "illegally mandated amount of continuous hours" right back at him.
OP, you made the right decision by staying and working. There really wasn't anything else that you could have done at that point. However, like I said early, definately complain up the chain of command and figure out what policies (or non-policies) led to this situation. Clearly your facility needs an emergency on-call system for situations like this. And absolutely, if your supervisor is an RN, than he should have been the one to come in and relieve you.