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 was in the hospital with a... Read More

  1. 5
    I don't understand why the 7p-7a nurse wasn't instruced to relieve you at the hospital. It's a well known fact that an admission decision is almost never made in 3 hrs. Yes, i'd be really ticked. I don't know about legality nursing license wise (some reason 18 hrs is chiming in my head - i think that's for residents, but perhaps us lowly nurses have something similar), but i do know that you are not supposed to drive a car in NJ after you've been awake for 24 hrs.

    also - if i were the parents i'd be raising cain over this - i certainly wouldn't want my medically fragile child to be minded by a nurse that's been on for 24 hrs without a break.

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  2. 2
    It appears that this is legal in New Jersey:
    8:43E-8.5 Overtime procedures

    (a) Except as provided for in (b) below, an employer shall not require an employee involved in direct patient care activities or clinical services to work in excess of an agreed to, predetermined and regularly scheduled daily work shift, not to exceed 40 hours per week. The acceptance by any employee of work in excess of this shall be strictly voluntary. The refusal of an employee to accept such overtime work shall not be grounds for discrimination, dismissal, discharge, or any other penalty or employment decision adverse to the employee.

    (b) The requirements of (a) above shall not apply in the case of an unforeseeable emergent circumstance when:
    1. The overtime is required only as a last resort, and is not used to fill vacancies resulting from chronic short staffing; and
    2. The employer has exhausted reasonable efforts to obtain staffing. However, exhaustion of reasonable efforts shall not be required in the event of any declared national, State or municipal emergency or a disaster or other catastrophic event which substantially affects or increases the need for health care services or causes the facility to activate its emergency or disaster plan.
    Here's a link to the rest of the Department of Labor statues that might relate here:

    However, I would definately call your main office and explain what happened and ask what the policy is in situations like this. I'd also want to make sure that your manager really did "exhaust reasonable efforts" to find a replacement. I'd like to know why the night nurse didn't answer the phone or come in for her shift. I certainly hope there was some disciplinary action taken against her for her no-call/no-show absence.

    By the way, I used to work home health and, yes, the home health nurse has to stay with the patient until they are admitted. In the ER, the hospital does not assume care of the patient. Once the patient is admitted, then the hospital is responsible.
    Last edit by Ashley, PICU RN on Oct 28, '11
    noahsmama and tvccrn like this.
  3. 6
    Quote from knightroseLPN
    And I was under the impression also that I could not leave my patient with anyone except the next nurse. The parents were not able to take care of the baby.
    You would have been leaving him with a nurse----at the hospital!!! Sounds like your supervisor is a real piece of work....
  4. 1
    In 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.
    DizzyLizzyNurse likes this.
  5. 2
    This 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.
    netglow and DizzyLizzyNurse like this.
  6. 2
    In 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.
  7. 4
    When 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.
  8. 3
    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? 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.
    netglow, DizzyLizzyNurse, and linda1212 like this.
  9. 2
    Legal 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.
    DizzyLizzyNurse and Esme12 like this.
  10. 1
    We 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.
    sparklie.lady likes this.

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