Mandatory night rotation - legal?

  1. I work the day shift in a smallish community hospital (nonprofit). We are unionized. Our contract does have language that allows for days to rotate to nights in the event of a night shortage. I have worked here for 10 years and have never been in this situation and so have thought nothing of it. About 5 mos ago we lost our night nurse. We have had a traveler for part of that time and another one is coming in Jan. We have been filling in - each of us usually picks up 1-2 nights/wk to minimize the stress for one another. This is extremely hard on me and many of my co-workers. My body clock is such that I can only sleep between the hours of 8pm - 5 am. I am incredibly sleep deprived when I have to work nights (patient safety?) and the half hour commute home in the morning is downright scary for me. Here is my question - do we have a good chance of ending this practice if management is put on notice that we are doing this under diress and that, regardless of what the contract says, we cannot ensure safe patient care in our sleep deprived state and that, further, we are not safe to drive home. If everyone affected by this signed a statement to this effect would they not legally have to stop this practice if only to protect themselves? Any lawyers or nurses out there with any opinions or experience on this matters? Thanks!
    Last edit by tineann on Dec 23, '05 : Reason: typo
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  2. 32 Comments

  3. by   Katnip
    I don't know if that would help or not. I doubt it. It's in your contract to fill in nights when necessary.

    If everyone refuses to work nights who will watch the patients? The hospital also has an obligation there.

    Their only real alternative would be to require someone moves to nights permanently.

    I can sypmathize since I can't sleep during daylight hours, either. I fell asleep a couple of times while driving home after a night shift.

    Instead of getting a petition where everyone refuses to work nights, I'd have your union try to work something out that is feasible for everyone.
  4. by   SFCardiacRN
    Talk to your union. There may be senority issues. But the shift has to be filled. We are facing the same situation and decided as a group to rotate since no one volunteered to take the shift permanently. We also decided the next hire would be for the late shift.
  5. by   tineann
    Thanks for the responses. A couple of other pieces of info. Our union just settled with the hospital last night at the 11th hour. We were close to striking- not over this issue...however, all the strike nurses were in town and were being oriented to Pyxis etc. Obviously nights would have been covered by the strike nurses. Necessity is the mother of of invention. If they were forced to find nurses that felt comfortable and safe working nights I can't help but think they would find them. Might mean paying large sums of money - but what is the price for safety? I sometimes feel that nurses don't force issues enough and that we are then left in compromising positions.
  6. by   suzanne4
    This has gone on in nursing since I can remember, and longer. If there is no covereage for the off-shift, it neeed to be covered by someone. You see it more in smaller hospitals, or even in large ORs where the night shift nurse takes the holiday or vacation time that they also receive, same as you.

    Sorry, but you already know that help is coming. The hospital is not going to hire a nurse to cover those couple of weeks. Plus trying to get a travel nurse over the holidays is quite hard, especially when it would only be a few week contract.

    If the show were on the other foot, what would you have done if you were management? Especially if it is in your contract that the shifts would need to be covered?
  7. by   chris_at_lucas_RN
    Some people are put together to work nights, others couldn't do it if their lives depended on it.

    I suspect hospitals that require night rotations will change their policies with the first hurt or dead patient, or the first hurt or dead nurse, when it is clear that the sad event was the result of being overtired. Sadly, I suspect it will still take a lawsuit and a nice big settlement to get their attention.

    Replicated research strongly suggests that forcing yourself (or someone else forcing you) to violate your body's rhythms with regard to rest and sleep is a huge no-no.

    Some people do very well working nights. Others work great doing long shifts on weekends. Still others need to work M-F only.

    When will hospitals become human friendly?

    You have my sympathy.
  8. by   tineann
    Chris, I appreciate your response and would agree that when the tragic event occurs, a precedent will be set and management will then need to get more creative (ie probably pay more money for a person who can safely fill in while they wait for a qualified applicant).

    Suzanne, I hear what you are saying and I am really not one that automatically vilifies management. I do believe, though, that they are looking out for their best interests (as am I). If they can piece it together for 2 mos until the traveler comes rather than hire a very expensive pool nurse then they will do it - especially if the contract allows them to do that. However, if they can, in 10 days, bring in 60 out of state nurses to cover for a potential strike (which they just did at my hospital).. why can't they cover nights until a suitable replacement is found? Especially if the health and welfare of the patients and staff are at risk? My issue as I have already stated is that I believe there are serious safety issues involved here. I do believe if a patient death (god forbid) and ensuing lawsuit was attributed to a sleep deprived nurse being forced to work nights then the hospital might rethink it's policy. But why does it have to come to this?

    Nurses work hard and I think that there are not alot of people in society who could do what nurses do - but I do not think that means we need to be martyrs as well. What really blew me away when this happened on our unit 5 mos ago (I work inpatient psych) was that I found out that the neuro floor had been on night rotation for a year! Does this mean they are just exceptionally dedicated nurses (which I am sure they are) or could it be that they are really being taken advantage of? I mean,come on, this is outrageous. Why would management change a thing if these nurses just quietly continued to rotate?

    Thanks all for the thoughts/opinions and different angles.... it is helping me to process this issue.
  9. by   IrishItalianRN
    I had to work nights for a short amount of time and it helps if you can get your physician to prescribe something to help you sleep (I was taking Ambi*n. We also put blankets up in our room to block out any sunlight. I don't know about your particular situation of only being able to sleep 8p-5a... but i am the same way... my body says ITS TIME TO SLEEP! after 9 lol
    So that is just an idea.... my other problem with that shift is just the pure hatred for leaving my house at 1130 at night to be to work at 12a when i know i should be sleeping!
    As for the petition I have no idea how that will turn out.. I dont know how unions work because here in AZ we dont have them. I suspect though that since it is in your contract, a petition will do no good.
    TRUST ME i sympathize for you because I despise graveyards!
    I think the best thing you can do for yourself is figure out a way to get sleep and just fulfill the obligation. It's only 1 or 2 nights a week JUST until they get a replacement right?
  10. by   suzanne4
    I understand where you are coming from, actually had to rotate to nights. When all of us started many years ago, there was no such thing as straight day positions, you wither could get straight pms or nights, or rotate between days and pms or nocs. There are actually quite a few hospitals that still require the rotation, two months of days, and then one month of nights. And this is in California, where the unions are extremely strong.

    And just so that you are aware, the funds that they use to cover for a potential strike, usually come from different monies that are required for salaries.

    Unfortunately, depending on how you look at it, your contract has this included that you will cover nights as needed. And it is up to the hospital to decide on when it would be or will be needed.

    And to say that it is completely unsafe, isn't going to fly, if you worked on a service where you took call, you would see what I mean. Every single OR nurse has taken call at one time or another, and things got done. Not all ORs have 24/7 coverage, and every shift is covered otherwise by a call team, or even call teams. And they have been up all night either transplanting a heart or saving a gunshot victim. You did not hear them complain.

    I know that these are my own personal feelings but unless your union does something in your next contract, this is something that will need to be dealt with.
    Last edit by suzanne4 on Dec 23, '05
  11. by   sjrn85
    You have been there for 10y and have only recently been confronted with this issue?

    I'm sorry, but I am not sympathetic at all. First of all, it's in your contract. Second, as suzanne pointed out, few places grant straight day shift, and many services require on-call. I've had to do that...work hard 8-10h, then get called out at 2:00am.

    Strike funds come from public monies, not from the hospital; one of many reasons why hospitals don't care about the $$$ strike-breakers make. It's not coming out of their pockets.

    Your only recourse is to a) find another job with straight days and never any on-call/fill in for off shifts (good luck with that), or; 2) change your contract the next time negotiations roll around.
  12. by   spidermonkey
    Not sure if it's legal or not, but I have had to- both in smaller hospitals, and in a large teaching hospitals. It is unavoidable at times, & the shifts have to be covered. Two of us were 7 mos pregnant at one time, and we still had to rotate- my manager was very understanding though, and I called in a couple of times- as she advised us to do if we were just too tired to do it. Apparently admin. made no exceptions & our manager had to schedule everyone on a rotating basis- including herself. It ended up only being a couple shifts/wk over a 3 wk period. Back then, we never thought of protesting it, we just dealt w/it- and even though I was hired for day shift, I understood that extenuating circumstances might happen that would require flexibility on my part.
  13. by   spidermonkey
    When I graduated from nursing school, the ONLY positions available were nights, so we adjusted. After a yr or so on nights, a 3-11 position became available. Eventually I went to days, but still understood nights had to be covered in the event of vacations, illness, etc. When I went to PACU, I had to take call-- sometimes we'd be on call working most of the night, no sleep, and had to work the next day. Our wkend call was from 4:30p.m. Friday to 7 a.m. Monday. Most of the time I could leave by noon Monday, but we were expected to show up for our shift as scheduled. There are a few people who naturally do better on nights- but most people have to adjust- docs do it to to get thru residency, etc. If you're going to work in a hospital- or any facility operating 24/7- it's a fact of life.
  14. by   allele
    I'm afraid I'm with the majority. I know it's awful to work nights, especially when you're not used to it....but in the end it MUST be covered and you need to honor your contract. The institution you work in AND it's nurses must have agreed to it. And like a previous poster said, you know there's an end in sight. I worked nights for eight years and in all honesty I HATED every minute of it! Now I'm straight days and I will fill in on nights with a big 'ol smile on my face, knowing it's just temporary and I'll make it though somehow....and it's not permanent anymore!! LOL Meanwhile, while you wait for the end, search allnurses for all the tips on working nights. I know there have been MANY threads on tips and tricks to make it through the night, from sleep schedules to what to eat to meds to room darkening and the list goes on! Good luck with your night shifts and I hope you safely get through them. Nothing lasts forever, this won't either.

    P.S. I work about 40 minutes from home too, if I have to nap before getting behind the wheel, I do. God knows there are plenty of beds! Sometimes I've even stopped about half way home in a parking lot to nap in my car!! LOL This may not be feasible for everyone (if they kids, etc.) but it worked for me!

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