forced overtime??

AnnemRN · Jan 3, 2010

I had this conversation the other day with a colleague. I do not work for free, so when I have overtime I make sure I call it in. On the other hand, the colleague told me that several nurses including herself are working off the clock. I'm sure the employer loves the fact that they are not having to pay for those hours, but it undermines the nurse who continues such practice. It also has a negative effect on those nurses that do put down their overtime. The employer then wonders why one nurse can complete a heavy assignment in 8 hours and another nurse cannot.

Labor laws do cover the hourly nurse who has overtime. We just don't push the issue. In the past, I worked for an agency that scheduled assignments that didn't allow for breaks or lunch. Fortunately, someone reported the agency to the labor board. The labor board did an investigation and not only fined them, but made them pay us all back time for lunches missed. After that, the agency made sure we all had time for our breaks and lunches and would counsel you if you forgot to put them on your timesheet.

behindthedoor · Jan 3, 2010

Bravo. I especially concur with the 'undermining" thought. We must show solidarity here.

AnnemRN · Jan 4, 2010

Bravo. I especially concur with the 'undermining" thought. We must show solidarity here.

I absolutely agree with you.

Lacie, BSN, RN · Jan 4, 2010

Karen RN I really need to take a chapter from your book. I am doing hours and hours of paperwork at home and I want to stop. Its going to be real hard to recondition my employer that I am tired of being taken advantage of but I am going to try. thanks for the encouragement. I am going to find out the labor laws in my state but being that Fl is a right to work state I doubt there is very much protection. How I yearn for a union. We havent even been trained for the new Oasis yet or given the new forms. I see trouble brewing.

I agree we need to step up and organize to get protection for employees in florida. Particularly directed to Nurses and other health care works. We can bring up valid issues and still they can turn around and terminate you with no reason since "right to work" state. I live in Florida and the way employers treat healtcare workers, again primarily nurses is sickening!! I know of an MD who is doing some organizing at the VA clinic and plan to speak to him in relation to nurses and unionizing. Dailysis, Home Health, LTC seems to be the worse. Associations fight to get mandatory staffing for hospital. What about us lowly people who seem to have been forgotten about. We like having rights and protection also. I lost my job 6 months ago because I needed treatment from the VA for a sevice connected disability and couldnt get my employer to give me the days to go nor make any reasonable accomadations for my disability. Of which she was fully aware of when she hired me!! Yes something needs done.:angryfire

HmarieD · Jan 4, 2010

We havent even been trained for the new Oasis yet or given the new forms. I see trouble brewing.

There is definitely trouble brewing, your agency should have been using the new forms for at least 4 days including today, and possibly longer depending on the date of completion (M0090 date). Do not do any OASIS visits using the old form or you will have to re-do.

AnnemRN · Jan 5, 2010

I agree we need to step up and organize to get protection for employees in florida. Particularly directed to Nurses and other health care works. We can bring up valid issues and still they can turn around and terminate you with no reason since "right to work" state. I live in Florida and the way employers treat healtcare workers, again primarily nurses is sickening!! I know of an MD who is doing some organizing at the VA clinic and plan to speak to him in relation to nurses and unionizing. Dailysis, Home Health, LTC seems to be the worse. Associations fight to get mandatory staffing for hospital. What about us lowly people who seem to have been forgotten about. We like having rights and protection also. I lost my job 6 months ago because I needed treatment from the VA for a sevice connected disability and couldnt get my employer to give me the days to go nor make any reasonable accomadations for my disability. Of which she was fully aware of when she hired me!! Yes something needs done.:angryfire

If you had worked there for at least one year then, the family medical leave act (FMLA) would have applied.

I find most employers in the medical field fail to tell us about this important federal act that protects us from losing our jobs because of health issues.

Abbies · Jan 5, 2010

We do all documentation in the home on the laptop. The clients are understanding. We are discouraged from working without documenting the actual time spent because it is important that Medicare have an accurate account of the time required for each patient. We can never hope to receive adequate compensation for our work if we under-report. It really helps to be realistic about what I can accomplish in one visit. I tend to front-load heavily and focus on priority issues, later I complete less urgent goals. It is the scheduler's duty to fit any new assignments into my schedule without overloading me or causing me to go into overtime. They really have to be aware of this now that the focus has shifted more to outcomes. I have to hustle to meet expectations: start of care 3.5 hours (which I cannot do and it has never been an issue), routine 1.5, routine with lab 2.5, evaluations 2.25, DC 2 hours. All associated tasks including travel need to be included in these time frames. No reasonable time spent outside of these expectations are questioned. We would be questioned if we did not document and record time spent on a patient.

behindthedoor · Jan 5, 2010

Thanks for the clear reply. These expectations seem more than reasonable. If I understand you correctly, you would be expected to see two SOCs in one 7.5 hour day; three SOCs and one revisit in a twelve hour day. Do I have that right?

AnnemRN · Jan 5, 2010

A start of care for my agency is worth 2.0 patients, everything else is worth 1 patient. That includes recertifications, resumption of care, discharges and any patient visits with labs. My agency does not consider travel time either.

Routinely, I have assignments that have been in 2 or 3 different towns ( not close to each other) with 2 discharges, 1 recertification, 2 visits with lab draws and 1 routine (nothing out of the ordinary) visit. My agency counts this as a 6 patient day.

Abbies · Jan 7, 2010

Thanks for the clear reply. These expectations seem more than reasonable. If I understand you correctly, you would be expected to see two SOCs in one 7.5 hour day; three SOCs and one revisit in a twelve hour day. Do I have that right?

Yes, 2 SOC would be a full day but rarely are 2 starts assigned to one nurse in a day. They have always asked me first and given me the option of saying no.

I know our expectations seem reasonable but when adding travel time, doctor calls, coordinating between team members, patient families/caregivers, documentation required when visiting facilities (and now our added marketing duties while in those facilities), ordering and tracking supplies, faxing, scheduling, or whatever it can be challenging. (and not to forget to keep track and code every second under the proper charge for payroll as well as keep the master schedule updated) I would have to cut way back on patient time if required to meet expectations I see from these other agencies. Or... they could always buy me a faster laptop. :idea:

IndianaHH · Jan 9, 2010

Good Evening Ladies...

Yep.. the forced overtime.....off the clock. I have been guilty of working on my laptop on my weekend off because I didn't want to hear the lecture on "you need to watch the overtime". It's a bit difficult to keep the pt care, the new oasis, the supplies order, the labs delivered, the drs faxed ad naseum when unrealistic expectations are set by non medical personnel. The CEO's/Pres of homehealth companies who only look at spread sheets.

In an early post to this subject I stated the agency I work for had sliced and diced the field nursing staff to just 2 RN, 1 LPN for the week, and a RN for the weekend. Currently the census is almost 100. The pay is an hourly rate until the end of the month, which a pay for visit system initates. There is no point system....just number of visits... which 6 a day is the minimum. No consideration of mileage between pts or drive time. Thus far last wek I drove 55 miles admit a pt...at 8 pm at night!! This is after working since 7am that morning, traveling 150 miles. The office REFUSES to adhere to the policy that referrals after 4 pm will not be accepted. Homehealth is not 24 hr care, it assistance to the patient and family. What ever happend to hrs 8-5??

Im going off track......anyway.. I was so tired, worn out...and fed up to the point that I decided last Monday I would submit my 2 wks notice. Funny thing happened on the way to the forum... the LPN submitted her 2 wk notice. I didn't have the heart to turn mine in also.

So now... this office has only 3 nurses.....the central office's solution to the need of another nurse.????? A contract nurse... which costs double what the LPN would be.....

What is wrong with corporate manager that they cant figure out... nurses are people also? Not automatics which do not require food, rest or freedom from the pager?

I've gotten long winded.....I still haven't decided NOT to submit my resignation....its a matter of time...

caliotter3 · Jan 10, 2010

IHH You should not be putting them first just because the LPN beat you to the punch. If you want to resign now, do it. But as in all situations, I would have to advise you to have another job in line first. You don't want to be out there with no income. Next time refuse the admission after four pm if you have met your daily quota. Enough is enough and too much is too much. You know that.