Mandatory Overtime???

Q. · Apr 3, 2001

From what I understand, patient abandonment is grounds for termination - hence the upheaval about MANDATORY overtime.

What your administration appears to be doing is playing semantics.....how sad.

Brownms46 · Apr 3, 2001

Originally posted by nanablue2:
Our hospital claims they do not require mandatory overtime. WHat is this? We are frequently told that if administration cannot staff the next shift it is considered patient abandonment if you do not voluntarily stay for a double. Can this be done?

Boards of nursing have responded to this very situation, and have declared that NOT staying beyond your shift is NOT pt abandonmet. This is a tactic some hospitals have used to scare staff into thinking they have to stay for fear of losing their license. Also a hospital can NOT force you to return to work, without at least an 8hr turn around. I have worked for a hospital as a newbie, that had mandatory overtime, and sometimes you're barely able to get through your shift, because of being sick, or other reasons. Even though you won't receive problems from the board if you refuse an assingment, you probably can expect it from you employer, if you don't play along. I would never work for a place that used these tactics! I arrive on time, work my shift, and unless things are just crazy when it's time for me to leave, I'm gone. Also if I arrive, and my assignment isn't a safe one(and this has happened), I immediately inform whomever, that I WON'T take the assignment until the situation is corrected!

I once arrived at work, and found out I would be working with a new grad, and myself on a step down tele unit. We were told upon arrival, that another RN was supposed to be coming. I told the new grad, who they were going to put IN CHARGE, to NOT take report, and I marched her, and myself to the staffing office. I informed them, that until there was another RN there, we would NOT be taking report! I didn't care who had to stay, or who had to come to the floor, including a nursing supervisor! This was a 30 bed tele unit, and there was NO WAY, I was going to voluntarily walk into this situation! I have also walked onto a floor, and been told, that I would do team meds(15-18 pts) AND take 5pts primary care!!! I asked them where was the elevator!!! The nurses station was filled with nurses, and othere professionals! I informed this opened mouth, wide eyed charge nurse, that I enjoyed, and valued my license, and there was NO WAY, I was going to take that assignment! No one said a word! The assignement was changed! What some people accept sometimes baffles me! But that is them, and I am me, and I won't allow anyone, to pressure me into doing something I don't feel is safe! Sorry I got off the subject.

Brownie

[This message has been edited by Brownms46 (edited April 03, 2001).]

JennieBSN · Apr 3, 2001

Hi. I'm another one who has no idea what 'mandatory overtime' is. Am I to understand that this is when your employer forces you to stay past your scheduled shift to cover staffing shortages? Is this prevalent at other hospitals? Not to sound like a doofus, but I've honestly NEVER encountered such a thing....please elaborate!

Stargazer · Apr 3, 2001

kday, yes, your understanding is correct, and yes, many hospitals have tried it. My own hospital got away with this for 6 or 8 weeks until someone finally alerted the state nursing board and the hospital was told in no uncertain terns to KNOCK IT OFF. Not coincidentally, it was very shortly after this that I left this hospital.

JennieBSN · Apr 4, 2001

Originally posted by Stargazer:
kday, yes, your understanding is correct, and yes, many hospitals have tried it. My own hospital got away with this for 6 or 8 weeks until someone finally alerted the state nursing board and the hospital was told in no uncertain terns to KNOCK IT OFF. Not coincidentally, it was very shortly after this that I left this hospital.

Thank you!! Now, one more question, if you don't mind...isn't this practice, uh, ILLEGAL? I thought nurses weren't legally permitted to work longer than 18 hours without an 8 hour break. I've always heard that if you did, and something happened and you got sued, you'd be toast in court because of this supposed 'rule.' Fact or fiction??

OC_An Khe · Apr 4, 2001

kday,

Each state is different so check with your state board of nursing with regards patient abandonment, as for hours worked direct those questions to your state board of labor.

Q. · Apr 4, 2001

Originally posted by Stargazer:
kday, yes, your understanding is correct, and yes, many hospitals have tried it. My own hospital got away with this for 6 or 8 weeks until someone finally alerted the state nursing board and the hospital was told in no uncertain terns to KNOCK IT OFF. Not coincidentally, it was very shortly after this that I left this hospital.

Stargazer, I get mandated every week!! I get mandated to stay an additional 4-8 hours after my 12 hour shift! We've had nurses sleep over because they have to come in 4 hours later! You mean to tell me that we can refuse? Can't they fire us for that?

I've love to get this hospital by the balls. What can I do??

Stargazer · Apr 4, 2001

Originally posted by Susy K:

Stargazer, I get mandated every week!! I get mandated to stay an additional 4-8 hours after my 12 hour shift! We've had nurses sleep over because they have to come in 4 hours later! You mean to tell me that we can refuse? Can't they fire us for that?

I've love to get this hospital by the balls. What can I do??

Susy, reread the first part of Brownie's post above and then contact your state nursing board immediately. In hindsight, I am completely embarassed that my unit of very strong, smart, opinionated nurses allowed ourselves to be abused this way for almost 2 full months before anyone thought to contact the board and DO SOMETHING.

Brownms46 · Apr 4, 2001

I have taken the liberty of copying some Board of Nursing responses to questions about pt. abandonment. The first one is from Kansas, and reads as follows:

A nurse must accept a specific patient assignment then walk away during that work period without obtaining an appropriate relief/replacement worker to constitute patient abandonment.

This is BRN of Mass's response:

When the Board evaluates a complaint of patient abandonment, it will determine whether patient abandonment has occurred based on information demonstrating that the licensed nurse:

accepted responsibility for the nursing care of a patient or group of patients;

voluntarily withdrew from caring for the patient or patients with any ongoing nursing care need;

failed to give reasonable notice to an appropriate person that she or he was withdrawing from caring for the patient or patients so that arrangements could be made for continuation of safe care; and

failed to report essential information to an appropriate person.

The Board evaluates each allegation of patient abandonment on a case by case basis. In general, the Board would not consider that patient abandonment has occurred when a nurse is asked to work beyond the nurse's established work schedule and informs the employer that she or he is unable to do so.

The following situation is an example of patient abandonment:

A nurse accepts an assignment of patient care and then leaves the facility. The appropriate licensed nursing staff does not know that the nurse is not in the facility, nor has the nurse given a status report on her patient or patients to another nurse who assumes responsibility for patient care.

The following situation is not an example of patient abandonment:

A nurse ends her or his employment relationship without advanced notice, provided that the nurse has not accepted responsibility for the nursing care of a patient or group of patients.

The following is California's BRN statement of pt. abandonment:

Abandonment of Patients

Inquiries have been received by the Board of Registered Nursing regarding which actions by a nurse constitute patient abandonment and thus may lead to discipline against a nurse's license.

For patient abandonment to occur, the nurse must:

A. Have first accepted the patient assignment, thus enabling a nurse-patient relationship, and then

B. Severed the nurse-patient relationship without giving reasonable notice to the appropriate person (e.g., supervisor, patient) so that arrangements can be made for continuation of nursing care by others.

A nurse-patient relationship begins when responsibility for nursing care of a patient is accepted by the nurse.

Refusal to accept an assignment or a nurse-patient relationship is not considered patient abandonment by the Board of Registered Nursing (BRN). Failure to notify the employing agency that the nurse will not appear to work an assign shift, and refusal to work additional hours or shifts would also not be considered patient abandonment by the BRN. Once the nurse has accepted responsibility for nursing care of a patient, severing of the nurse-patient relationship may lead to discipline of a nurses licenses.

I have found similar statements in just about every board I checked online, but won't list them all.

Concerning Mandatory Overtime, please read the following. For those of you, who this law would protect in your present jobs, I suggest you contact those sponsoring this bill, and offer your voice.

CAPT supports federal legislation

to ban mandatory overtime

Congressman Tom Lantos of San Mateo has proposed a federal law making it illegal to order any of the nation's licensed healthcare employees to work overtime except in legitimate emergencies.

Because Lantos introduced the bill late in the 2000 session, it did not go anywhere. But Chris Walker of his Washington DC staff told Outreach that it will be re-introduced in 2001 with a different number and will begin the full hearing process.

Walker said this year's bill was intended "to start the debate as early as possible on this very important issue. Many employers have taken advantage of healthcare employees who fear loss of their jobs on grounds of patient abandonment if they refuse to work overtime."

He conceded it will be an uphill battle, because the bill already is opposed by the American Hospital Association and other influential groups. On October 30, CAPT's Board of Directors voted to support the new bill when it's introduced.

This year's bill, HR 5179, proposed to amend the federal Fair Labor Standards Act to say that "no licensed health care employee, including registered nurses but excluding medical doctors, may be required by an employer to work beyond 8 hours in any workday or 80 hours in any 14-day work period."

The exception would be during a natural disaster or government-declared state of emergency in the county where the employee works. The law would make it illegal to take action or discriminate against an employee for not working overtime, but it would not limit voluntary overtime.

Although HR 5179 is titled the "Registered Nurses and Patients Protection Act," it would cover California's Psych Techs and all other licensed healthcare workers in the country, except MDs.

In introducing the bill September 14, Lantos said: "In this era of full employment, it is simply easier and cheaper for hospital administrators to require existing employees to work overtime than it is for them to recruit and train new employees.

"But no employer should be allowed to force an employee to work overtime or face termination unless there is an emergency situation that requires immediate emergency action. In the healthcare field, we are not just talking about an employee's right to refuse overtime work. We are also talking about patient safety."

California representatives co-sponsoring the bill are Lynn Woolsey, Grace Napolitano, Lucille Roybal-Allard, Juanita Millender-McDonald, Barbara Lee and Bob Filner.

Brownie

oramar · Apr 5, 2001

Brownie, I do not think this wording will help nurses in many situations. If you have had the assignment for 8 hours and there is no one to replace you how can you leave? Call your supervisor and tell her to take the assignment you say. Well the supervisor is all ready to cover the ER or ICU which is short. What do you do then? This is not a hypothetical question I went though this a couple of times. An assignment with protest sheet is an option but it does not get you out of the building.

Brownms46 · Apr 5, 2001

Originally posted by oramar:
Brownie, I do not think this wording will help nurses in many situations. If you have had the assignment for 8 hours and there is no one to replace you how can you leave? Call your supervisor and tell her to take the assignment you say. Well the supervisor is all ready to cover the ER or ICU which is short. What do you do then? This is not a hypothetical question I went though this a couple of times. An assignment with protest sheet is an option but it does not get you out of the building.

First, let me say I'm sorry to hear, that this has happened to you. This is an awful thing to face after working your required 8hrs.

Next, the above wording is not mine, but the BRN is different states. I did not paraphase, I copied it word for word. I feel that the board has address the situation you encountered. This won't be a popular or considered a professional way. It will not get you in good with your employer either, but here it is, right from the BRN.

B. Severed the nurse-patient relationship without giving reasonable notice to the appropriate person (e.g., supervisor, patient) so that arrangements can be made for continuation of nursing care by others.

Now back to my words...if the supervisor can't cover your shift, then your unit's head nurse, or nurse manager needs to come in, or find someone to give you relief.

I once was told I couldn't get ONE break for 10min during my entire 12hr shift!! Only 10 min...and the charge nurse had the nerve to tell me, that He saw me go to the bathroom earlier! So?? I stood up to him, and the supervisor came down to give me a break! She tried to make me feel guilty for asking for a break. I did, but I took it anyway!

I refuse to allow anyone to take advantage of me, when they feel that they can get away with something, just because everyone else allows them to do this! I do my job, provide caring patient care, excellent "customer service", but everyone needs time to regroup.

Many hospitals use the tactic of appealing to, your fear of lost of employment, your fear of losing your license, and your fear of your patients not getting good care, to get you to accept what should be unacceptable, and illegal. The above bill proposed is saying, that this should be illegal to require anyone to stay beyond their shift. It also proposes to address the problem of your being threatened because of your refusal to do so.

Most of my time as a nurse, has been as a single parent, when my children were little, with no relatives within 1,000 miles of us. I couldn't afford to allow these tactics to keep me from leaving at the end of my shift. Charity starts at home, and spreads abroad. My first responsiblity was to my family, and then to someone elses. I have seen Head Nurses come in to allow someone to go home, many times, without causing a problem. No reason it should anywhere else either.

But these are "my" solutions, and others will have to decide on their own, what they will, and won't allow! I have 5 different state licenses, and applying for my 6th. I (Thank God), have no sanctions on any of them, and have excellent references, as I have been told by many new employers. Yes, I do let some situations slide, if I see they're unavoidable, and have never abandoned a pt., in any sense of the word. I just speak up for myself, and will continue to do so!

I would also refer you to your BRN, and find out what they're position is on your particular situation. Once you receive this information, it will be up to you how you use it.

Brownie