WA Appellate Court says nurses cannot have 'break buddies' must use designated break nurse - page 2

U.S. Circuit Court of Appeals says “NO” to break buddies at MultiCare | Washington State Nurses Association We're dealing with this right now in Oregon as well. The board/bean counters won't... Read More

  1. by   ClaraRedheart
    Ummm...No. This is ridiculous. I usually set myself up to take my break at the same time every day. Right before I hand my patients off, I check with each of them to see if they need ANYTHING! I also make sure there are no medications due within 30 minutes and know those due within an hour so I can tackle that when I get back. I do what it takes to not set my break buddy with a mess . 90% of the time, they don't even have to answer a call. Same with those that I relieve for lunch. I would rather break when I am comfortable that my patients don't have major issues that don't need taking care of, not when a break nurse is available to relieve me as one of 8 of the nurses on the floor. She doesn't know my patients or their needs, and if she's relieving a new nurse every 30-40 minutes, it's impossible to keep up. This is a ridiculously stupid idea to implement on a med-surg floor.
  2. by   Nurse Beth
    Having a break nurse prevents the nurse from being "on call" during her break.
    Which by definition, makes it not a break.
  3. by   gemmi999
    My workplace currently uses a breaker nurse. It is helpful but at the same time the Charge RN views the breaker as an extra set of hands and will routinely pull them from breaking to assist with critical patient's that come into the ER. I couldn't imagine having to do a breaker buddy in our ER, it's
  4. by   cleback
    Quote from Nurse Beth
    Having a break nurse prevents the nurse from being "on call" during her break.
    Which by definition, makes it not a break.
    I don't agree that this is always the case. When I worked in a specialty area, a medsurg nurse would come and "break" me. However, because the break nurse was often unfamiliar with the specialty, I would stay on the unit on case something happened. I don't think these new provisions take into account these situations. I maintain that it would be safer to have a decent ratio to start with so that someone on your floor, who is presumably familiar with the patient population, can cover your break. That would also prevent a nurse from being "on call" during break.
  5. by   klone
    If you are staying on the unit "in case something happens" then by legal definition, you are on call and not on break. Unfortunately (fortunately?) hospitals have to follow the letters of the law.

    Even with good ratios, having a break buddy and doubling up your assignment for 30 minutes would still go against most facilities' staffing plans, which is in violation of state law, in those states that have these laws in place.

    It's not financially feasible to only assign every nurse HALF a patient assignment so that they can watch each other's patients for 30 minutes without being in violation of law.
  6. by   Creamsoda
    Quote from Nurse Beth
    Having a break nurse prevents the nurse from being "on call" during her break.
    Which by definition, makes it not a break.
    Ive always wondered about this. When I eventually might get a break, its always interupted. And I know if something happens, i have to go back. Its not like I can go run errands on my break.
  7. by   elephantlover
    I work as a CNA. The RNs on my unit take a few minutes when they can. Managment wants us to use break buddies, but this simply is not practical for our workflow. I cannot think of a safe alternative. In theory like the concept of having a resource nurse take over for breaks--however I see many issues with this being applied into practice.

    At a minimum, I believe nurses and assistive personal should be compensated for their breaks because they are "on call." I rarely have the opportunity to take an uninterrupted full 30-minute break. I NEVER get to take my paid 15 minute breaks.

    Lawmakers and nurses need to work together to find a safe solution.
  8. by   159Nursesrule
    We only get a 30 minute lunch break and are required to keep our headset on. When someone goes on break we cover for each other so yes we will have 10 patients no one ever says anything about it. But don't take a lunch and get fractional overtime and they go berserk.
  9. by   lrobinson5
    So for people using break buddies is there not a charge nurse on the floor to relieve nurses for breaks? Or is it not common for them to do break relief?
  10. by   akulahawkRN
    Quote from 159Nursesrule
    We only get a 30 minute lunch break and are required to keep our headset on. When someone goes on break we cover for each other so yes we will have 10 patients no one ever says anything about it. But don't take a lunch and get fractional overtime and they go berserk.
    Since you're required to keep your headset on, that means you're not likely being completely relieved of all work duties while on break. That means you're actually not taking a break from a payroll perspective. That means your lunch break must be compensated as "time worked." You should take a close look at the FLSA work orders (Federal Law) and see if your facility is violating those orders. Your state may also have its own work rules too, so check those. If you're under a union contract, that can supercede (to a degree) the work rules so look there as well.

    Where I work, we're required to be given a 10 minute break every 4 hours, a 30 minute meal break every 6 hours (but before 6 hours and 1 minute), and if we're on a 12 hour shift, employees can agree to waive the 2nd meal break. Where I work, we actually get 15 minute breaks and a 30 minute lunch. Most of us (to my knowledge) have agreed to waive the 2nd 30 minute meal break.

    We also try to have sufficient break nurses in the department to provide all nurses their timely breaks. I'm an ED RN so our census can vary wildly. When the census slows down and have "excess" staff vs occupied beds, we assign those nurses to do breaks. That's a variation of "break buddy" nurses but if doing so would cause a nurse to go over-ratio, we can't do it. So... when that happens, we must be paid for missing breaks (1 hour regardless of "paid" breaks missed) and missing our meal breaks. When that happens, we also incur incremental overtime...

    Missing breaks can be quite expensive. Think of it like this: if you have 10 nurses and no breaker nurses, that means the employer has to pay each nurse an extra 3 hours (equivalent) for missing those meals breaks with incremental OT (at a DT rate). So over a 12 hour shift, those 10 nurses normally are budgeted for 120 hours but miss all the breaks and now it's equivalent to 150 hours (equivalent of 30 hours over budget). With one breaker, all the nurses get their 30 minute meal and therefore also don't get incremental overtime. That saves 20 hours. If you have a 12 hour breaker nurse, you've got 18 hours "cushion" before exceeding the 150 hours. At that point, all the nurses could still miss all their "paid" breaks and you're still under by 8 hours... Or you could have the breaker continue doing breaks and you improve that even though some nurses will still miss a break and therefore get their 1 hour.

    Oh, and I forgot to mention that this is under the rules in the state where I work, miss one or miss all "paid" breaks, it's still only one hour paid extra to you. Same goes for meal breaks. Yes, they're treated separately.
  11. by   akulahawkRN
    Quote from lrobinson5
    So for people using break buddies is there not a charge nurse on the floor to relieve nurses for breaks? Or is it not common for them to do break relief?
    Where I work (in an ER), we usually have staff nurses assigned to doing just breaks. The charge nurse rarely will do break relief as their duties generally preclude being able to take on a full assignment, even for a short time. When census gets low enough, we do use a variant of the break-buddy system, but that's only when/if doing so won't put someone over-ratio.
  12. by   JKL33
    Quote from 159Nursesrule
    We only get a 30 minute lunch break and are required to keep our headset on. When someone goes on break we cover for each other so yes we will have 10 patients no one ever says anything about it. But don't take a lunch and get fractional overtime and they go berserk.
    Not to be a jerk-type employee, but then why don't more RNs "go berserk" about being "required to keep our headset on" and, as someone mentioned earlier, being prohibited from running errands while on unpaid break?

    I have successfully argued (respectfully, of course) that there are two choices:

    1) Pay me and dictate what I do with my time

    2) Don't pay me, and don't dictate what I do with my time

    Those are the only two options. I do not work for free unless I'm voluntarily working for a good/charitable cause. But certainly not when someone else is running a business that is making money and just so happens to need what I'm selling in order to run it.
  13. by   jenniam
    When I lived in California (the land of unions and mandated patient ratios), I was hired as a break nurse. The position was 20 hours a week and I worked 2300-0300. I gave 30 minute lunch breaks (they'd give me a 5 minute report and hand me their phone) to the nurses and if there were more nurses than I had slots, the charge nurse, who did not take patients, would cover their lunches (she would take their phone).

    A few of the nurses enjoyed signing up for an extra break nurse shift or two per week as it was only 4 hours and they could go into that overtime money.


    A very different story where I am now, unfortunately.
    Last edit by jenniam on Aug 13 : Reason: added info

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