On the clock: Nurse unions seek ban on forced OT in 2009

[NRSKarenRN, BSN, RN]

on the clock: nurse unions seek ban on forced ot in 2009

..."when you're in the hospital, you're usually there for highly technical nursing care, highly toxic drugs, highly specialized care," burger said. "mistakes made then can be lethal."

thomas dolan, president and ceo of the american college of healthcare executives, said there are two sides to the patient-safety argument. "if people work too long, they're more likely to make mistakes. but on the other hand, if you bring in temps, you also have more mistakes," said dolan, who personally opposes the mandatory overtime ban, although the ache does not officially take a position on the issue.

a study published in the july/august 2004 issue of health affairs, titled "the working hours of hospital staff nurses and patient safety," concluded that nurses made three times as many errors on shifts that lasted longer than 12 hours, regardless of whether the shifts were mandatory or voluntary. since fewer than 20% of the 5,317 shifts studied ended on time, the researchers recommended hospitals stop using nurse overtime, especially on shifts scheduled to last 12 hours.

"the long and unpredictable hours documented here suggest a link between poor working conditions and threats to patient safety," the study's authors concluded.

yet a study in the may 1, 2006 issue of policy, politics, & nursing practice, titled "impact of nursing overtime on nurse-sensitive patient outcomes in new york hospitals," found an association between nurse overtime and lower rates of mortality, though the authors said they did not consider the report definitive. clarke said that mandatory overtime bans decrease flexibility that administrators can use in creating innovative schedules, like those involving longer shifts over fewer days per week. the laws also hurt the workers for whom the unions don't speak--those who relish the chance to bring home bigger paychecks by working overtime. "the downside depends on how (the law) is written," clarke said.

in 1987, members of the minnesota nurses association became the first in the nation to have a mandatory overtime ban included in all of their labor agreements, with a state law coming several years later that was amended as recently as 2008, union spokeswoman jan rabbers said.

today, at least 15 states have laws or labor regulations banning mandatory nurse overtime: california, connecticut, illinois, maryland, minnesota, missouri, new hampshire, new jersey, new york, oregon, pennsylvania, rhode island, texas, washington and west virginia....

some are more inclusive than others. new york's law, which was passed last june, applies the ban only to nurses, while in neighboring pennsylvania the law applies to a far broader swath of workers that includes most direct-care nonsupervisory hospital workers, as well as laboratory technicians. "we had to fight hard to keep everyone in," said cathy stoddard, a pennsylvania rn and executive board member of seiu healthcare pennsylvania. "we had people saying, 'drop everyone but nurses.' we had to hold on and fight to keep everyone in."

[BrnEyedGirl, BSN, MSN, RN, APRN]

No responses on this one yet?

I'm not sure how I fall here. I do believe that each person handles the long hours differently, some can work longer than others, some people need more sleep to function etc. I work in Missouri, and honestly am not familiar with the laws,..will do some research. I know that at my hospital I'm not allowed to stay on the clock more than 16hrs unless we're on disaster alert. I must also have 8hrs off time if I work a 12 hour shift or longer.

I have been working nights for about 14 yrs and have learned what I can and can't do. My personal situation often dictates how I schedule my shifts or pick up shifts. I work 45 min from home. I am not a person who can drive home, crawl straight into bed and be asleep 20min later. If I clock out at 0700, walk into my house at 0755, change clothes, say goodbye to my family who is leaving for the day, and let the dogs out one last time, I'm lucky to crawl into bed by 0845. I'm usually "wound up" when I get home and find myself taking a hot bath, reading or logging on to allnurses for a bit before I can sleep. I'm happy if I'm asleep by 1000, my alarm goes off at 1600 for the start of the next night. I can function on 6hrs of sleep for three consecutive 12hr shifts, but after that 3rd one I find myself having trouble getting to sleep the next morning and then I sleep 10 to 12 hours. This pretty much ruins that day off,..but it's the life I've chosen and my family understands.

I have found myself picking up extra shifts or staying an extra 6 hours and it's rough. I remember times when I would walk into the med room and not remember what I came in for. I have had times when I've looked at a chart 4 or 5 times before it sinks in that I need to grab 50 of Fentanyl for Ms Jones in room 5,..then I've had to look again to remember what room I'm going to,...etc. I've found my self at triage taking a pt temp and they say "you just did that". I got stuck at a small ER once during a bad snow storm. No one could make it to work so we took turns sleeping in empty rooms for 3 or 4 hours then working, this went on for over 72 hours. I found some of my charting where I actually wrote down a conversation that was going on in the room around me! Is this safer than having no one there,...I don't know. Then of course you have to struggle with the long drive home alone.

The problem I have with absolutely no overtime is what do you do when no one shows up to care for your pts? I understand and truly believe that it isn't my personal responsibility to staff the hospital 24/7. I am an employee and I do my job to the best of my ability and go home. Maybe these laws will force employers to staff better, which is really what we all want,...but so far I'm not seeing that.

I work with other nurses who like the OT, they will sign up for 8 or 9 12 hour shifts in a row. I don't know how they do it. I work with some who leave at 0500, get home in time to get 3 kids ready for school, two out for the bus then take one to school by 0845. They come home to sleep until 1400 then go pick up kids from school and "nap" on the sofa until it's time to work at 1700. I couldn't do that every day either.

I'm not sure what the answer is. I would never want to find myself in a position that I either had to stay and work or lose my job or license. If I'm too tired to work I shouldn't be expected to work. There are laws about driving a car with no sleep, it only makes sense for similar laws to exist for health care workers, bus drivers, air line pilots etc. If peoples lives are at risk we really must be at the top of our game and not impaired in any way.