Wage Theft: Justice in the Workplace

[Imagepoem]

Let me start with some background. I'm new to nursing, but I'm not new to work. I have bailed hay, milked cows, operated machines in factories, cared for the mentally disabled, washed dishes, cooked, worked as a lab technician and spent 15 years as a professional in commercial art. I have long standing relationships with clients thanks to my work ethic and honesty. I became a nurse after providing care to my child who eventually died in a hospital. It is my goal to be a source of professional support for patients and families who endure experiences similar to mine. I was inspired through those experiences by nurses and other professionals who performed their duties with exemplary professionalism and compassion.

Unfortunately, not all institutions have the organizational integrity that inspired me. I'd like to share my analysis of how a particularly insidious labor policy played out. Wage theft refers to non payment of wages by one's employer. For an in depth explanation visit (http://www.nclnet.org/worker-rights/148-wage-theft/525-wage-theft-six-common-methods) In my case the policy was clearly stated. The nurse would be paid for the 8 hour shift and any time required to complete nursing tasks after the shift would be unpaid. Nonpayment of wages has a direct effect on the quality of nursing and the culture of the institution as follows:

1. The wage agreed to as terms of employment is lowered placing financial strain on the nurse. Time is money and a deal is a deal. Non payment allows the employer to lower your compensation at will. This effects the quality of your life.
   
2. There is no cost constraint on the employer to prevent them from assigning unreasonable workloads. As long as the employer can make credible threats, the nurse will feel compelled to work for free. For nurses, usually this means the institution will hold her license hostage as a means to coercing the nurse to comply with unpaid hours.
   
3. Nurses will cut corners in various ways to meet the demands of unreasonable workloads. Nurses falsify assessments, sign for treatments that were not performed, and forego proper procedures such as time consuming infection control protocols.
   
4. Nursing becomes unmanageable on an institutional level. Once nurses begin cutting corners, records of work become unreliable. From one shift to the next no one can really tell if tasks were performed because nurses are compelled to sign off on everything regardless. Sometimes there is direct pressure to falsify records to comply with state audits. Once this occurs patient outcomes cannot be assessed because there is no reliable data to provide insight into effectiveness of treatment.
   
5. The management abdicates authority and the ability to maintain discipline. By placing nurses in a compromised position they have no moral authority to criticize nurse performance. Furthermore, the records of performance are unreliable. The net effect is that dishonesty is rewarded and honesty is punished.
   
6. Nurses lose confidence in each other. The record is always in doubt and the nurse is always in fear of losing her license. In many cases nurses who attempt to maintain integrity will be ostracized by those who habitually cover up errors and omissions.
   

​Under financial pressure, institutions that engage in these illegal practices will often continue to cut staff and overload nurses until the institution itself is in grave condition. Unfortunately, this is a condition that is almost impossible to remedy because effective management has been rendered impossible by its own policies. In the meantime patient outcomes suffer tremendously. The points I have made are by no means comprehensive. I welcome observations from others who have experiences similar situations.

As nurses we should not be complicit in these circumstances. The economy is tough and we need to work to survive, but we did not get into nursing to do harm. I am certain from what I have seen that toleration of unfair labor practices is directly related to harm of patients and I encourage all nurses to stand up for their rights. When we allow ourselves to be taken advantage of, patients suffer neglect and abuse and in many cases we do more harm than good.

[traumaRUs, MSN, APRN]

I guess I'm confused - what are you advocating?

[imintrouble, BSN, RN]

I've worked in a few of those places.

It used to be you had two choices. Comply or quit. Changing the culture simply was impossible.

There's still two choices, but if you quit there's 50 nurses waiting to take your place, and you'll be one of 50 vying for the next job.

I hardly recognize nursing AND nurses anymore.

[Imagepoem]

In my case I was vocal to my management about my disapproval. When it was clear that this place was going to continue to put my license in jeopardy I quit the job and reported the labor issue to the department of labor. We will see what comes of it. I'm advocating that nurses should be more activist.

[jadelpn, LPN, EMT-B]

The act of working off the clock questions legality. At most places I have had experience with, no one works off the clock anymore, as it was found to be a liability to the faciity to do so.

We had one nurse who literally said "I did not do it" after signing off on an order not completed. "Wasn't me" is a viable option if a nurse has clocked out for the day and continues to work. There is not a shred of proof that the nurse was even there, however, the facility can counter with "we never said that, we assumed the nurse stayed clocked in"

Additionally, we have had instances were one was clocked out, assisted with a patient, and then got hurt--workman's comp nightmare....

Mandatory overtime to get work done is usually on the clock. Which stinks, but so many of the facilities are requiring it as part of someone's job description--in some flowery language that seemingly means something different than it appears at first.

However, it doesn't surprise me one bit that facilities do this kind of thing--supports a "the patient doesn't really matter as much as the bottom line" mentaility of aggressive business models in a facility setting.

I am so sorry at the loss of your child. I can only imagine what a fire that burns to advocate for something better.

[herring_RN, ASN, BSN]

Please do NOT work off the clock.

Accessing patient records in order to finish charting can be a HIPAA violation.

Hospital malpractice insurance does not apply if you are not officially working.

As JadeLPN posted if you are injured Workers compensation will not apply.

It is dishonest.

Yoy are technically trespassing.

The employer can get away with violating the law.

Without a union it will take a lot to get everyong together to stop the illegal and unsafe practice of clocking out and then working.

[brandy1017, ASN, RN]

It is illegal to sign off that you did something that wasn't done and you can be prosecuted as happened to nurses in NY a couple years back. NY Attorney General decided to put in hidden cameras in nursing homes and then went after the nurses who charted the patient's were turned when they weren't. It's not just your license on the line! You could end up in prison!

[OCNRN63, RN]

I've worked in a few of those places.

It used to be you had two choices. Comply or quit. Changing the culture simply was impossible.

There's still two choices, but if you quit there's 50 nurses waiting to take your place, and you'll be one of 50 vying for the next job.

I hardly recognize nursing AND nurses anymore.

​Amen to that.

[OC_An Khe]

Please do NOT work off the clock.

Accessing patient records in order to finish charting can be a HIPAA violation.

Hospital malpractice insurance does not apply if you are not officially working.

As JadeLPN posted if you are injured Workers compensation will not apply.

It is dishonest.

Yoy are technically trespassing.

The employer can get away with violating the law.

Without a union it will take a lot to get everyong together to stop the illegal and unsafe practice of clocking out and then working.

Well put. Wage theft by "coercing" nurses to work off the clock, and working through breaks and not getting paid for it, should be reported to the appropriate authorities.

It takes time to change the culture but unions can speed up that process.

[LadyFree28, BSN, LPN, RN]

In my case I was vocal to my management about my disapproval. When it was clear that this place was going to continue to put my license in jeopardy I quit the job and reported the labor issue to the department of labor. We will see what comes of it. I'm advocating that nurses should be more activist.

The depart of labor doesn't take issue like that lightly.

About 2 years ago, I relieved a check for unpaid overtime; I suspect I will get another one soon after a lawsuit directed at local area hospitals will be settled in the future.

I don't work off the clock, nor am I bullied into doing so-or felt bullied into doing so-legality is on my side.

Sometimes things aren't able to get done, and they get passed along to the next shift. It happens, and I don't go martyr over it either-and won't; not sure if I can convince others to do so though, and even unionizing can't change that-if it did, we would be the most powerful union in the country-FAR more powerful than the teamsters IMHO...I'm willing ready and able and exercise in doing so...who ELSE is willing???

[ixchel]

Stories like this are coming out of a hospital near me. I'm not applying to work there. Sad thing is they're hiring new grads out of my graduating class already, and we don't graduate for another month. Hard to not try for a job where you know you could have a shot. But when the media is sharing first-hand accounts of angry nurses being forced to either trade in their paid time off or get fired, while they watch their co-workers of many years get fired all around them, the call of the almighty paycheck wins. The closest hospital besides that one is 45 minutes away. This facility is buying up all of the private practices, plastering their building with health grades awards, while on the inside they're destroying the morale of their employees. It is sad.

[HouTx, BSN, MSN, EdD]

Interesting. My viewpoint -

Nurses (and other licensed professionals) exist in a workplace dichotomy. We are answerable to two "masters"... our employer and our licensing board. We can never use the excuse "my employer made me do it" as a justification to violate our nurse practice act. Any nurse who begins to knowingly falsify records or 'cut corners' as described by the OP... is betraying the foundations of his/her profession.

Jobs come and go. If your employer is expecting/forcing you to violate professional standards, the only professionally acceptable response is resignation.