What are OSHA's restrictions on shift length for Nurses?

General E. Speaking, RN, RN · Feb 3, 2011

I'm not sure but can't you only work 16 hrs with a minimum 8 hrs between shifts? This will be an interesting thread.

nurse2033, MSN, RN · Feb 3, 2011

I seem to think that the max shift length is 18 hours but I dont' have anything to back that up. Of course, it is not safe to work that long without breaks. I can't imagine OSHA basically negating safe practices for an emergency. As for finding replacements- not your job. Admin has the job of staffing the facility. It sounds like you worked 24 and were on the phone getting replacements, but I hope that's not the case. If that is the case, that is a catastrophic failure of management. Do you take turns going to the store to get supplies and food? Perhaps there's a treadmill for you to run on when the power gets low. Do you have to shovel the walks as well?

kakamegamama · Feb 3, 2011

The OSHA website could probably answer your questions about their view on straight hours worked without relief. It seems that 16 hours is considered maximum, with 18 as a possibility, but I'm not 100% sure. Either way, once a nurse has worked past 18, she/he & the patients are at risk, imo. I agree with the other posters that admin. should find someone, not the floor nurse. I had a nurse manager tell me once that she was not going to find my replacement (I gave her over a week's notice that I was not going to be able to work a particular shift--I was PRN). My response was to do so, although I did wonder what her job was in that scenario.

ItsTheDude · Feb 3, 2011

osha doesn't cover such, it could contradict other laws such as the flsa and there are jobs that let you sleep/rest while "working" prolonged hours.

of course, if you do a crazy shift, 24 hrs or so and something bad happens, the lawyers will come a running and the courts will set a punishment ($) for the questionable scheduling.

the legal dept of any health care organization would probably cut the head off of any supervisor allowing this to happen, clear liability issue.

icb1977 · Feb 3, 2011

I'm not an RN, my wife is. She wasn't on the phone calling for replacements, she was tending to the patients, not hitting the phone tree for her relief. It wasn't until it got close to her next "pre-scheduled" shift and when she brought it up on the phone to her boss, that it was thrown on her shoulders.

I was just curious as to if you could legally work even if you wanted to, after such a long shift. The 3 nurses did relieve each other to give each other breaks throughout that time however. It allowed for quick power naps, even so once the daytime came they really didn't have the ability to keep rotating as the patients woke up too.

icb1977 · Feb 3, 2011

itsthedude:

I agree, when things go wrong, people are quick to throw you under the bus. A RN has to not only protect the patients, but also themselves too. It is my opinion, that a RN saying I'm too fatigued to work another shift is in fact a protection to both patients and themselves. Making sure that the patients get adequate care.

General E. Speaking, RN, RN · Feb 3, 2011

of course, if you do a crazy shift, 24 hrs or so and something bad happens, the lawyers will come a running and the courts will set a punishment ($) for the questionable scheduling.

What of the nurse's license? I am wondering, if God forbid, something terrible were to happen related to fatigue?

nurse0520 · Feb 3, 2011

I am curious why OSHA isnt called more often or something? It seems just in the short time I have been a nurse, there are too many situations where we can't get breaks, work without enough CNAS too many patients, hazzardous weather just to name a few. Another thing is this not for profit business, is all the so called profits just the administrations outrageous salary?

belgarion · Feb 3, 2011

OSHA is pretty much a paper tiger. It takes a whole lot to get them up and moving and their fine structure is a joke. Most states have laws regarding how many hours nurses can work at a time, patient ratios, mandatory OT and such. It's also somesthing CMS or the joint commission might be interested in. Who knows? They might actually be good for something after all.

Esme12, ASN, BSN, RN · Feb 3, 2011

I'm not an RN, my wife is. She wasn't on the phone calling for replacements, she was tending to the patients, not hitting the phone tree for her relief. It wasn't until it got close to her next "pre-scheduled" shift and when she brought it up on the phone to her boss, that it was thrown on her shoulders.
I was just curious as to if you could legally work even if you wanted to, after such a long shift. The 3 nurses did relieve each other to give each other breaks throughout that time however. It allowed for quick power naps, even so once the daytime came they really didn't have the ability to keep rotating as the patients woke up too.

In the event of a disaster declaration staff can be mandated to stay until relieved.....rest/food breaks required. This came up during Katrina.......but if you are at work and you are not relieved you may not abandon the patinets without giving report to someone that accepts their care. This is more mandated by Federal labor laws and State by State Nurse Practice laws......this is not an OSHA issue. Years ago after an ice storm we...the nurses went to the kitchen and made breakfast that day while waiting for staff to arrive. People had a lot of cereal that morning but they got fed!

Each facility has different disaster preparedness plans (Joint Commision/state mandated) and phone disaster trees that are activated. When you sign on to care for patients there is a certain obligation that accompanies with that responsibility. Unlike other jobs....patients don't get better during a snow storm and they need care. This is the importance of relieving your co-workers....if you don't go in......someone doesn't leave. BUt it is the manager/administrations responsibility to obtain staff. I have requested help with phone calls and sometimes a co-worker gets a yes quicker than I can (it's easier to say no to me than their friend). BUt it is the administrator/manager to ensure staffing.

The best plan I have been involved with is when bad weather....snow storms.....are massively predicted.....the next 2-3 shifts are offered to stay at the hospital with on call pay so they are available for the shifts. Complimentry breakfast offered and usually pizzas were ordered for the nurses/staff that stayed. Many nurses would go home ,get their things and return with munchies and movies for a giant sleep over. For those that choose to be at home for whatever the reason of if the storm became worse than planned we sent hospital vehicles/personel with 4x4 vehicles to retireve staff and return them home. The savings in OT,staff staying working a double because there was no relief, made this plan pay for itself.

BUt in a disaster situation there are policy/state driven protocols that are enacted for everyone's benefit. BUt things occur.......like if you worked a double in the ED and were just finishing up the morning of Sept 11.....you worked until the work was done and then stayed just a little longer just to be sure.........That is what makes this profession just a little different that everything else........it's not just a profession...it's a vocation. Just food for thought....

Kyrshamarks, BSN, RN · Feb 3, 2011

OSHA is not responsible for things like policing if people do not get their breaks. OSHA is responsible for the PHYSICAL safety of people at work and that there are no hazards present that moght injure a worker.