National Nurses United

Massachusetts Ban Against Forced Overtime Takes Effect MASSACHUSETTS R epresentatives from the Massachusetts Nurses Association/National Nurses United, along with state Rep. Denise Garlick, RN, held a press conference��at the State House Nov. 1 to brief the public and news media about a new law to ban the dangerous practice of mandatory overtime as an alternative to providing safe registered nurse staf���ng levels in the state���s acute-care hospitals. The new law went into effect on Monday, Nov. 5. On Aug. 6, Gov. Deval Patrick signed into law a healthcare payment reform bill that included a ban on mandatory overtime proposed by MNA/NNU. This measure protects patients and saves money by preventing medical errors and complications resulting from RNs being forced to work excessive hours, according to Garlick, who serves on the Legislature���s joint committees on Public Health and Health Care ���nancing, which played a key role in crafting the legislation. ���We did not want hospitals to utilize the pressure of payment reform as an excuse to cut care at the bedside,��� Garlick explained. ���The Legislature understands that the provision of nursing care is central to the delivery of quality patient care and, according to the research, it is also central to the provision of cost-effective and, yes, cost-saving care.��� MNA/NNU President Donna KellyWilliams, RN called the new law a ���landmark achievement. Forcing nurses to work when they are exhausted endangers patients and leads to costly, preventable medical errors and complications. The practice of mandatory overtime is indefensible by any patient safety standard, and yet hospitals continue to increase their use of this practice.��This legislation will put an end to that as of Monday.��� The law prohibits mandatory overtime, which is de���ned as hours beyond the predetermined and regularly scheduled number of hours that the hospital and nurse have agreed that the employee shall work, and any hours exceeding 12 hours in any given 24-hour period. This requirement is in NOVEMBER 2012 keeping with the recommendations of the Institute of Medicine, the most prestigious medical research body, which issued a report in 2002 calling for a ban on mandatory overtime. The law prohibits nurses from working mandatory overtime except in the case of ���an emergency situation where the safety of the patient requires its use and when there is no reasonable alternative.��� ���Emergency situation��� will be de���ned by a newly established health policy commission that will conduct a public hearing and consult nurses to determine what constitutes an emergency situation, but is widely understood to be a county, state, or nationally declared disaster situation. The law also prohibits mandatory overtime being used as an alternative to providing appropriate staf���ng for the level of patient care required. ���This means hospitals cannot do what they have done for years, which is to post schedules with numerous holes built into the schedule,��� said Garlick. ���It is the hospital���s responsibility to have enough nurses to cover the shifts needed to provide patient care��� safely. She also pointed out that increases in census or sick calls by nurses did not qualify as emergencies but were to be expected as part of running a hospital. ���When Hurricane Sandy hit, nurses had no problem working as long as it took to keep their communities safe,��� said Garlick. ���But day-to-day operations of a hospital do not correlate to the requirements for responding to a once-in-a-century storm.��� The law requires that hospitals report all instances of mandatory overtime to the Massachusetts Department of Public Health and that W W W. N A T I O N A L N U R S E S U N I T E D . O R G these reports be made available to the public. The law protects nurses by prohibiting any discrimination, dismissal, discharge, or any other employment decision based on a nurses��� refusal to accept work in excess of the limitations on mandatory overtime. MNA/NNU plans to monitor and report compliance by employers, and has already mailed all nurses in the state about the law informing them of their rights, said KellyWilliams. The union has also created a page on its website with an online form for nurses to report any instances where they have been mandated to work overtime. MNA will share its data with the appropriate agencies. The dangers and costs of mandatory overtime have been well documented in a number of scienti���c studies published in the last decade, which included ���ndings that nurses working mandatory overtime are three times more likely to make costly medical errors. Over a decade ago, MNA nurses went on strike at St. Vincent Hospital in Worcester and Brockton Hospital���for 49 and 104 days respectively���to stop this dangerous practice. After a period of relative stability, nurses have seen hospitals revert back to mandatory overtime as their primary staf���ng tool. In the past two years, this practice has been at the core of contentious negotiations at Tufts Medical Center and Morton Hospital in Taunton (where nurses voted to go on strike over the issue), Baystate Franklin Medical Center, and Cape Cod Hospital. Barbara Tiller, a nurse at Tufts Medical Center, where nurses almost went on strike over this issue in 2011, explained how her employer and others across the state were cutting staf���ng and relying on forced overtime. ���We were the poster children for what the Legislature in their wisdom sought to prevent with the passage of a state law to ban mandatory overtime,��� Tiller explained. ���Now, thanks to this law, we have a means of holding hospitals accountable for providing safe conditions to ensure safe patient care.��� ���David Schildmeier N AT I O N A L N U R S E 5

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