National Nurses United

NEWS BRIEFS Massachusetts RN leaders with Gov. Deval Patrick Massachusetts Nurses Win Mandatory Overtime Ban MASSACHUSETTS O n aug. 6, 2012, in a Massachusetts Statehouse ceremony held in Nurses Hall and packed with nurses, healthcare advocates, labor associates, and legislators, Gov. Deval Patrick signed a sweeping health reform bill that included��a ban on the common hospital practice of using mandatory overtime (MOT) rather than providing safe registered nurse staffing levels in acute-care hospitals. The inclusion of the ban on MOT in this major piece of legislation has served to highlight it as a major success for nurses in Massachusetts. ���This is a landmark achievement in our state���s efforts to control costs, while maintaining safe, quality patient care,��� said Donna Kelly-Williams, RN, president of the MNA/NNU. ���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.��� �� MNA filed a bill to ban mandatory overtime at the beginning of the past 20102012 legislative session. In recent months, MNA ramped up its work with legislative leaders in both branches to incorporate the mandatory overtime ban in the payment reform bill. 8 N AT I O N A L N U R S E Under the law, a hospital will be prohibited, except in the case of a declared emergency, from requiring nurses��to work beyond their scheduled shift, and no nurse would be required to work more than 12 hours in a 24-hour period. Should a hospital assign a nurse to work a mandatory overtime shift, the new law requires that they report such incidents to the Massachusetts Department of Public Health, along with the justification for the assignment. These reports become public documents.�� The law also includes an anti-retaliation measure, which prohibits hospitals from discriminating against or terminating nurses who refuse to accept a work assignment in excess of the specified limitations. Nurses can refuse overtime without fear of retribution or discipline by their employer. Moreover, even in the event of an emergency, before mandating overtime, hospitals must make a good-faith effort to cover the overtime on a voluntary basis. The law also sets maximum shift lengths for nurses. Hospitals are prohibited from regularly scheduling a nurse to work more than 12 hours in a 24-hour period. Hospitals are further prohibited from permitting a nurse to work more than 16 consecutive hours in a 24-hour period. In the event a nurse works 16 consecutive hours, the hospital must provide that nurse with at least eight hours of consecutive off-duty time immediately following the 16-hour shift.���� The dangers and costs of mandatory overtime have been well documented in a number of scientific studies published in the last 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 decade, which included findings that nurses working mandatory overtime are three times more likely to make costly medical errors; and that overtime for nurses was associated with an increased risk of catheter-related urinary tract infections and bedsores, both preventable medical complications. In 2002, the Institute of Medicine issued a report linking mandatory overtime and the understaffing of nurses to thousands of patient deaths each year, and called for an all-out prohibition of the practice. �� Over a decade ago, MNA nurses went on strike at St. Vincent Hospital in Worcester and Brockton Hospital ��� for 49 and 103 days, respectively ��� to stop the dangerous practice of mandatory overtime. After a period of relative stability, nurses have seen hospitals revert back to the dangerous practice of mandatory overtime as their primary staffing tool. In the past two years alone, this practice has been at the core of contentious negotiations at Tufts Medical Center (where the nurses voted to go on strike over the issue), Baystate Franklin Medical Center, Cape Cod Hospital, and Quincy Medical Center. ���Twelve years ago, the nurses at St. Vincent Hospital were forced to strike to protect our patients from the dangerous practice of mandatory overtime,��� said Marie Ritacco, a registered nurse at St. Vincent Hospital in Worcester. ���Patients will now be protected from being subjected to a nurse who is too fatigued to practice safely. Nurses can no longer be forced to work excessive hours and put our patients and our licenses at risk.��� Stay tuned for updates on progress by state agencies in implementing the specific provisions of the law, including the ban on MOT. But for now, Massachusetts nurses are celebrating this seminal accomplishment. ���David Schildmeier SEPTEMBER 2012

• Cover