Healthcare News & Insights

Avoid big legal issues with nurses’ shifts, overtime

When it comes to the legal rights of nurses and other hospital staff during the work day, there are several huge pitfalls hospitals must avoid. Two recent cases demonstrate why hospitals need to be careful when scheduling nurses for overtime and making sure they’re paid properly for their work. 


If hospitals don’t pay attention to these issues, they may end up in the throes of a drawn-out, costly court battle – just like these facilities did.

Overtime woes

Relying too heavily on nursing staff after layoffs could be risky for your hospital, as was debated in a court case highlighted by The National Law Review.

In this case, Women’s and Infants Hospital in Rhode Island planned to pare back its staff as a cost-cutting measure. However, to keep up with its volume of patients, the hospital tried to force all remaining nurses into working mandated overtime.

But the nurses protested, and they decided to go on strike in hopes of getting the hospital to reverse its decision.

The hospital felt it was justified in its request, so it took the issue all the way to the state Supreme Court.

The facility tried to argue that if its nurses refused to work overtime, it would cause irreparable harm to the hospital. Not only would patients experience subpar care if the nurses didn’t work extra hours after the layoffs, the hospital would also have to divert patients it couldn’t handle to other hospitals, jeopardizing their health.

Women’s and Infants Hospital lost the case. According to the court, the hospital had diverted patients to hospitals for other reasons in the past, including similar issues with staffing. And it offered no evidence that this practice hurt patients in any way – or even that it hurt the facility’s bottom line at all.

Plus, the court said, if the hospital truly felt it needed extra staff while working out the dispute with its nurses, it could’ve hired temporary or per diem nurses in the interim.

So the hospital wasn’t justified in forcing nurses to take on overtime hours.

Breaks & payments

Another key point to keep in mind when scheduling nursing shifts: Staff need to be taking all their scheduled breaks. If they aren’t, it could land your hospital in hot water.

In another lawsuit, several nurses at Twin Cities Community Hospital in California filed legal action against their employer for several wage and hour violations, including failing to allow them to take their required breaks, according to an article in the Paso Robles Daily News.

The facility is also accused of mandating nurses to work overtime and paying them incorrectly on numerous occasions.

California has strict laws mandating a certain nurse-to-patient ratio in hospitals across the state, designed to keep nurses from being overwhelmed by too many patients. But, nurses at Twin Cities didn’t always have someone on staff to substitute for them while they went on break. So many nurses didn’t take their breaks at all for fear of breaking the law – or of something happening to their patients in their absence.

According to the nurses who are suing Twin Cities, this situation arose because the hospital was understaffed, and no one was making the effort to hire additional nurses. The result: Nurses on staff worked entire shifts without breaks, and they also worked multiple hours of overtime.

The hospital may also be on the hook because of errors with paying nurses for the overtime they worked. Nurses accused the facility of miscalculating the rate of pay they should’ve received for overtime, saying they didn’t receive all the money they were entitled to when working extended shifts.

The case is currently in litigation in a local court.

Preventing similar issues

To keep your staffing practices from falling under similar scrutiny, your hospital needs to make sure it’s following all appropriate laws regulating nurses’ wages, breaks and paychecks. Know the details of your nursing staff’s collective bargaining agreements, as well as any applicable state regulations governing how much they’re allowed to work.

Overworking nurses by having them take on too much overtime may not only have legal implications, it could also cause burnoutand burned-out nurses can put patients in real danger. It may be best to consider hiring a few extra nurses to ease the burden that overtime has on your existing staff.

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