Overtime has been a consistent part of hospital staffing for decades. The debate still rages on about whether having clinical staff work long shifts is more beneficial or dangerous to patients. And now, some recent legal challenges are bringing the issue to the forefront again for many facilities.
Harm to patients
In Michigan, a lawsuit was recently filed on behalf of a patient who was committed to a mental health hospital, according to an article in U.S. News & World Report (taken from the Associated Press).
The complaint, which was brought by a labor attorney in Detroit, alleges that the hospital’s mandatory overtime regulations have put patients in danger. According to the complaint, these requirements mean the facility is staffed by exhausted employees who have little control over patients’ behavior, which has contributed to an increase in violent incidents among patients.
Although the case focuses on one patient right now, lawyers are currently working to give the lawsuit class action status. If that happens, the outcome would affect over 600 patients.
The legal team is hoping the case will succeed because patients at the hospital are unique. Many of them are considered “involuntary” patients due to their illnesses. As such, they can’t just leave and seek treatment elsewhere. So lawyers are arguing that strict limitations should be placed on overtime to protect patients who have fewer options.
A case like this has the potential to set a legal precedent for facilities that admit mentally ill patients.
And even for those that don’t, it could influence how courts view mandatory overtime for employees of other hospitals and healthcare organizations.
Less overtime, more staff
Another attempt to limit overtime and boost staffing levels through legal means is happening in Washington state. There, nurses themselves are lobbying for laws that would reduce overtime hours and create specific staffing ratios that must be followed at all times.
According to an article in the Seattle Times, two bills are currently being reviewed by state legislators that would specifically address overtime, staffing and rest breaks. One bill addresses staffing issues by giving more power to hospital staffing committees. If hospitals don’t comply with recommended staffing levels, employees will have the right to request a state investigation into the facility. Additionally, each hospital staffing plan must be filed with the state, increasing transparency and accountability.
While nurses wanted more powerful legislation that’s similar to California’s requirements for mandatory minimum patient/nurse ratios, a bill of that nature isn’t likely to make it to lawmakers anytime soon.
A second bill removes an on-call loophole that impacts how much overtime nurses are allowed to work. Washington currently has a law on the books that bans hospitals from forcing nurses to work overtime unless an unexpected emergency arises. However, that didn’t prohibit hospitals from mandating on-call nursing shifts which, nurses argued, forced them to work overtime anyway.
The bill would not only forbid hospitals from using on-call time to fill “chronic or foreseeable staff shortages,” it would also require hospitals to give nurses regular, uninterrupted rest/meal breaks depending on the hours they worked.
Both Washington bills are currently working their way through various committees. Should either or both become law, nurses in other states may renew their efforts to have similar legislation pass to regulate their workdays. We’ll keep you posted.
In the meantime, hospitals should work to make sure they’re meeting recommended staffing ratios as closely as possible, and that they’re staffing shifts fully enough to limit workers’ overtime.