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Stop Mandatory Overtime
It’s a Public Health IssueAfter a decade of cost cutting, merger mania, and privatization, health care employers have created terrible working conditions that are driving nurses and other health care workers out of the health care industry. Those who remain are working in conditions of chronic understaffing, frequent forced overtime, no days off and lack of supervisory support. Airline crews have limits on their work hours to protect the public’s safety, as do truckers. The American Federation of State, County and Municipal Employees (AFSCME), AFL-CIO, is aggressively working to bring similar protections to both patients and the workers who care for them. It’s Sound ScienceA number of research studies have detailed the detrimental effects of inadequate staffing. Researchers have found that regular, predictable hours are safer for health care workers and their patients. Exhausted health care workers can inadvertently and unintentionally put a patient’s safety at risk. Working Conditions Affect Retention and RecruitmentIn the last decade, many health care workplaces restructured the delivery of care requiring nurses and other caregivers to provide care for greater numbers of patients who are increasingly sicker. Since that time, there has been a growing reliance on the use of mandatory overtime to meet staffing needs. In many workplaces, overtime is no longer an occasional requirement prompted by an emergency or unforeseen event. Rather, it is a routinized alternative to proper staffing. The health care staffing crisis in the United States is expected to grow as the baby boom generation ages and as boomers’ needs for health care increases. The growing use of mandatory overtime to deal with the staffing crisis is actually making the problem worse. All overtime should be voluntary. Health care workers are leaving their careers due to the overtime abuse and patient safety risks. Solving the staffing crisis requires improving the overall working conditions in health care. For instance, today there are one-half million nurses with licenses who are not engaged in the nursing profession. Unless the problem of mandatory overtime is addressed, more nurses will opt out of the profession, undermining other efforts by the nation to increase the supply of nurses. It’s Time for Legislative ActionWithout passage of legislation to stop manda-tory overtime, the practice will continue. Mandatory overtime and insufficient time off can endanger the safety and health of both workers and patients. Health care workers who refuse the overtime often are threatened with losing their jobs and their licenses. The overtime problem is so severe that health care workers have gone on strike over the issue. Meanwhile, bans on mandatory overtime are being proposed in state legislatures across the country. Stopping the practice of mandatory overtime would be a significant step towards improving public safety and the working conditions of our nation’s health care workers. AFSCME has been working with state legislators to address mandatory overtime. In 2002, 15 states introduced legislation to prohibit mandatory overtime. Four states — Maryland, Minnesota, New Jersey and Washington enacted mandatory overtime legislation while Texas passed state regulations regarding mandatory overtime. In prior years, Maine and Oregon enacted mandatory overtime restrictions while California passed state regulations. Research StudiesA partial list of research studies linking staffing with patient outcomes and long work hours with adverse health and safety effects: Health Resources and Services Administration, Nursing Staffing and Patient Outcomes in Hospitals, Harvard School of Public Health, 2001. Aiken, Clarke and Sloane. "Hospital Restructuring: Does It Adversely Affect Care and Outcomes?" Journal of Health and Human Services Administration, 2001. Aiken. "How the Organization and Staffing of Hospitals Affect Patient Outcomes," International Medical Forum, 103: 79-85, 1998. Kovner and Gergen. "Nurse Staffing Levels and Adverse Events Following Surgery in U.S. Hospitals," Journal of Nursing Scholarship, Vol. 30, No. 4: 315-321, 1998. Hayashi, Kobayashi, Yamaoka and Yano. "Effect of Overtime Work on 24-Hour Ambulatory Blood Pressure," Journal of Occupational and Environmental Medicine, Vol. 38, No. 10: 1007-11, 1996. Iskra-Golec, Folkard, Marek and Noworol. "Health, Well-Being and Burnout of ICU Nurses on 12- and 8-Hour Shifts," Work & Stress, Vol. 10, No. 3: 251-256, 1996. Smith and Lake. "Lower Medicare Mortality Among a Set of Hospitals Known for Good Nursing Care," Medical Care, Vol. 32, No. 8, 1994. For further information, contactAFSCME Department of Research and |
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