Presentation Transcript

1. Nursing 620 Policy Presentation—Mandatory Overtime

   Shannon Currie December 12th, 2009 “I have abided by the academic honor policy of this assignment”
2. Mandatory Overtime It is defined by Bosek (2000) as when “a person with authority is commanding a person with lesser authority or power to work extra hours not previously negotiated and that the person with lesser power is obligated to comply” (p. 99)
3. Mandatory Overtime Per the stated definition, mandatory overtime does not refer to over forty hours in one week Mandatory overtime means being forced to work any amount of time over your scheduled shift If you areforced to stay extra hours on your first day of work for the week…it is still considered mandatory overtime
4. Scope of the Issue In 2004 72% of hospitals had a nursing shortage (“The nursing shortage”, 2004) 75 Million Baby Boomers started hitting age 60 in 2007 adding strain to the healthcare system (Belknapp, 2008) Nurses of the baby boomer age are starting to retire and we are therefore losing a large pool of staff nurses
5. Scope of the Issue 49,000 qualified applicants were turned away from nursing school in 2008-2009 due to low faculty numbers or limited classroom and clinical space (American Association of Colleges of Nursing, 2009) That is 19,000 more students than had to be turned away in 2003! (Belknapp, 2008)
6. Scope of the Issue In 2002 over half of surveyed nurses reported working mandatory overtime at some point in the previous year (Golden and Jorgenson, 2002) The same survey showed that 14% of nurses reported working mandatory overtime every single day
7. Effects on Nursing Decreases Patient Safety 2008 survey reported that of the 14% of nurses reported committing a medication error in the last year, but that number jumped to 22% when looking at only those RNs that worked overtime (“Overworked Nurses”, 2008) ↑ in decubitus ulcer, catheter associated blood stream infections and catheter associated UTI when nurses work overtime and nurse to patient ratio is unchanged (Stone et. al, 2007)
8. Effects on Nursing Decreases Job Satisfaction Beckers et. al (2008) studied involuntary vs. voluntary mandatory overtime and found that employees who were forced to work overtime as opposed to choosing to work overtime reported more fatigue and a decreased job satisfaction. According to the American Association of Colleges of Nursing– Between 1:3 to 1:5 nurses leave the profession every year for a reason other than retirement (2009).
9. Effects on Nursing Increases occupational accidents and affects the personal health of nurses Golden and Jorgenson’s study (2002) found that “after nine hours at work, the accident rate begins to rise; in the 12th hour the accident rate was twice as high as the rate for the first nine hours” (para. 7). Overtime creates added stress to nurse personal lives increasing likelihood of HTN, DM, and other health problems.
10. Federal Level Attempts Several attempts have been made Bills have been introduced in 2001, 2003, and 2007 None have made any progress outside of referrals to committees
11. State Level Successes State Legislation has been much more successful at banning overtime Legislation always supported by the ANA and local nurses association
12. The American Nurses Association’s Nationwide State Legislative Agenda PROHIBITION OF MANDATORY OVERTIME ME WA MT ND VT NY NH MN OR MA WI ID SD CT RI MI WY PA IA NJ NE OH MD NV DE IN IL UT wv VA DC CO CA KY MO KS NC TN SC OK AR AZ NM GA AL MS AK TX LA FL Enacted legislation/adopted regulation to date 15 states; (12 states): CT, IL, MD, MN, NH, NJ, NY, OR, PA, RI, WA, and WV. ( 3 states) have provisions in regulations: CA, MO and TX Introduced legislation in 2008-9; (11 states): AK, IL, MA, NC, OH, VT, WA, & WI; MI, NY, TX included in staffing bills. HI March 2009
13. West Virginia BillsNurse Overtime and Patient Safety Act 2004 2007 Explicitly excluded CRNA from definition of nurse Mandates hours off between long shifts (i.e must have 8 hours off after working 12) Forbid work over 16 hours in 24-hr period Now included CRNAs in the definition of a nurse Restricted nurses day to no more than 12 hours in a 24-hour period Required hospitals to have the act posted in a conspicuous place at all times
14. Texas S.B. 476 Most recent state to ban mandatory overtime Signed into law by the Governor of Texas in June and went into effect in September 2009 Prohibits both mandatory overtime and enacts fees for those that attempt to discipline nurses who refuse to work overtime
15. Texas S.B. 476 Gives nurses more say in how staffing plans are created in hospitals Requires each hospital to have a staffing committee who will formulate a recommended nursing staffing plan Majority of committee must be bedside nurses The suggested plan from committee must be considered for use by administration
16. North Carolina Initiatives
17. Study Mandatory Overtime Bill passed in 2009 that says a study will be done in order to determine the affects of mandatory overtime of patient safety Committee to perform study will have members from both House and Senate and 1 RN and 1 LPN Study will last for 2 years $100,000 for study
18. My Opinions Mandatory overtime is dangerous and creates more problems than it fixes Federal level legislation does not work State Legislation has more support and more chance of passing Problem is nursing shortage. Mandatory overtime is a symptom of that problem
19. Nursing Shortage Recommendations Increase wages for all nurses, especially bedside nurses. This will make the profession more attractive to the general public. Increase the number of nursing faculty and then try to open more schools. Through scholarships, more incentives to teach etc. Retention, Retention, Retention! We are losing too many trained nurses everyday.
20. References American Association of Colleges of Nursing. (2009). Nursing shortage fact sheet. Retrieved Nov 26, 2009, from http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm American Association of Critical-Care Nurses. (2009). Mandatory overtime. Retrieved Nov 27, 2009, from http://www.aacn.org/ American Nurses Association. (2009). Mandatory Overtime. Retrieved Nov 24, 2009, from http://www.nursingworld.org Beckers, D. G. J., van der Linden, D., Smulders, P. G. W., Kompier, M. A. J., Taris, T. W., & Gurerts, S. A. E. (2008). Voluntary or involuntary? Control over overtime and rewards for overtime in relation to fatigue and work satisfaction. Work and Stress, 22(1), 33-50. Belknapp, S. (2008, September 6). The desperate United States nursing shortage. Retrieved Nov 27, 2009 from http://healthfieldmedicare.suite101.com/article.cfm/the_desperate_unit ed_states_nursing_shortage
21. References Beurhous, P.I., DesRoches, C., Donelan, K., & Hess, R. (2009). Still making progress to improve the hospital workplace environment? Results from the 2008 National Survey of Registered Nurses. Nursing Economics, 27(5), 289-301. Bosek, M. S. D. (2001). Mandatory overtime: professional duty, harms, and justice. Journal of Nursing Administration’s Healthcare Law, Ethics, & Regulation, 3(4). 99-102. Federal Aviation Administration. (2009). Pilot flight time, rest, and fatigue. Retrieved Nov 24, 2009, from http://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=6762 Golden, L., & Jorgensen, H. (2002). Time after time: Mandatory overtime in the U.S. economy. Retrieved Nov 24, 2009, from http://www.epi.org/publications/entry/briefingpapers_bp120/
22. References Nurse Overtime and Patient Safety Act of 2004. West Virginia Code. §21- 5F-1 to §21-5F-5. (Amended in 2007) Overworked nurses admit making medication errors. (2008, May 15). CTV News. Retrieved Nov 26, 2009 from http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080515/n urse_followup_080515/20080515 Safe Nursing and Patient Care Act of 2007, S. 1842, 110th Cong. (2007) Senate Bill 476. Texas Code. § 257-258 of the Health and Safety Code Stone, P. W., Mooney-Kane, C., Larson, E. L., Horan, T., Glance, L. G., Zwanziger, J., & Dick, A. W. (2007). Nurse working conditions and safety patient outcomes. Medical Care, 45(6), 571-578. DOI: 10.1097/MLR.0b013e3180383667
23. References Study Mandatory Nurse Overtime. HB 812. General Assembly of North Carolina Session (2009). The nursing shortage. (2009). Retrieved Nov 26, 2009 from http://www.nursingshortageinfo.com/index.shtml Trust for America’s Health (2009). Nursing shortage estimates (2010). Retrieved Nov 28th, 2009 from http://healthyamericans.org/states/states.php?measure =nursingshortage&sort=data Worthington, K. (2001). The health risks of mandatory overtime: The hidden cost of this all too-common practice. American Journal of Nursing, 101(5), 96.