107th Congress

Registered Nurses and Mandatory Overtime

Message to Congress ANA opposes the use of mandatory overtime as a staffing tool. We urge you to support legislation that would ban the use of mandatory overtime through Medicare and Medicaid law. Nurses must be given the opportunity to refuse overtime if we believe that we are too fatigued to provide quality care.

The Issues Surrounding the Use of Mandatory Overtime:

• Nurses across the nation are reporting a dramatic increase in the use of mandatory overtime as a staffing tool. We fear that this staffing methodology - deemed "mandation" by health care facilities - is having a negative impact on patient care, increasing the chances for medical errors, and driving nurses away from the bedside.

• In some facilities, nurses are being threatened with dismissal or with the charge of patient abandonment if they refuse to accept overtime. We are the only health care professionals who can lose their license (our ability to practice, our livelihoods) if found guilty of patient abandonment. Therefore, many nurses have no actual choice when confronted by a request for overtime, and many of us are regularly working shifts well in excess of 12 hours.

• Research shows that sleep loss influences several aspects of performance, leading to slowed reaction time, delayed responses, failure to respond when appropriate, false responses, slowed thinking, diminished memory and others. In fact, 1997 research by Dawson and Reid at the University of Australia showed that work performance is more likely to be impaired by moderate fatigue than by alcohol consumption. Their research shows that significant safety risks are posed by workers staying awake for long periods.

• Federal regulations have used transportation law to place limits on the amount of time that can be worked in aviation and trucking. Certainly, nursing has as much of an impact on public health and safety as these professions. Therefore, it is appropriate for Congress to place a ban on the use of mandatory overtime in nursing through health law.

• ANA maintains that the deterioration in the working conditions for nurses is the primary cause for the staff vacancies being reported by hospitals and nursing facilities - not a systemic nursing shortage. Nurses are opting not to take these nursing jobs because they are not attracted to positions where they will be confronted by mandatory overtime and short staffing.

• In fact, data from the Health Resources and Services Administration's (HRSA's) 2000 national sample survey of RNs shows that more than 500,000 licensed nurses (more than 18% of the national nurse workforce) have chosen not to work in nursing. This available labor pool could be drawn back into nursing if they found the employment opportunities attractive enough.

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