FOR IMMEDIATE RELEASE
April 20, 2000

CONTACT:
Hope Hall, 202-651-7027
Joan Meehan-Hurwitz, 202-651-7020
rn=realnews@ana.org
www.nursingworld.org/rnrealnews

Washington, D.C. - American Nurses Association (ANA) President Mary Foley, MS, RN, today issued an alert to all consumers regarding an alarming trend in many hospitals across the country.

"More and more hospitals are forcing registered nurses (RNs) to work mandatory overtime, placing both patients and nurses at increased risk," said Foley. "Nurses should never be forced to work excessive overtime, especially when they are tired, overworked, and have others depending on their arrival at home. Likewise, patients need nurses who are able to execute the sophisticated thinking, decision making, and technical skills required in delivering quality patient care. Forcing RNs to regularly work 16 hours or more at a stretch is dangerous, and the American public needs to know about this practice and the risk it presents to patients. Of course, real emergencies happen and nurses can always be counted on to respond, but using excessive mandatory overtime as a way to deal with on-going staffing shortages is wrong."

"These staffing issues come on the heels of the Institute of Medicine's (IOM) report on medical errors, which found that in the U.S., up to 100,000 deaths per year are due to medical errors. The IOM recommends that part of the solution rests in developing safe health care systems that address work hours, work loads, sufficient staffing and personnel support, shift assignments as well as the impact on patient care when nurses work beyond their ability to provide safe and quality services. It is absolutely derelict, in light of the IOM's findings and recommendations, that hospitals are still willing to jeopardize patient care."

"Many hospitals claim a nursing shortage as the reason to mandate overtime. While an RN shortage is a real issue in some areas, there are ways to address staffing that do not force RNs to work inhumane hours. Mandating excessive overtime is a calculated business practice aimed at saving hospitals money, yet hospitals are reporting profit margins higher than they have enjoyed in the past. Recent American Hospital Association (AHA) data show the nation's hospitals reporting record profits of $21.9 billion, giving them a profit margin of 6.6 percent – the second highest aggregate margin ever. Hospitals reduce expenses – thus increasing profit – by employing insufficient numbers of nurses and minimizing the number of employees paid benefits. Hospitals routinely keep too few RNs on staff to provide appropriate coverage and address fluctuating patient care needs."

"ANA supports the RNs currently on strike in Nyack, NY, and in Worcester, Mass., who have gone out in protest over mandatory overtime. It is never easy to decide to strike, but as we have seen time and time again, RNs are forced to take this action when hospitals fail to support safe standards of nursing practice. These nurses are on strike to protect both their own health and well-being and the unsuspecting patients who assume that hospitals provide safe, quality nursing care – not exhausted, overworked labor."

"The New York State Nurses Association and the Massachusetts Nurses Association worked long and hard to educate hospital management about appropriate staffing levels necessary to deliver high quality care. Nyack Hospital and St. Vincent Hospital, which is owned by for-profit Tenet Health Care Corporation, have repeatedly refused to address RNs' concern for patient care and for nurses' safety in the workplace."

"Tenet, like many hospital organizations, is quite profitable. Its recently released third quarter earnings report shows a 23 percent rise in net profits over the same period last year. While realizing that kind of profit, Tenet still insists on the right to require as much as eight hours of mandatory overtime, even following an original eight-hour shift. This practice forces some RNs to work up to 16 non-stop hours. Nurses who refuse the overtime can be threatened with losing their jobs or licenses under an alleged patient abandonment charge. This threat is blatant intimidation. Nurses themselves know that working while exhausted will increase the risk of committing an error that harms a patient, or predisposes themselves to injures – like needle sticks – on the job. However, when threatened with job loss or action against their license, some nurses feel obligated to stay."

"Hospital managers who rely on mandatory overtime ignore general standards and acceptable practices that relate to public safety and well-being. Public transportation, airlines and trucking companies – all have to respect standards regarding shift lengths and the amount of rest an employee must have before coming onto an assignment. Nurses attend to the sickest among us – and yet hospital managers are putting profits before patients."

"While the New York and Massachusetts strikes are very visible and public actions against mandatory overtime, RNs across the country are dealing with similar staffing dilemmas. ANA is working diligently on many fronts to address this public health issue. Working with its constituent members, ANA promotes legislative and regulatory initiatives that address nursing workforce, nurse staffing, and mandatory overtime issues. Additionally, ANA consistently alerts consumers about their right to demand a safe and qualified health care workforce."

"Patients and families need to ask their doctors, nurses, and hospital management about staffing in their local hospitals. If possible, consumers should call or visit a hospital before being admitted to determine the level of RN staffing. Some questions the public can ask include:

• Will I have an RN caring for me?
• How many patients are assigned to each RN on the unit where I most likely will stay?
• Are those RNs routinely required to stay beyond their scheduled shift?
• What is the hospital's policy on requiring a defined amount of time off for rest before returning to duty?
• How does the hospital provide for RN staffing when there is an unexpected shortage in the unit?

"The nurse staffing shortage is real and by all accounts it is growing. Employers, such as hospitals, contribute to this problem by maintaining a hostile and dangerous work environment for nurses. ANA believes this issue demands full public awareness along with full attention to the threatened quality of health care in the U.S. ANA continues to work on many fronts to advocate for professional standards of care and a safe work environment. ANA insists that nurses be able to deliver the highest quality care possible."

The American Nurses Association, through its constituent member associations, represents some 120,000 RNs under collective bargaining agreements. Many of these contracts call for restrictions on the circumstances under which mandatory overtime is used and the amount of mandatory overtime that can be required.

CONTACT: Joan Meehan-Hurwitz at 202.651.7020 or Hope Hall at 202.651.7027 for more information on studies regarding nurse staffing and patient outcomes or to arrange interviews with

• ANA President Mary Foley
• United American Nurses, ANA's labor entity, Director, Susan Bianchi-Sand
• Patty Franklin, ANA Workplace Advocacy, Senior Staff Specialist
• Constituent member association spokespersons

NOTE TO MEDIA:

Graphics for television or print are available in jpeg format. Graphics read: ANA - logo Mandatory Overtime {Inside a red circle with slash across circle}

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ANA is the only full-service professional organization representing the nation's 2.6 million registered nurses through its 53 constituent associations. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying Congress and regulatory agencies on health care issues affecting nurses and the public.

2000 press releases

Other past press releases: 1999 | 1998 | 1997 | 1996

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