FOR IMMEDIATE RELEASE

February 10, 2005

CONTACT:
Cindy Price, 301-628-5038
Carol Cooke, 301-628-5027
rn=realnews@ana.org

ANA Applauds Bill Prohibiting Use of
Forced Overtime Among Nurses

Silver Spring, MD - The American Nurses Association (ANA) today hailed the Safe Nursing and Patient Care Act of 2005, a bill introduced by Rep. Pete Stark (D-CA) and Rep. Steven LaTourette (R-OH) that would strictly limit the practice of forcing nurses to work overtime.

The proposed legislation would address the current nurse staffing crisis in the U.S. by strictly limiting mandatory overtime among nurses, a dangerous practice that has contributed to a recent exodus of nurses from the nation's hospitals and a decline in safe, quality patient care. ANA has been at the forefront of the push for this legislation and worked collaboratively on its development with members of Congress and other organizations representing nurses.

"Study after study has shown that the use of forced overtime among nurses endangers nurses and their patients," said ANA President Barbara Blakeney, MS, RN. "The Safe Nursing and Patient Care Act would prevent health care facilities from forcing exhausted nurses to work extra shifts, an unsafe practice that puts both patients and nurses at risk," she added.

As evidence, Blakeney pointed to "The Working Hours of Hospital Staff Nurses and Patient Safety," a study published in the July/August 2004 issue of Health Affairs, which found that the risk of making an error greatly increased when nurses worked shifts longer than 12 hours, when they worked significant overtime or when they worked more than 40 hours per week. This study reinforced findings of the 2003 Institute of Medicine Report, "Keeping Patients Safe: Transforming the Work Environment of Nurses," which found that nurses' long working hours pose a serious threat to patient safety.

If passed, the Safe Nursing and Patient Care Act would:

• Prohibit health care facilities that receive Medicare funding from requiring a registered nurse (RN) or licensed practical nurse (LPN) to work beyond an agreed to, predetermined, regularly scheduled shift. In no instance could a nurse be required to work more than 12 hours in a 24-hour period or for more than 80 hours in a two-week period.

• Include nondiscrimination protections for nurses who refuse overtime and for nurses who provide information and/or cooperate with investigations about the use of overtime.

• Include an exception in the case of a declared national, state or local emergency. Such an emergency would be in response to a disaster, not to a staffing deficiency resulting from management practices.

• Provide for a study by the Department of Health and Human Services on the maximum number of hours that may be worked by a nurse without compromising patient safety.

The ANA has warned that mandatory overtime is dangerous for patients and nurses, and that the practice is exacerbating a growing nursing shortage that is expected to worsen dramatically over the next 10 years.

To counter staffing insufficiencies that are already occurring, many health care facilities have increasingly imposed mandatory overtime. Typically, an employer may insist that a nurse work an extra shift (or more) or face dismissal for insubordination, as well as being reported to the state board of nursing for patient abandonment, a charge that could lead to a loss of license. At the same time, ethical nursing practice prohibits nurses from engaging in behavior they know could harm patients, thus leading to a dilemma for many nurses.

"The good news is that we have had some success in prohibiting forced overtime at the state level," Blakeney noted. "So far, 10 states - California, Connecticut, Maine, Maryland, Minnesota, New Jersey, Oregon, Texas, Washington and West Virginia - have either banned or severely limited the use of mandatory overtime, and similar measures have been introduced in 15 other states. But because the trend of forced overtime amongst nurses is such a significant threat to patients' and nurses' safety, we must protect nurses across the nation. That is why we have called on Congress to protect the public by taking federal action."

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