Massachusetts Nurses Association
Press Release, 08/06/12

New Measure Prohibits Hospitals from Forcing Nurses to Work Excessive Hours

As an Alternative to Providing Safe Staffing Levels

BOSTON, MA -  Members of the Massachusetts Nurses Association/National Nurses United were at the State House today to witness Governor Deval Patrick’s signing of a new health care cost containment law that includes  a ban on the dangerous practice of utilizing mandatory overtime as an alternative to providing safe registered nurse staffing levels in the state’s acute care hospitals.

 This measure will protect patients and save money by preventing mistakes, errors and complications resulting from RNs being forced to worked excessive hours.  The mandatory overtime ban was included in the much anticipated health care cost containment legislation, which was approved by the House and Senate last week.

The MNA/NNU had filed a bill to ban mandatory overtime at the beginning of this two-year legislative session.  In recent months, the organization began working with legislative leaders in both branches to incorporate the mandatory overtime ban in the payment reform bill.  "This is a landmark achievement in our state's efforts to control costs, while maintaining safe, quality patient care," said Donna Kelly-Williams, RN, president of the MNA/NNU.  "Forcing nurses to work when they are exhausted endangers patients and leads to costly, preventable medical errors and complications.  The practice of mandatory overtime is indefensible by any patient safety standard, and yet hospitals continue to increase their use of this practice.  This legislation will put an end to that."   
Under this law, a hospital could not, except in the case of a declared emergency, require a nurse  to work beyond their scheduled shift, and no nurse would be required to work more than 12 hours in a 24 hour period. Hospitals who assign a mandatory overtime shift are required to report those incidents to the Department of Public Health, along with the justification for its use. Any nurse can refuse overtime without fear of retribution or discipline of any kind from their employer.  

The dangers and costs of mandatory overtime have been well documented in a number of scientific studies published in the last decade, which included findings that nurses working mandatory overtime are three times more likely to make costly medical errors; and that overtime for nurses was associated with an increased risk of catheter-related urinary tract infections and bedsores, both preventable medical complications.  In 2002, the Institute of Medicine issued a report linking mandatory overtime and the understaffing of nurses to thousands of patient deaths each year, and called for an all out prohibition of the practice.  

Over a decade ago MNA Nurses went on strike at St. Vincent Hospital in Worcester and Brockton Hospital -for 49 and 103 days respectively - to stop the dangerous practice of mandatory overtime. After a period of relative stability, we have seen hospitals revert back to the dangerous practice of mandatory overtime as their primary staffing tool. In the past two years alone this practice has been at the core of contentious negotiations at Tufts Medical Center (where the nurses voted to go on strike over the issue), Baystate Franklin Medical Center, Cape Cod Hospital and Quincy Medical Center.
 
"Twelve years ago, the nurses at St. Vincent Hospital were forced to strike to protect our patients from the dangerous practice of mandatory overtime.  Patients will now be protected from being subjected to a nurse who is too fatigued to practice safely.  Nurses can no longer be forced to work excessive hours and put our patients and our licenses at risk," said Marie Ritacco, a registered nurse at St. Vincent Hospital in Worcester.
 
We thank the legislature, especially the conferees on this bill, as well as the lead sponsors of our mandatory overtime legislation, Representative Jim O'Day and Senators Mike Rush and Jack Hart, and Representative Denise Garlick, who worked with us to make this life-saving initiative a reality. We thank Senate President Murray and Speaker DeLeo for making health care cost containment and patient safety a priority this legislative session.

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Founded in 1903, the Massachusetts Nurses Association is the largest professional health care organization and the largest union of registered nurses in the Commonwealth of Massachusetts.  Its 23,000 members advance 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 the Legislature and regulatory agencies on health care issues affecting nurses and the public.  The MNA is also a founding member of National Nurses United, the largest national nurses union in the United States with more than 170,000 members from coast to coast.