Nurses Look To Change Hospital Staffing Practices

Last Wednesday, Nurses urged members of a Ohio House panel to move legislation that would bar requiring them to work overtime as a condition of employment.

Rick Lucas, testifying on behalf of the Ohio Nurses Association, told members of the House Commerce & Labor Track Committee that mandatory overtime is a dangerous staffing tool utilized by hospitals. He said at his hospital, nurses were able to end the practice through negotiations, but most nurses across the state are unable to do the same. “Prior to ending mandatory overtime at our organization, this dangerous practice affected me both professionally and personally,” Lucas said during testimony on the measure (HB 163). “I work as a rapid response nurse, often encountering patients at their sickest and most vulnerable times. In these situations, I need to be at my absolute best for my patients. Recognizing subtle changes in condition, adjusting and delivering high risk medications, and collaborating with the team on an effective plan of care are all negatively impacted if I’m impaired due to fatigue.”

Lucas went on to say that studies have found that nurses who work more than a 12.5-hour shift are much more likely to make a medical error, which is the third leading cause of death in America. “All Ohio patients and families deserve better,” he said. “They deserve a nurse who is on top of their game to ensure patients are receiving the best care possible.”

In response to a question from Rep. Michele Lepore-Hagan (D-Youngstown), Lucas said that hospitals could hire more nurses to address staffing needs. He also told Rep. Hagan that there are instances when staff feel pressured to work while ill because of strict time off policies. Rep. James Hoops (R-Napoleon) asked why hospitals would not bring in another nurse rather than pay overtime. Lucas called the decision not to do so “short-sighted.” He also told Rep. Hoops that collective bargaining units are able to address the issue on a hospital-by-hospital basis.

Shelly Malbert, a former board member at the ONA, emphasized that the measure does not eliminate overtime, just a hospital’s ability to flex staff. “I would also like to share that use of mandatory overtime and lack of nursing resources is not a new problem, but one that has continued to get worse over the past few decades. When I begin my career in 1986, we occasionally had staffing issues. Nurses pitched in and worked extra. But over the years, working conditions have continued to deteriorate,” she wrote. “Nurses have left the bedside and the ones who remain can no longer handle the unfathomable demands. Even in today’s global pandemic, I am confident that Ohio nurses are not surprised by the publicized staffing issues as a result of COVID-19. The pandemic has merely exposed and exacerbated an already existing problem.”

ONA CEO Lisa Ochs said the legislation will allow for real conversations between nurses and their employers about additional work in a fatigued condition. “We believe it is time for Ohio to join 18 other states, including Texas, West Virginia, and Pennsylvania, in working toward combating nurse fatigue by prohibiting mandatory overtime,” she wrote. “Additionally, this legislation would protect nurses from feeling coerced into working additional hours, beyond their regular shift, through the threat of termination or licensure sanction in non-emergency situations.”

Dr. Gina Severino, also on behalf of the ONA, said the legislation has the potential to improve a workforce shortage problem among nurses. “Are nurses leaving the profession due to increased workload, short staffing and mandatory overtime?” she asked in written proponent testimony. “Mandatory overtime is part of a vicious cycle. Mandatory overtime leads to nursing fatigue, which leads to job dissatisfaction, which in turn leads to frequent absenteeism, which leads to job turnover and ultimately leading to increased healthcare costs.”