At 350 pages, the state’s new health cost control law contains multitudes. (Readers, can you name the poet? “I am large. I contain multitudes.” True, not actually written in reference to health reform.)
We’ll surely be focusing on a wide range of the law’s elements, but here’s one called to our attention today by the Massachusetts Nurses Association: The bill that Gov. Patrick signed into law today bans mandatory overtime for nurses. (Here’s the full relevant text.) Some background from the nurses association:
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.
In short, mandatory overtime is out as a means of dealing with a nursing crunch. But those crunches are expected to grow. Word also arrived today from the Massachusetts Hospital Association that the nurse vacancy rate has been rising, and in the coming years, a shortage is predicted. From the MHA: Continue reading
Earlier, I posted excerpts from a Massachusetts Nurses Association press release saying that staff reductions at Tufts Medical Center are resulting in less than adequate patient care. I also cited a May 2010 letter from nurses to the Tufts Medical Center Board of Trustees detailing a few examples of sub-standard care due to lower staffing levels. Here is the medical center’s response:
The stories that the MNA sent you that were included in their May 2010 letter to our Board of Trustees are baseless and unverified – our nursing administration and others looked into these when they sent the letter to the Trustees and found them to have no basis in fact. They are incredibly inflammatory and are a scare tactic from the MNA.
When you mention the “unsafe staffing reports,” the reader needs to know what they are. They are union tools that carry the union logo and are submitted to the union after the fact. Nursing managers who are on the floor are able to remedy any situation in which a nurse feels the need for assistance on the spot. There is no independent verification of these reports by any credible third party. There is no clinical, regulatory or legal standard to be followed in filing them. So you understand, nurses have multiple options from which they can choose to get immediate help in any situation – Tufts Medical Center does not wait to see a copy of a report filed with the union to make adjustments to staffing levels or other adjustments on a floor when nurses need assistance.
Contrary to the union’s assertion, there have been no across the board cuts of nursing staff at Tufts Medical Center. In fact, we have added many clinical care technicians over the past year to assist nurses in their work and enable nurses to focus on nursing-specific duties instead of removing meal trays and emptying bedpans.
Tufts Medical Center is proud of the exceptional care our nurses and other caregivers provide. Our quality has been verified by numerous third party sources. The University HealthSystem Consortium, which reviews quality data for the vast majority of academic medical centers in the country, recently ranked Tufts Medical Center 6th on its adult and pediatric Honor Roll with Distinction. The Joint Commission has reviewed our care repeatedly and found it to be outstanding. It is disheartening to see the MNA repeatedly try to besmirch the terrific institution for which its members work so hard and of which they should be so proud.
The Massachusetts Nurses Association is trying to use our hospital as a prop to push its legislative agenda as part of a high-pressure bargaining tactic. We recently began contract negotiations in good faith with the MNA, and are disappointed they would disrupt its members’ critical work as caregivers with these tactics. The MNA’s repeated attempts to falsely impugn the quality of our care are dishonest and a disservice to patients.