Contemporary Health Issue

The Ohio house bill 346 also protects nurses by providing laws on staffing. HB 346 “requires hospitals to establish staffing plans, with meaningful input from direct patient care nurses, which are consistent with the principles of safe staffing developed by the American Nurses Association and other nationally recognized organizations” (Ohio Nurses Association, 2011). The American Nurses Association as well as other nursing organizations should continue to advocate for nurses to work towards decreasing nursing workload and preventing burnout.

Whether or not mandatory overtime is required varies from facility to facility. Like many other issues, there are both pros and cons to this topic. Witkoski,S, Sloane, D, and Aiken L (2012) did a study and concluded that nurses who worked 10 or more hours a shift were more likely to experience burnout and were dissatisfied with their jobs with an intent on quitting. Burnout can affect the quality of care a nurse provides to patients. Burnout can be the cause of a nurse not noticing subtle changes of patients which could potentially lead to patient neglect. Although there are cons to working long shifts there are some pros. When nurses work 12hour shifts, they often meet or exceed their weekly hours over the course of a 3day work week. Since they would only be working a three-day work week, it provides nurses with a better work-life balance and flexibility (Witkoski,S, Sloane, D, and Aiken L 2012), giving nurses more time outside of their job to do whatever they would like. Getting this kind of flexibility is great for nurses like myself who are either back in school or have families to take care of, or just need a little more time to recover and

The Fair Labor Standards Act has been amended many times and is virtually an ever-changing law, however, it does not cover all employees. There are several classes of “exempt” employees, including salaried employees in the executive/managerial, administrative, and professional areas. Outside salespeople are also considered exempt. One of the issues facing companies today is knowing which employees are exempt and which are non-exempt. There are tests to determine if an employee is exempt. In 2004 the tests changed to a standard test, which is whether or not the employee’s salary is $455/week or greater and the duties test, which allows for exempt status if more than 50% of the work performed by an individual is “exempt work.” (Pass and Broadwater) Exempt employees do not receive overtime pay, which can be a substantial cost savings to a company. My previous employer required that an exempt manager close the center each night even though we had non-exempt team leads who acted as managers in most capacities. The reason was to avoid overtime costs.

Various factors have negatively influenced the nursing field. Those factors involve, but not limited to staff shortage, staffing ratios, mandatory overtime, violence issues, etc. In 2011, 16 states established limitations on the practice of mandatory overtime operated by nurses (ANA, 2011). Forced overtime laws monitor either nurse mandatory overtime or cumulative work hours. As prevention for nurses working mandatory overtime, state law permits employees to decline the offer of overtime by healthcare organizations, except during a medical emergency, which requires increased need for medical personnel unexpectedly. The overall goal of achieving mandatory overtime regulations is to produce supported practicing circumstances for nurses, as well as improve the quality of care for the patients.

Reasons for mandatory overtime varies from natural disaster to lack of staff. Many companies, organizations, and hospitals require mandatory overtime because of staffing issues. “Increasingly, however, nurses are reporting that mandatory overtime has become standard operating procedure instead of a last resort to short staffing. In fact, in some hospitals, mandatory overtime is routinely used in an effort to keep fewer people on the payroll, as well as to alleviate immediate shortage needs.” (Huston,

In October 1998 the new European Working Time Directive was implemented. Its purpose was to prevent employers from expecting their employees to work excessively long hours. This meant that doctors were only allowed to work an average of 48 hours a week. As a result Registered Nurses had to take on tasks that were previously only performed by doctors taking them away from the patient’s bedside. In March

In 2010, the Patient Protection and Affordable Care Act, or PPACA gave many Americans the opportunity to have health care coverage that previously may have not been available to them. The reform is primarily aimed at decreasing the number of uninsured and underinsured Americans. The landscape of health care is changing and nursing is evolving alongside it. This health care overhaul gives nurses a vital role in leading the reform revolution. With more than three million strong, nursing is the biggest sector of the nation’s health care labor

For some nurses, mandatory overtime can be an advantage due to financial instability but mostly mandatory overtime can cause fatigue, burnout, injuries, errors, inadequate sleep and deficits in performance. According to research working long hours which consists more than 40 hours a week or over 12 hours a day leads to an increased medication errors and patient mortality. The probability of making medication errors increases tremendously when nurses work longer than 12.5 hours a day. During surveys regarding reasons of overtime, 60 % of nurses stated that overtime was obligatory as part of their job, 29 % of nurses stated that they volunteered and 41% of nurses stated that they were “on call hours” (Bae, 2012)

Give examples of legislation that impact on. Employee holidays, rest periods, working hours and night working. Explain why these are important for both the employee and employer

Mandatory overtime in the field of nursing is described as forced overtime to maintain an adequate amount of staff present to meet the needs of the hospital. With a normal work schedule, a nurse usually works 12-hour shifts, usually three times a week. With the obligatory hours that are extended with overtime due to the continuation of nursing shortages, a nurse’s shift can be continued ranging from 12 to 16 hours, with very short notice. This mandatory action is related to putting not only nurses, but also patient’s health at risk. The advantages that accompany mandatory overtime are overshadowed by the disadvantages that surpass the benefits of working extended hours, therefore, mandatory overtime should not be allowed in the nursing work place.

As nurses we strive to always practice in the best of our ability. One way that that we can further our efforts is to utilize our voice through health-care lobbying. The best approach to health-care lobbying is to first understand the legislative process. Consequently the purpose of this paper is to distinguish the legislative process as well as convey the benefits of health-care lobbying to not only the workers but the patients.

With the huge diversity and changeability of human biology, it is impossible to imagine a reality without some mutations, changes, or issues in the organs and tissues of humans. Thus, it rightly follows that medications and pharmaceuticals have been created in an effort to counteract the various ailments and illnesses that people can experience. However, as time has gone on and these pharmaceuticals have become more and more high-tech, regulated, and trusted, they have also become incredibly commercialized. Worse still, medications have become incredibly expensive and can be unattainable for some people.

Mandatory overtime has become an increasing problem for nurses who work in many hospital settings. Mandatory overtime is defined as additional hours added to a nurse’s current shift, making the nurse feel as if it’s a threat of being fired or disciplinary action will be taken in some form if they refuse to stay and work. Extensive overtime studies have established and confirmed that there are serious dangers to both the nurse and the patient being cared for in all types of healthcare settings.

Limited attention has been paid to the hours worked by nurses, or the effects of these hours on patient safety (Rogers, 2008). Even though most nurses favor 12- hour shifts and overtime, it is associated with difficulties staying awake during times of duty, reduced sleep times, and triple the risk of making an error (Rogers, 2008). The most significant risk of making an error occurred when nurses were scheduled to work 12.5 hours or more.

The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week. (Trossman, 2009). Working longer hours in a high stress area will always increase the error rate. Designating an adequate number of RN positions to ensure nurses work an appropriate schedule without overtime and that their workload allows for breaks. Managerial staff must work to develop specific policies about the length of work times based on the setting, patient and provider needs. Those policies should limit nurses from working more than 12.5 consecutive hours. Provide education for all care providers on the hazards and causes of fatigue. Continue to document unsafe staffing conditions and work with others to change the current work culture so that it recognizes the effects of fatigue on patient safety, as well as the nurse. (Berger, et al. 2006)