Legislature(2005 - 2006)HOUSE FINANCE 519
04/07/2006 09:00 AM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB51 | |
| HB271 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 271 | TELECONFERENCED | |
| *+ | HB 362 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 51 | TELECONFERENCED | |
HOUSE BILL NO. 271
"An Act relating to limitations on overtime for
registered nurses in health care facilities; and
providing for an effective date."
REPRESENTATIVE PEGGY WILSON, sponsor, introduced HB 271.
She reported that this is not an overtime issue. It's a
safety issue for both patients and nurses. Truck drivers
have a limit to the number of hours they can work
consecutively for safety reasons. Pilots can only fly 8
hours within a 24-hour period. Air traffic controllers work
a limited number of hours per shift. Railroad engineers are
also limited in the number of hours they can work. The
common denominator is that lives are at stake if a mistake
is made. Nurses who monitor our health should be in the
same category.
Representative Wilson related that mandatory overtime causes
significant problems for both patients and healthcare
workers. Forcing nurses to work beyond their regularly
scheduled shift has been linked to increased error rates in
providing patient care, and increased injury rates for both
patients and health care workers. For nurses, these errors
or mistakes may cause life-threatening situations for both
the patient and the nurse, from back injuries to medication
errors to client deaths. With these mistakes and errors,
there is also the chance of lawsuits with loss of licenses
and increases in malpractice insurance rates.
Representative Wilson reported that surveys have shown that
the exodus of registered nurses, therapists, technologists,
technicians and service and maintenance workers is directly
attributable to difficult working conditions, including
inadequate staffing, mandatory overtime and insufficient
compensation. Mandatory overtime is one of the main reasons
nurses leave nursing. Recent studies indicate that one in
five nurses are considering leaving nursing. When polled on
their reasons for leaving, mandatory overtime is always
listed in the top ten reasons. In the face of a severe
nursing shortage, nurses need to be kept at the bedside.
Representative Wilson observed that as baby boomers retire,
more nurses will retire, which will cause further problems
with shortages. She stated that eleven states have enacted
legislation to prohibit mandatory overtime. Similar
legislation has been proposed in 19 other states.
Representative Wilson related that HB 271 has two major
components. The first is that the growing shortage of
nurses in the workforce is escalating, which empowers nurses
to evaluate their own limitations. She cited two studies
that show that mandatory overtime is detrimental to worker
performance and contributes to medical errors. HB 271
requires a semi-annual report that will provide insight into
how both private and public institutions are responding to
the shortages. This report will document the total number
of overtime hours worked broken down by voluntary and
mandatory, the number of on-call hours worked broken down by
voluntary and mandatory, and also the number of hours used
by contract nurses.
10:41:22 AM
Representative Wilson informed the committee that the
evidence is very strong that prolonged work hours and
fatigue affect worker performance. A study by the Institute
of Medicine provides compelling evidence that nurses working
long hours has an adverse effect on patient's safety. The
Institute of Medicine estimates between 44,000 and 98,000
hospital deaths can be attributed to medical errors each
year. Mandatory overtime is a serious contributing factor
to medical errors. The final recommendation of the
Institute Of Medicine is that all overtime - voluntary and
mandatory - should be curtailed.
Another study titled "The Working Hours of Hospital Staff
Nurses and Patient Safety" published in the July/August
issue of Health Affairs found that the risk of making an
error was three times higher when nurses had to work shifts
that were longer than 12 hours, when they worked significant
overtime, or when they worked more than 40 hours in a week.
10:44:33 AM
Representative Stoltze expressed support for nurses. He
questioned the affects of employment displacement.
Representative Wilson observed that some institutions that
are having trouble attracting nurses, have forced nurses
into overtime.
Representative Stoltze suggested that displacements would
put pressure on overtime requirements for nurses in
Anchorage. Representative Wilson responded that she was
assured that would not happen.
Representative Weyhrauch questioned if suggestion boxes
would be mandated so that patients could voice complaints.
Representative Wilson was unsure.
10:48:15 AM
Representative Weyhrauch questioned if lunchtime is counted
in the 12 hours. Representative Wilson noted that the clock
stops when a nurse leaves the floor and it begins again when
they return.
Representative Weyhrauch questioned if coercion is a state
of mind and how it could be quantified. Representative
Wilson responded that it would be coercion if they feared
job loss and added that they should be able to say no.
10:49:51 AM
Representative Weyhrauch questioned how a facility could
respond to allegations of coercion. Representative Wilson
responded that the intent is to allow the nurse to decline
extra hours. In response to a question by Co-Chair Meyer,
she observed that hours vary. Some have 12-hour shifts,
with rotating schedules.
10:52:17 AM
Representative Kerttula noted that problems with overtime
are at state facilities, not at private hospitals.
10:52:54 AM
ROD BETIT, PRESIDENT, ALASKA STATE HOSPITAL AND NURSING HOME
ASSOCIATION (ASHNHA), testified in opposition to the
legislation. He maintained that the need for the bill has
not been documented and that mandatory overtime reporting is
not required. He provided members with a chart detailing
the results of a survey by ASHNHA. The survey looked at
critical access, nurses union, shortage, length of shift,
nurse vacancy, mandatory overtime, on-call policy, the use
of temporary nursing services used to fill the gaps, and the
number of grievances filed by nurses. ASHNHA also looked at
the starting nursing salary. He concluded that higher
salaries at private intuitions were a factor in API's
inability to hire staff. He added that API receives the
hardest cases and that they have no choice in the cases they
take. He did not think that overtime is being used to fill
the nursing gap. Their members want to be able to come up
with local solutions to their problems.
11:02:03 AM
KATHLEEN GETTYS, PRESIDENT, RESIDENT HOSPITAL NURSES
BARGAINING UNIT, ANCHORAGE, testified in support of the
legislation. She provided members with written testimony.
She observed that healthcare is exempt from overtime
limitation. She questioned why you would want a nurse to
work for you when it has been clearly demonstrated that
overtime contributes to medical errors and compared nursing
to piloting. Mandatory overtime contributes to greater
costs in hiring and training. She observed that the cost of
serious care adds approximately $22,000 to $28,000 per
patient from mandatory overtime.
She noted that they anticipated a loss to the Mat-Su Valley
with the option of transportation.
11:07:02 AM
Ms. Gettys addressed coercion and grievances filed at
Providence Hospital. There is no clear delineation about
whether overtime is voluntary or forced. Full-time at
Providence equals 36 hours per week, in any combination.
There have been no grievances filed at Providence, but there
is a report that is filed called "Assignment Despite
Objections".
11:08:20 AM
Representative Kerttula asked what the report shows and if
it could be made public. Ms. Gettys responded that it could
be made public without using names. Most of the reports
involved assignment to a unit without adequate preparation,
or wrong patient placement. The purpose of the report is to
increase the quality of care. Working conditions are
excellent. Representative Kerttula asked if the report
shows incidences of overtime. Ms. Gettys replied that it
does. Representative Kerttula requested a copy of the
report.
11:10:56 AM
MIKE ALEXANDER, NURSE, ANCHORAGE, testified about mandatory
overtime at API, which is clearly stated up front. It is
difficult to work a 16-hour shift and it puts the patient at
risk. Having a choice to work overtime is important.
11:13:34 AM
DIANNE O'CONNELL, ALASKA NURSES ASSOCIATION, testified in
favor of the bill, as revised, for the sake of patient and
community safety, for protection of the nursing staff, and
for the purpose of gathering data about the use of mandatory
and voluntary overtime.
11:15:51 AM
RON ATTLER, API, ANCHORAGE, testified about compensation and
incentives. He maintained that the state's compensation
plan needs a serious overhaul in order to retain and recruit
nurses. He applauded Representative Wilson's hard work. He
testified in opposition to HB 271.
Co-Chair Chenault stated that amendments would be
forthcoming.
HB 271 was heard and HELD in Committee for further
consideration.
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