“Nurses know that after their 14th or 15th hour, they’re questioning their judgment,” says Mary Robinson, a 30-year veteran of the profession. Robinson is one of 600 nurses who’ve been on strike for five weeks against mandatory overtime at McLaren Regional Medical Center, Flint’s premier hospital. At McLaren, says the nurses’ union, it’s not unusual for management to schedule RNs (registered nurses) for 16-hour days.
The Flint nurses’ stand — one that seems destined to keep them on the picket line through the holidays — is part of a national trend by nurses to resist the long hours that they say threaten patient well-being. The American Nurses Association (ANA) issued a consumer alert in April about the spreading tendency of hospitals to use mandatory overtime as a normal staffing mechanism. “Patients need nurses who are able to execute the sophisticated thinking, decision-making, and technical skills required in delivering quality patient care,” said ANA President Mary Foley.
More bluntly, Kay McVay, president of the militant 31,000-member California Nurses Association (CNA), says, “All the studies show that once you’ve gone through 10 hours you’ve lost your edge. Once you get to the 12th hour, you’re borderline dangerous.” The CNA has bargained to curtail mandatory overtime in 30 of its contracts and has written a bill now in Congress to prohibit forced overtime for licensed health care employees.
In May, in a six-week strike watched by nurses across the country, the Massachusetts Nurses Association (MNA) beat back mandatory overtime at a unit of the country’s second-largest for-profit health care corporation, Tenet Healthcare Corp. “It felt like David vs. Goliath,” said RN Debra Rigiero, co-chair of the MNA bargaining unit, “and David won!”
Admitting defeat, CEO Robert E. Maher Jr. commented, “We came to the conclusion that we are right at the beginning of a revolution in nursing ... We believe nurses throughout the United States are willing to work long and hard to fight mandatory overtime.”
He got that right, according to Alan Napier, an intensive care nurse at McLaren and president of American Federation of State, County and Municipal Employees (AFSCME) Local 875. Management is offering arbitration on the overtime issue, he says, but his members view this as a stalling tactic.
“These nurses refuse to go back to work till we get language on mandatory overtime,” Napier says.
For the time being, the hospital has hired 250 nurses supplied by U.S. Nursing Corps, a Denver-based firm that specializes in providing strike-breaking nurses to hospitals involved in labor disputes. Some 40 to 60 AFSCME members have also crossed the line.
Bernie Hoffmann, senior vice president for corporate services for the hospital’s parent company, McLaren Health Care Corporation, maintains that forced overtime for nurses is rare. For example, from April through August, mandatory overtime was less than one-half of 1 percent of hours worked, he says.
Nurses counter that Hoffman’s numbers are narrowly defined and very deceptive; they do not include overtime hours worked “on call,” which are also mandatory. “We can work 16 hours and then be expected to be back the next day at 3,” explains nurse Mary Robinson.
Nurses’ organizations emphasize that the long hours they object to come about not because of emergencies but because management prefers paying overtime to hiring more staff. According to Napier, McLaren’s director of nursing has said it makes “better business sense” to use the on-call system than to hire more full-time staff. “They like overtime because you don’t pay benefits,” says McVay.
Rigiero notes, “Our CEO claimed that mandatory overtime was a hospital industry standard. It’s not a standard any hospital administrator should be proud of.”
The difference between the ways managers and nurses view overtime is illustrated at Detroit Receiving Hospital. Nursing Services manager Judith McKanna emphasizes that “overtime is built into schedules with staff participation.” Once staff shortages are explained, she says, nurses volunteer for overtime or to rotate shifts.
But nurses in one Receiving medical-surgery unit say that their most recent schedule was handed down with no staff input. The affected nurses drafted a letter of protest to management that spelled out the reasons behind the overtime: too few nurses on the job, such as staffing an 18-20 bed unit with only one RN and one LPN (licensed practical nurse).
Of course, as any autoworker can testify, health care isn’t the only industry where overtime is a runaway phenomenon. “It’s happening in every industry you can think of,” says McVay. “But in this one if you’re tired and you make a mistake, it can mean a life.”
On Dec. 4, more than 1,000 supporters joined the Flint nurses for a rally outside the hospital. Autoworkers’ locals have taken up gate collections — one big GM local netted more than $5,000 — and are planning “adopt-a-family” funds for Christmas. The traditional sign of support from passing motorists — the honk — is so constant that the nurses have asked supporters to “simply flash your headlights after 8 p.m. so that we disturb the neighbors as little as possible.”
“Just knowing that the community is supporting you is such a morale booster,” said Rigiero as she prepared to ask her members to donate to the Flint nurses. “It just confirms that you’re doing the right thing. Ask them to hold out as long as they can. Their patients need it.”
To contribute, send checks to Local 875 RN Strike Fund, PO Box 4160, Flint, MI 48504. Visit www.afscme875.org/.Jane Slaughter is a Detroit-based freelance writer. Send comments to [email protected]