From the Massachusetts Nurse Newsletter
July/August 2013 Edition
Last August, Gov. Deval Patrick signed into law a health care payment reform bill that includes a ban on mandatory overtime proposed by the MNA/NNU. That provision prohibits hospitals from requiring a nurse to work beyond her regularly scheduled shift except in the case of an emergency situation where the safety of the patient requires its use and when there is no reasonable alternative.
This summer, the Massachusetts Health Policy Commission completed long-awaited guidelines, which define what constitutes an emergency situation for purposes of allowing mandatory overtime. Consistent with the MNA/NNU and the Legislature’s intent, the Health Policy Commission made clear in its statement of goals for the emergency guidelines that the law and the new guidelines “prohibit the use of mandatory overtime as a staffing strategy.”
The guidelines achieve the MNA/NNU goal by allowing administrators to use mandatory overtime only in rare and specific circumstances, including:
- Cases of municipal, state or national emergencies
- In the wake of major catastrophic events, such as the Marathon bombing, major storm or act of terrorism; or a major internal hospital disaster, such as a power outage, riot or building collapse
- The guidelines clearly prohibit declaration of an emergency due to day-to-day hospital operations and prohibit mandatory overtime as a result of understaffing of nurses, sick calls, the flu season and leaves of absence
What to do if your hospital attempts to violate the law
Under the new guidelines, hospitals must file reports (via an online reporting system) for every instance within 30 days of when they declare an emergency and assign mandatory overtime. They must provide an explanation of what type of emergency occurred to cause the need for MOT, list the number of nurses assigned overtime and the number of hours each nurse was forced to work beyond his or her shift.
The hospital reports are not readily available to the public, though the MNA is working with the DPH to ensure greater public transparency. Also, the MNA is concerned about the accuracy of the reporting by hospital administrators.
To ensure the industry complies with the law and is accurate in its reporting, the MNA encourages nurses to report all instances of mandatory overtime to the MNA online at massnurses.org. We will track your reports against those filed by the hospitals to ensure all instances of mandatory overtime are reported. More importantly, we will use this information to work with the Health Policy Commission to make changes to their guidelines to prevent hospitals from abusing this law.
The guidelines also require hospitals to provide reasonable alternatives to the use of mandatory overtime by utilizing float pools, per diems, and the posting of full schedules up to four weeks out. Finally, the guidelines provide for ongoing monitoring of the industry’s compliance with the new rules, and the opportunity to revisit the guidelines if they are being abused.
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