Mandatory Overtime:
Not an Answer to Your Staffing Problems
Signed into law on December 18, 2008 and effective July 1, 2009, the Prohibition of Excessive Overtime in Health Care Act limits the circumstances under which a PA health care facility can mandate overtime to only two – unforeseeable emergent circumstances and completion of a patient procedure already in progress. This new law is applicable to all health care facilities: general and special hospitals, rehabilitation hospitals, hospice, ambulatory surgical facilities, long term care nursing facilities, inpatient drug and alcohol treatment facilities and cancer treatment centers.
The American Nurses Association’s position is now and has always been that “Mandatory overtime is one of the many workplace issues that may be contributing to nurses leaving the workforce. Concern for the long term effects of overtime leading to fatigue includes potential for diminished quality of care, errors or near misses, as well as the negative impact on the care-givers health.” But with unemployment rates exceeding 10% in some states and health care being designated a growth industry in this economy, health care facilities are stilling finding it difficult to staff nursing positions due to high turnover rates, poor performance and lack of qualified candidates. As a result, overtime is soaring as patient care needs continue to be met for the population that is aging now at the highest growth rate ever.
Overtime can be an answer to your problems but only if used appropriately and in accordance with the Act. In addition to emergent circumstances (defined as an act of terrorism, a natural disaster or widespread disease outbreak), the law allows mandatory overtime for unexpected absences, discovered at or before the start of a scheduled shift, which could not be prudently planned for by an employer, and which would significantly affect patient safety. Mandatory overtime can be used in these circumstances but it needs to be the option of last resort. The health care facility must attempt to fill the vacancy with regular hours, per diem and agency before resorting to mandatory overtime hours. They must exhaust all reasonable efforts to obtain staff in any other way possible.
The law also allows overtime by agreement between the facility and the staff. An employee may “accept” work in excess of their originally agreed upon number of hours. And although an employee who works a consecutive 12 hours shift is entitled by law to 10 hours of off duty time, they may also waive the requirements voluntarily.
The Act does not define “mandatory” but hospitals should be cautious when implementing “voluntary” overtime sign- up sheets or other methods of identifying staff to cover call offs and vacations which may be perceived by employees as being a mandatory condition of their employment.
