Respecting the professional judgment of nurses about their ability to work additional hours beyond their shift should be the norm at our nation’s hospitals. But, too often, management’s concern for the bottom line, rather than patient safety, results in nurses being forced to work 14, 16 and even 18 hours in a single shift. That is why RNs Working Together is supporting the Safe Nursing and Patient Care Act of 2007 (H.R. 2122), which would strictly limit mandatory overtime for nurses.

Numerous studies—not to mention common sense—tell us that long hours and sleep deprivation adversely affect the ability of RNs to provide quality, error-free care. In the Institute of Medicine’s (IOM) To Err is Human, it was estimated that as many as 98,000 hospitalized Americans die each year as a result of errors in their care. A 2003 IOM study concluded “evidence revealed that the typical work environment of nurses is characterized by many serious threats to patient safety.” The report also noted the most “serious” threat was the long hours worked by some nurses. In sum, mandatory overtime can increase the likelihood of medical errors.

In addition to increasing the likelihood of medical errors, long hours, along with short staffing, are critical factors in driving the high levels of job dissatisfaction among many working nurses. A report by the then-U.S. General Accounting Office concluded: “[T] he current high levels of job dissatisfaction among nurses may also play a crucial role in determining the extent of current and future nurse shortages. Efforts undertaken to improve the workplace environment would reduce the likelihood of nurses leaving the field and encourage more young people to enter the nursing profession….” Clearly, limiting mandatory overtime would play a key role in slowing the departure of nurses from the profession.

The Safe Nursing and Patient Care Act of 2007, introduced by Reps. Pete Stark (D-Calif.) and Steven LaTourette (R-Ohio), would:

• Set strict federal limits on the ability of health facilities to require mandatory overtime. Nurses would exercise their professional judgment in deciding to volunteer to work overtime. Forced mandatory overtime would be allowed only when an official state of emergency was declared by federal, state or local government.
• Provide the U.S. Department of Health and Human Services with the authority to investigate complaints from nurses about violations as well as the power to issue civil monetary penalties of up to $10,000 for violating the act, and the ability to increase fines for patterns of violations.
• Require the Agency for Healthcare Research and Quality to report back to Congress with recommendations for developing overall standards to protect patient safety in nursing care.

Limiting the number of hours that someone can and should work is nothing new. To protect consumer safety, there are government standards that limit the number of hours that pilots, flight attendants, truck drivers, railroad engineers and members of other professions safely can work. The fact there are not similar limitations for nurses—the people whose judgment and skill our country’s patients rely upon—makes no sense. RNs Working Together urges members of the House to become co-sponsors of the Safe Nursing and Patient Care Act of 2007 (H.R. 2122).