Gov. David A. Paterson signed a law banning mandatory overtime for nursing staffs in 24-hour facilities that goes into effect next summer, but local administrators are trying to understand what the law means now.
In the past, health care facilities have been allowed to require nurses to work more than their regularly scheduled hours with no cap, according to the governor's office. This law would stop that practice.
Tina Gerardi, who heads up the New York State Nurses Association said such legislation has been in the works for eight years.
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Nathan Littauer Hospital patient Doris Fernandez looks on from her hospital bed as Paula Bowman, registered nurse, scans Doris’ medication tag on her wrist into the Medication Verification System at the hospital Wednesday.
"Our members across the state have told us that employer mandated overtime is endangering their patients and their own health," Gerardi said in a news release. "This is a landmark measure for both patients and nurses.
"We're still looking at the law," Acting Fulton County Residential Facility Director Ernie Gagnon said Wednesday. "We're trying to figure out how to interpret the language."
Gagnon said the law addresses staffing situations that are outside the provider's control and exempts home care agencies from the legislation.
"Generally, most nurses will volunteer [to stay on duty when they are needed]," Gagnon said. "Voluntary overtime isn't prohibited by the law."
Gagnon said in the past, when he has tried to limit overtime, there have been those who wanted the overtime on a regular basis.
"Some people rely on the overtime to supplement their income," he said. "Our shifts are normally eight hours. We try to break [overtime] into four-hour blocks when needed."
Gagnon said part of the law protects nurses from being sued for patient neglect if they refuse overtime.
"We're trying to work it all out before it goes into effect," he said.
Gagnon said the FCRF has about 60 registered and licensed practical nurses as well as a pool of 10 per-diem nurses who can work on an as-needed basis. He said the facility has a 176-patient capacity and at present has 170 filled beds.
In comparison, the Well Nursing Home has 100 beds with a dozen RNs and typically 15 to 20 LPNs.
"The [New York State] Health Department doesn't say we must have a certain number of nurses on staff," Gagnon said. "That's left up to the facility."
Neal E. VanSlyke runs the Wells Nursing Home. He said the 100-bed facility has a fairly stable professional nursing staff with little turnover. He, like Gagnon, said no required level of nurses-per-patient ratio is required.
"It's whatever the facility feels comfortable with," VanSlyke said.
He said he didn't expect the new law would have much effect on WNH.
"We don't have much difficulty with staffing," VanSlyke said. "We are pretty well staffed with RNs and LPNs."
He said he could imagine some facilities in metropolitan or very rural areas having trouble with short staffing, but the new law has flexibility with voluntary overtime and special considerations for emergency situations where either disaster or patient safety is involved.
"But you won't be able to say to a nurse 'you must stay' anymore," VanSlyke said. "We have more turnover with certified nurse assistants, but the law doesn't apply to them."
VanSlyke said some facilities may have to change their policies.
"We've been stable at Wells," VanSlyke said. "Some nursing homes do struggle with staffing, though. It would affect them more."
At St. Mary's Hospital in Amsterdam, spokeswoman Jackie Marciniak said she expected no big changes at the hospital due to the new law.
"We never have done mandatory overtime for nurses," she said. "I see no effect on us."
Sue Kiernan at Nathan Littauer Hospital and Nursing Home is vice president of development for the hospital's foundation. She said she saw no big changes in store for NLH either.
"We set up staffing a month in advance," Kiernan said. "Sometimes too many call in [sick], and we have to assure safe patient care."
Kiernan said the hospital was fortunate in having long-term, stable staff.
"We're lucky," Kiernan said. "We've got almost a full complement of nurses. Most of them have been here for years. Our recruitment and retention has been excellent. It's not an ongoing problem."
Kiernan said the union contract with the hospital's nurses solved most of their problems and already took care of what the new law was dictating.
"Our union contract addresses all of this," she said.
At Mt. Loretto Nursing Home in Amsterdam, Director of Nursing Joyce Heede said she didn't expect big changes for her facility either.
"We don't do much overtime," Heede said. "We only do overtime when it's necessary, and usually we have volunteers for the overtime. There are always those who want to make some extra money."
Heede admitted that full staffing can be a problem and turnover is often an issue.
"It's hard to keep staff," she said. "There are always greener pastures."
Heede said her nursing staff runs between 25 and 30, not counting volunteers and per-diem staff.
Gagnon said he saw another recent factor that would help with staffing levels.
"With the spike in fuel prices, I see a lot of professionals who had been commuting to Albany staying closer to home," he said. "Nurses are coming back to the area so they won't have to commute."
Richard Nilsen is a general assignment reporter and can be reached at firstname.lastname@example.org.