Too many hours 

A BOSTON GLOBE EDITORIAL
This story ran on page A18 of the Boston Globe on 4/7/2000

At a time when American hospitals are struggling to reduce the toll of up to 100,000 accidental deaths that occur in their wards each year, it is a step backward for a hospital to require its nurses to work 16-hour shifts. But that is exactly what is at issue in the nurses' strike at St. Vincent's Hospital in Worcester.

Today, a federal mediator is to meet with the nurses and Tenet Health Care, the hospital's for-profit owner. The big remaining issue in the eight-day-old strike is mandatory overtime. While the threat to public safety posed by health workers' strikes makes them difficult to support, there is no question that both the public and the nurses will benefit if there is a compromise on overtime.

The hospital wants the right to require up to eight hours overtime after a regular eight-hour shift. A nurse could reject such a demand only once every three months. For their part, the nurses propose two hours of mandatory overtime, plus two hours more that nurses could work at their discretion. While eight-hour overtime provisions are not unprecedented, recent contracts in Boston-area hospitals have included four- or five-hour limits.

It is easy to see why an eight-hour mandatory overtime clause would appeal to Tenet. Hospitals are under great pressure to curb costs, and this gives Tenet extra flexibility in scheduling.

But 16-hour shifts take a toll on nurses caring for the more seriously ill patients that fill hospital beds these days. In its report late last year on the epidemic of medical errors in hospitals, the prestigious Institute of Medicine specifically recommends designing hospital jobs with attention to the effect that long hours and work loads have on alertness.

Recently, the state Board of Registration in Nursing concluded its controversial disciplining of Dana-Farber Cancer Institute nurses in the fatal and near-fatal overdoses of two patients in 1994. That action demonstrated the high professional standard that the board believes nurses must maintain. But it is difficult to meet that standard and protect the safety of patients while working to exhaustion. Sixteen hours is too much. 

This story ran on page A18 of the Boston Globe on 4/7/2000. © Copyright 2000 Globe Newspaper Company.

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