News & Events

Baystate Franklin Medical Center Nurses Worked 3,980 Shifts Longer Than 12 Hours in One Year; RNs Detail Nursing Practice Concerns in Letter to Hospital President

05.16.2017

Greenfield, Mass – The registered nurses of Baystate Franklin Medical Center, represented by the Massachusetts Nurses Association, sent a letter Monday to BFMC President Cindy Russo detailing thousands of extra-long shifts that are leaving nurses exhausted and which are inconsistent with patient care best practices.

BFMC nurses worked shifts longer than 12 hours nearly 4,000 times in the past 12 months.

“We are working while exhausted…” the MNA BFMC Committee writes in the letter. “Among our most important issues in negotiations for which a long-term solution is urgently needed is understaffing that forces RNs and others to work overtime and extra shifts without rest. In the past two years most RNs were convinced to move from 12 hour shifts to 8 hour shifts on the rationale presented by BFMC management that academic studies correlate long shifts to fatigue, medical errors and negative patient outcomes.  We agreed.

“But when we used to work 12s, we would be off duty a number of days. Now we are supposedly on 8s or 10s, scheduled for more days a week than before, but we are often really working four or five 12s, with no rest, because there is not enough staff, and so we are forced to pick up additional shift after shift after shift and can’t go home at the end of our shifts. This is antithetical to the safe patient care studies management was (accurately) citing to us two years ago.”

During the past 12 months at BFMC:

  • Nurses worked 3,980 shifts longer than 12 hours.
  • 2,768 times nurses working 12-hour shifts could not leave at the end of their shift.
  • 1,193 times nurses who were scheduled to work 8 hours were not able to stop working for more than 12 hours.
  • There were 433 shifts of 13 hours or more; 70 shifts of 14 hours or more, 131 shifts of 15 hours or more, 22 shifts of 16 hours or more and 5 shifts of 17 hours or more.
  • It is illegal under Massachusetts law for an RN ever to work 16 or more hours, even in a declared federal or state emergency. But BFMC data shows that this happened 27 times. The longest shift was 17.5 hours.

·         Despite RN Mandatory Overtime having been made illegal in Massachusetts in 2012 (M.G.L.c 111, section 226), management admitted to the DPH 24 incidents of MOT from July 2016 through mid-March 2017. A review of the incident reports management provided to the DPH show that none of those incidents appear to be lawful, as not one fell under the law’s criteria for waiver for emergency situations.

Noting that BFMC’s president was quoted in the press saying, “As an organization here, do I feel that our staff is overworked? That’s not my opinion.” The nurses ask in their letter, “By what method did you come to that opinion?”

In 2004, the Institute of Medicine – part of the National Academies of Sciences, Engineering, and Medicine – published a report outlining improvements to nurse working conditions. “Keeping Patients Safe: Transforming the Work Environment of Nurses” called for a ban on nurses working more than 12 hours in a 24-hour period.

In the event that nurses are required to work excessive hours because of an emergency, this information should be immediately disclosed to the public so that elective admissions can be postponed and other admissions diverted to different units or facilities. Similarly, in any instance where a nursing shortage prevents [a health care organization] from securing sufficient nurses to prevent work hours in excess of 12 hours in any 24-hour period and more than 60 hours in any seven day period, this information also should be disclosed to the public, so that elective admissions can be referred to other facilities or delayed until staffing is remedied. If an admission cannot be delayed or referred to another HCO, the patient and their family should be informed about the shortage of staffing and that nursing staff is working under conditions adverse to patient safety.”

Nurse Working Conditions and Patient Safety Outcomes,” a review of outcomes data for more than 15,000 patients in 51 U.S. hospital ICUs published in the journal Medicare Care, showed that overtime for nurses was associated with an increase risk in catheter-related urinary tract infections and skin ulcers.

The Working Hours of Hospital Staff Nurses and Patient Safety,” published in Health Affairs, demonstrated that nurses working mandatory overtime are three times more likely to make a medical error.

Background on Bargaining

BFMC nurses have been bargaining with Baystate since November 2016. Nurses have voted 93 percent to authorize a one-day strike and filed seven unfair labor practice charges against Baystate Franklin with the National Labor Relations Board. The strike authorization vote gives the MNA BFMC Bargaining Committee the authority to call a one-day strike. Bargaining is over a new contract to replace the agreement that was scheduled to expire Dec. 31, 2016. A federal mediator joined the bargaining process in February.  

For more details, including the letters to the president, NLRB charges and hospital schedules, mandatory overtime reports and text messages showing a pattern of BFMC not having enough nurses for its patients, please contact Joe Markman at 781-571-8175 or jmarkman@mnarn.org.

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.