[Congressional Record Volume 147, Number 44 (Thursday, March 29, 2001)]
[Extensions of Remarks]
[Pages E497-E498]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     INTRODUCTION OF H.R. 1289: THE REGISTERED NURSES AND PATIENTS 
                             PROTECTION ACT

                                 ______
                                 

                            HON. TOM LANTOS

                             of california

                    in the house of representatives

                        Thursday, March 29, 2001

  Mr. LANTOS. Mr. Speaker, today with my distinguished colleagues, 
James McGovern of Massachusetts and Hilda Solis of California, I 
introduced H.R. 1289--legislation that would restrict the ability of 
hospitals, including hospitals operated by the Veterans' 
Administration, to require registered nurses to work mandatory overtime 
hours as a normal course of business. Increasingly, hospitals and other 
employers in the health care field are requiring their employees to 
work overtime. Our legislation--the Registered Nurses and Patients 
Protection Act--would stop that unsafe and exploitative practice.
  The Fair Labor Standards Act grants nurses the right to receive 
overtime compensation even though they are licensed professionals, but 
it does not limit the amount of overtime that nurses can work, nor does 
it permit them to refuse mandatory overtime. Our legislation would 
change that inequity. Under our bill, mandatory overtime for licensed 
health care employees (excluding physicians) would be prohibited. The 
bill amends the Fair Labor Standards Act to prohibit mandatory overtime 
beyond 8 hours in a single work day or 80 hours in any 14 day work 
period. The legislation provides an exception in cases of a natural 
disaster or a declaration of emergency by federal, state or local 
government officials. Voluntary overtime is also exempted.
  Mr. Speaker, no employer should be allowed to force an employee to 
work overtime or face termination, unless there is a situation that 
requires immediate emergency action. In other cases, employees should 
have the right to refuse overtime. If workers are physically and 
psychologically able to work additional hours, that should be their 
choice; it should not be the decision of a supervisor or hospital 
administrator.
  In the health care field, the issue is not just employees' rights. 
More importantly, it is an issue of patient safety. When nurses are 
forced to put in long overtime hours on a regular basis against their 
own better judgment, it puts patents at risk. A nurse should not be on 
the job after the 15th or 16th consecutive hour, especially after he or 
she has told a supervisor ``I can't do this, I've been on the job too 
many hours today.''
  Mr. Speaker, nursing is a physically and mentally demanding 
occupation. By the end of a regular shift a nurse is exhausted. Health 
care experts and common sense tell us that long hours take a toll on 
mental alertness, and mandatory overtime under such conditions can 
result in inadvertent and unintentional medical mistakes--medication 
errors, transcription errors, and judgment errors. When a nurse is 
tired, it is much more difficult to deliver quality, professional care 
to patients. Increasingly, however, nurses are being forced to work 16, 
18, or even 20 consecutive hours in hospitals all across our nation.
  Studies have shown that when a worker (especially a health care 
worker) exceeds 12 hours of work, and is fatigued, the likelihood that 
he or she will make an error increases. A report of the Institute of 
Medicine on medication errors substantiates these common sense 
assumptions. The report states that safe staffing and limits on 
mandatory overtime are essential components to prevent medication 
errors.
  An investigative report by The Chicago Tribune found that patient 
safety was sacrificed when reductions in hospital staff resulted in 
registered nurses working long hours of overtime because they were more 
likely to make serious medical errors. The report found that nursing 
services were deliberately cut in order to preserve historic profit 
levels.
  Mr. Speaker, I am delighted to report that this legislation has broad 
support from the individuals most involved in this matter and the 
associations and organizations that represent them. These include the 
American Nurses Association (ANA), the California Nurses Association 
(CNA), Service Employees International Union (SEIU), American 
Federation of State, County and Municipal Employees (AFSCME), the Black 
Nurses Association and others. It is also supported by the American 
Federation of Government Employees (AFGE), which represents nurses and 
health care workers at our nation's veterans' hospitals.
  Mr. Speaker, we need to give nurses more power to decide when 
overtime hours hurt their job performance. A nurse knows better than 
anyone--better than his or her supervisor and certainly better than a 
profit-driven hospital administrator--when he or she is so exhausted 
that continuing to work could jeopardize the safety of patients. You 
don't have to be a brain surgeon to know that forcing nurses to work 12 
or 16 hours at a time is a prescription for bad health care.
  Mr. Speaker, we cannot continue to allow hospitals to force nurses to 
work so many hours that the health and safety of patients are put at 
risk. I urge my colleagues to join me as a cosponsor and support the 
Registered Nurses' and Patient's Protection Act.

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