A hospital strike now in its third week is putting a spotlight on staffing shortages at the same time Ohio lawmakers are debating legislation that would allow nurses to refuse mandatory overtime.
Many of the nurses among the 2,200 workers on strike at Mercy Health St. Vincent Medical Center in Toledo say they are tired of repeatedly being on-call or forced to work beyond their regular shifts because of understaffing.
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The nurses say they sometimes only get a few hours of sleep before they're expected to be back assisting with surgeries or caring for the sick, which creates a dangerous situation for both them and their patients.
"This is not a bakery where if I miss an ingredient, I can throw it out and start over," one of the striking nurses, Michele Powers, said. "There are times when we're so rushed that it sets up a potential disaster."
The use of mandatory overtime in hospitals isn't new, but nursing associations say it's increasing and becoming a more contentious issue within the health care industry. Eighteen states now have laws that limit it.
Labor disputes between hospitals and nurses over staffing concerns seem to be on the rise, experts say.
In New York, about 10,000 nurses threatened to strike in April at three hospital systems until an agreement was reached to set minimum staffing levels. Last year, nurses in Michigan, Texas, California, Pennsylvania, Washington, and Nevada either walked off the job or demonstrated during disputes over staffing and mandatory overtime.
Ohio lawmakers are considering a bill that would allow nurses to say no when they're asked to work beyond scheduled hours. It would stop hospitals from disciplining or firing nurses who refuse overtime except during disasters or emergencies that bring in a large number of patients.
The Ohio Hospital Association argues the proposal would get in the way of patient care, saying hospitals need flexibility in staffing because of the always changing number of patients.
"We believe, through current measures in place, that we are putting patient safety first," it said in a statement.
The Ohio Nurses Association says mandatory overtime causes fatigue and burnout among nurses. "They end up risking their lives and their patients' lives because they're scared and don't want to lose their jobs," said Brian Burger, president of the association.
The daughter of a Cincinnati-area nurse told Ohio House lawmakers in early May about how her mother, Beth Jasper, fell asleep while driving home after working a long shift and died in 2013.
"Nurse fatigue is real. It's not only a danger to patient care ... but it's a danger to the nurse," Emma Jasper said. "Nurse fatigue is the reason I don't have my best friend by my side any longer."
The hospital strike in Toledo that began May 6 involves nurses, paramedics, physical therapists and custodians. One of the issues the workers are upset about is health care costs, but mandatory overtime and staffing concerns are at the center of the labor dispute.
The hospital, which is part of the Cincinnati-based health care system Mercy Health Bon Secours, has said the way it handles staffing is reasonable and common within the industry.
In a statement to The Blade newspaper last week, it said the practice of asking employees to be on-call "is a reasonable and responsible process to ensure each patient has the specialized care he or she needs while respecting the work-life balance of our associates and their families."
Powers, a surgical nurse, said she was on-call just over 40 hours a week last year — on top of her regular 40-hour work week.
"It's nothing more than a crutch because they don't want to hire more help," she said.
It wasn't unusual, she said, when she worked in general trauma to work a 12-hour shift and then get called back into work in the middle of the night.
"We are expected, regardless of when we leave, to then get back on time the next morning," she said. "Some people just stay and take a nap."