Ensuring that nurses receive full, uninterrupted rest breaks has been a priority for WSNA for the past several years and is the top priority again in 2010. This issue is critical for nurses to maintain the alertness and focus required to provide safe and quality patient care.
Fatigue = unsafe patient care
Research confirms what we already know from our own experiences; nurses working long hours leads to decreased alertness, vigilance, concentration, judgment, mood, and performance. The result is an increase in medical and medication errors. Full uninterrupted rest and meal breaks are critical for nurses to maintain the mental alertness and focus required to provide safe and quality patient care for the duration of a shift. Current practice of claiming that brief interruptions in work activities provide adequate intermittent breaks is detrimental to patient safety and nurse wellbeing.
To ensure quality and safe patient care, nurses must receive uninterrupted rest breaks. Patients today are sicker and demand an increased level of nursing care. Full uninterrupted rest breaks are critical for nurses to meet the demanding needs of the profession. Current practice of claiming that brief interruptions in work activities provide adequate intermittent breaks is detrimental to patient safety and nurse wellbeing.
Intermittent breaks = no breaks at all
State regulation requires rest periods of not less than 10 minutes of paid time in each four hours of working time while allowing in certain industries for intermittent breaks instead of an uninterrupted break. Current practice among many health care employers is to claim necessary brief interruptions in work activities as intermittent rest periods and deny full, uninterrupted rest breaks.
A “rest period” is intended to be an opportunity to completely stop work duties, exertions, or activities for personal rest and relaxation. Activities like going to the bathroom or getting a drink of water should not be characterized as personal rest and time away from work or exertion. Similarly, conferring with colleagues and sitting down to chart are related to carrying out nursing duties and cannot be viewed as activities for relaxation and rest.
Here are the facts:
Myth: This bill undermines patient safety.
Fact: Patient safety depends on nurses staying alert and focused. Nurses intercept 86% of medical errors before there is harm to patients. Ensuring that nurses have uninterrupted breaks will enhance patient safety and reduce the 98,000 hospital patient deaths every year due to medical error.
Myth: This bill removes caregivers’ professional judgment about when interruptions to a break are reasonable, given patient needs.
Fact: The bill clearly preserves the nurse’s professional judgment. It allows breaks to be interrupted when the specific expertise or skill of the nurse is needed to prevent patient harm. It also allows breaks to be interrupted for national or locally declared emergencies or when a hospital disaster plan is activated.
Myth: This bill removes the nurses’ flexibility to schedule breaks.
Fact: The bill provides flexibility by allowing the rest break to be taken at any time during each 4 hour period. Hospitals are free to determine how to provide the breaks. Nurses can temporarily choose to take shorter breaks that amount to at least 10 minutes during a four hour period.
Myth: This bill forces nurses to abandon patients during procedures like surgery and impedes communication with physicians.
Fact: The bill does not disrupt or undermine surgery or other critical patient procedures. No nurse would ever abandon a patient in the midst of surgery or critical patient procedure. Current licensing law prohibits nurses from leaving their patients without transferring patient care to another appropriate caregiver. A exception in the bill allows breaks to be interrupted to avoid patient harm.
Myth: This issue is best addressed in collective bargaining and staff committees.
Fact: This issue is one of patient and nurse safety, and a consistent standard needs to be set across the State regardless of collective bargaining contracts. Staffing Committees do not have the legal authority to ensure meal/rest periods and hospitals can choose not to adopt the proposed plan by the staffing committees.
Myth: This bill is too expensive for hospitals to implement.
Fact: We know that working conditions is a primary reason that many nurses leave bedside nursing. Every percentage point increase in nurse turnover costs the average hospital $300,000 per year and hospitals that have high nurse turnover spend about $3.6 million more than hospitals that have a high retention of nurses. The cost for a hospital to replace a single nurse is $60,000-$100,000. Graduate nurse turnover rate is estimated to range from 55% to 61%.
For full text of HB 3024, click here: http://apps.leg.wa.gov/documents/billdocs/2009-10/Pdf/Bills/House%20Bills/3024-S2.E.pdf
