Contemporary Health Issue

Contemporary Health Issue 1

Contemporary Health Issue Part II: Mandatory Overtime

Contemporary Health Issue 2

The Legislative Process Behind Limiting Mandatory Overtime

Introduction

Nurses of the 21 century are expected to act quickly and appropriately when confronted with various complex clinical situations in this competitive healthcare market. Nurses cannot do so if they lack the fundamental knowledge of the regulations and statutes that have been established by their particular State Board of Nursing and the government. Therefore, it is imperative that the nurses have a solid understanding of the legislative process, as it could affect the way in which he/she delivers quality patient care. This paper will discuss the steps in the legislative process in regard to the Safe Nursing and Patient Care Act of 2005, detail history of similar types of legislation, and note the stand various healthcare organizations have taken on the issue of mandatory overtime.

The Legislative Process

The Safe Nursing and Patient Care Act of 2005, bill S. 351 and H.R. 791, was proposed with the intent to "improve working conditions for nurses and quality of care for patients. It limits the ability of hospitals and other healthcare providers to require mandatory overtime from nurses." This is a process that does not happen overnight. So the question arises, what is the process of introducing bill to legislative bodies and once introduced how do they become law? According the website www.genome.gov , there are potentially 10 steps a bill can go

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through before becoming a law. The following quotation includes excerpts taken from the website

Step 1: A bill is born- Anyone can draft a bill; however, only members of Congress can introduce legislation, and, by doing so become the sponsor(s).

Step 2: Committee Action- Once the bill is introduced; it is then referred to committee. The bill is then examined carefully and its chances for passage are first determined.

Step3: Subcommittee Review- Bills are often referred to a subcommittee for study and hearings. Hearings provide the opportunity to put on the record the views of executive branch, experts, other public officials and supports, and opponents of the legislation.

Step 4: Mark Up- When the hearings are completed, the subcommittee may meet to "mark up" the bill; that is make changes and amendments prior to recommending the bill to full committee. The subcommittee can either vote or not vote for the bill. If they don't vote for the bill, it dies immediately.

Step 5: Committee Action to Report a Bill- After receiving the full report from the subcommittee the full committee votes on its recommendation to the House or Senate.

Step 6: Voting- After the debate and approval of any amendments, the bill is passed or defeated by the member voting.

Step 7: Referral to Other Chamber- When the House or Senate passes a bill, it is referred to the other chamber where is follows the same path of committee to

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floor action. This chamber may approve the bills as received, reject it, ignore it, or change it.

Step 8: Conference Committee Action- When the actions of the other chamber significantly alter the bill, a conference committee is formed to reconcile the differences between the House and Senate version.

Step 9: Final Action- After the House and Senate has a bill in identical form, it is sent to the president. (www.genome.gov )

Now let's consider the aforementioned process in terms of The Safe Nursing and Patient Care Act of 2005. This bill was introduced in the House of Representatives by Pete Stark and Steven LaTourette with 99 cosponsors; the bill was then taken to the chief clerk and numbered H.R. 791. An identical bill was introduced in the Senate by Edward Kennedy with 18 cosponsors; the bill was taken to the chief clerk and numbered S.351. H.R. 791 was subsequently referred to the House Energy and Commerce and House Ways and Means then to the subcommittee on Health, where it currently remains. S. 351 was read twice and referred to the Committee on Finance, where it currently remains.

History of Similar Legislation

If someone were to ask what the job description of "today's nurse" is, what would the answer be? A nurse is a professional who provides holistic quality patient care but is mandated to work hours in excess of their scheduled shift. Unfortunately, mandatory overtime has become a means of meeting staffing needs during this critical staffing shortage. The Safe Nursing and Patient Care Act of 2005 is just one bill in which the

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issue of mandatory overtime is the focal point. According to the Service Employees International Union (SEIU), six states have enacted legislation restricting mandatory overtime for nurses and other healthcare workers. The following is excerpts

taken from the SEIU website regarding those states that have recently enacted mandatory overtime legislation:

Maine. New legislation provides explicit job protection to nurses who refuse to work more than 12 consecutive hours excluding emergency cases that would affect patient care.

New Jersey. The state legislature passed S 2093 prohibiting health care facilities from mandating employees to work more than 8 hours a day or 40 hours a week, barring unexpected emergency situations.