Chairman Specter, members of the Subcommittee, my name is Patti Hefner and I am a Registered Nurse at the Sewickley Valley Hospital in Sewickley, Pennsylvania. I have been a registered nurse since 1969.
On behalf of the American Nurses Association (ANA) which represents the nation’s registered nurses through its 54 constituent member associations including state and territorial nurse associations thank you for allowing me the opportunity to comment on the proposed changes to the overtime provisions.
At the outset of my testimony, I want to address the Labor Department’s claim that these proposed changes would not affect registered nurses. To be considered an exempt employee, nurses like all professionals have to meet strict educational requirements. Under the proposed rule, as both the text of the rule and the regulatory analysis make plain, work experience may be substituted “for all or part of the educational requirements” for any learned profession, including nursing. This will allow employers, under the proposed rule to exempt all registered nurses regardless of their level of education from overtime compensation.
Also, according to Ross Eisenbrey of the Economic Policy Institute, the new regulations will make it much easier to establish that “a” primary duty of a nurse is administrative or executive. An otherwise non-exempt nurse who spends 90 percent of his or her time providing patient care could still be found to have a primary duty that is administrative or executive, especially since the administrative duty tests have been substantially weakened.
Our members represent the interests of registered nurses practicing in hospitals and nursing homes and a wide range of other health facilities. The implementation of these proposed revisions to the Fair Labor and Standards Act (FLSA) will have implications for their practice, their work environment and the quality of patient care they provide.
Under these proposals millions of workers, including nurses who enjoy overtime protection would no longer qualify for overtime pay. Make no mistake about it. The proposed changes to the overtime regulations will mean a huge pay cut for these workers. For nurses, it will mean longer hours with less pay and likely mandated hours.
Mr. Chairman, the nursing profession is at a crossroad. Our nation is struggling with a growing shortage of registered nurses (RNs) which impacts our hospitals, long-term care facilities, home health agencies and public health clinics on a daily basis.
The shortage is growing just as the need for nursing services in mounting. America’s demand for nursing care is expected to balloon over the next twenty years as a result of the aging population, advances in technology, and various economic and policy factors. The Bureau of Labor Statistics estimated that attrition and retirement will create more than one million openings for RNs between 2000 and 2010. More money, by itself, will not solve the projected labor shortages, but no labor shortage has ever been solved without a market-based set of economic incentives. Mr. Chairman, I know of no nurse that went into the profession with the hope of becoming a millionaire. Enhancing the professionalization, stature and respect of all nursing will make the profession more attractive.
One of the main reasons 500,000 registered nurses have left the profession is conditions at the workplace. Nurses across the nation are reporting a dramatic increase in the use of mandatory overtime. Today, mandatory overtime is the most common method used by facilities to cover staffing insufficiencies. This dangerous staffing practice is having a negative impact on patient care, fostering medical errors and driving nurses away from the bedside. A recent ANA survey of nearly 5,000 nurses across the country revealed that more than 67 percent are working unplanned overtime every month. Increased reliance on mandatory overtime has occurred at the same time that patient acuity has increased, the use of sophisticated technology has increased, and the length of hospital stay has decreased.
Last November, the Institute of Medicine (IOM) released a report which shows a clear link between the nursing work environment and patient safety, and recommends improvements in health care working conditions that would lead to safer patient care. The study, Keeping Patients Safe: Transforming the Work Environment of Nurses recommends to limit the number of hours a nurse can work to 12 hours in any 24-hour period and 60 hours in any seven-day period.
Currently, nurses where I work, and across the country are paid for overtime, whether voluntary or forced. Overtime pay is not money that most families use to pay for extras such as luxury items or lavish vacations. For most overtime pay is the money used to put food on the table and clothes on the backs of their children. Expanding the number of professional workers, such as registered nurses, who are exempt from overtime protections, will lower the marginal cost of overtime for the employers. Under this misguided proposal, nurses will be working the same long hours they now work----in fact, probably longer hours, without overtime compensation. This proposal will take away the one thing that discourages hospital administrators from forcing nurses to work overtime---the cost factor!
Mr. Chairman, the public understands the vital role that nurses play in delivering quality health care to their patients. Just last month Gallup’s annual survey on the honesty and ethics of various professions rated nurses at the top. We speak on behalf of the patients when we say these proposed regulations will lead to more nurses leaving the profession resulting in reduced care, increases in medical errors, ending in potentially tragic results for the patients that we serve. I urge you to help prevent these proposed regulations and changes to the overtime provisions.
Mr. Chairman, thank you once again for this opportunity to speak to you on this important matter. I would be happy to answer any questions that you may have.
