So you’re going under the knife early in the morning — the optimal time, since you read that Duke University study showing that surgeons are “fresher” then and outcomes are better — but as you lie on the slab ready to go under, you notice the OR nurse’s eyes are drooping and the surgical technologist is stifling a yawn underneath her mask.
What gives? You, of course, want the entire surgical team on top of its game, rested and ready to do the job, right?
You may not know that the nurses attending to you in the operating room — or handling your care and administering your meds elsewhere in the hospital — may be nearing the end of a 12-hour shift, one in which they may not have been given adequate time for breaks to eat, rest or even go to the bathroom.
They may well end up performing admirably when it comes to your care — or their fatigue might contribute to the 250,000 patient deaths in the U.S. each year attributed to medical errors, according to Johns Hopkins University researchers. (The Journal of Patient Safety has the count at 400,000 each year.) And multiple studies have shown that regular breaks for nurses reduce the risks of errors great or small — ominously called “decision regret” — yet many nurses and technologists in hospitals throughout Washington state are performing their jobs, up to 12 hours at a stretch, without adequate time to rest and recharge.
A common-sense state bill requiring nurses to take regular rest breaks and prohibiting mandatory overtime or “on-call” status has passed the House of Representatives on a bipartisan vote and is awaiting state Senate action in the coming weeks.
For the sake of patient safety, and for the health and well-being of the medical workers themselves, we urge the Senate to follow suit and pass a substitute HB 1155 to ensure that nurses are treated with the same respect and care they give to patients under their charge.
At first blush, this legislation seems like an easy call. After all, federal regulatory safeguards are in place to limit the number of hours airline pilots can fly or truck drivers can stay behind the wheel. Those rules are for everyone’s protection, not just the worker. Nurses, then, should benefit from the same type of protections.
But we acknowledge that affording nurses this right will put a strain on hospitals in both big cities and rural locales. We acknowledge the concerns from representatives of the Washington Hospital Association, who warn that such a law could delay some hospital procedures and would cause price increases due to having to hire more nurses in a field already at a deficit. And we acknowledge that there are some instances — traumatic emergencies, for instance — in which breaks are not feasible. (That’s one reason why the bill recently was amended to exempt those assisting on organ transplants or with sexual-assault victims from breaks.)
We acknowledge all that, but affording nurses (and licensed practical nurses, certified nursing assistants and hospital technicians) with uninterrupted rest breaks throughout a shift remains the right and safe thing to do.
Seventeen states, including Oregon and California, have laws that prevent hospitals from using a loophole to institute mandatory overtime and skirt scheduled breaks for nurses. There is no documentation showing a causal relationship between breaks for nurses and higher patient costs — though recruiting enough nurses remains a widespread national problem.
Those who still believe that affording nurses breaks will exacerbate nursing shortages may not have consulted the numerous studies showing that burnout and high turnover cost hospitals thousands each year. Each nurse, one study shows, costs $58,000 to recruit and train, so it’s better to take steps to keep nurses from leaving via burnout in the first place.
Most of all, though, the bill should pass as a safety measure for us all.
What no one wants to see is a situation like what happened to Dalynn Parrish, a neurosurgery surgical technician at Sacred Heart Medical Center in Spokane. She told the Spokesman-Review that during a patient’s extended cranial tumor operation she passed out after working long hours without being given a break to take prescription medication of her own.
“Luckily, the patient was not impacted when I lost consciousness,” she told the paper. “But it made me worry for the thousands of patients whose nurses, technicians, and respiratory therapists are also not able to take care of their own biological needs during an uninterrupted break.