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Nursing Home Staff Overtime Has Potential for Neglect

A number of recent reports indicate a growing number of nursing home staffers are working excessive amounts of overtime, leading to a greater potential for reduced care quality and possibly neglect and abuse.

In one case, a long-time nursing assistance in Pennsylvania clocked an average of 80 hours each week for a full year. Her routine jobs included feeding, dressing and bathing nursing home residents. One registered nurse in the same area worked the equivalent of 90 eight-hour overtime shifts over the course of two years. In a single nursing home, staffers clocked 125,000 hours of overtime over the course of two years.

Another report out of New York detailed how a single, county-run nursing home ran up a $745,300 bill for overtime in 2014, which represented a nearly 22 percent increase from just one year earlier.

While we don’t have any recent comparisons involving Florida nursing homes, officials interviewed for the aforementioned reports indicate such figures are standard industry-wide. This creates a serious concern regarding the quality of care our elder residents are receiving.

Overtime hours alone aren’t conclusive evidence of neglect or maltreatment. However,  our West Palm Beach nursing home abuse lawyers know there is no question the quality of care may be significantly diminished when caregivers are routinely expected to put in 16-hour-shifts. Caregiver fatigue is real, and can have serious consequences for wards who depend heavily on them for the fulfillment of basic needs.

One gerontologist opined workers cannot physically perform at an optimal level when they are putting in so many hours. Additionally, fatigue can lead to conflicts, mistakes, oversights and, ultimately, injuries.

The 2008 handbook issued by the Institute of Medicine recommends nursing staff work no more than 12 hours in a 24-hour shift and no more than 60 hours in a week. The reason cited was the reduction of fatigue resulting in errors. Specifically, extended shifts and frequent overtime can be associated with:

  • Reduced sleep times
  • Difficulty staying awake on duty
  • Triple the risk of error

Loved ones need to be aware that when staffers at nursing homes consistently work extensive overtime, the operation is likely running with inadequate resources, so more is asked of individual workers.

Industry insiders say staffing is a constant challenge, and there is “always” a need for some staffers to put in overtime hours. Many companies, particularly for-profits, do not limit the number of overtime hours staffers can work, though hours must be approved by management.

When asked why nursing homes don’t simply hire more employees to fill the void, one administrator responded it’s preferable to hiring many new employees because it diminishes the rapport between patients and nursing employees.  However, one wonders how much rapport is being built when workers are tired, stressed and overworked. Such factors come into play when looking at the high turnover rates at facilities with excessive overtime among nursing staffers.

The August 2014 issue of the American Journal of Nursing specifically indicated long hours were associated with errors and compromise patient safety.

The more likely reason nursing home administrators don’t want to hire more workers is they are trying to save on the built-in labor costs associated with hiring more workers, such as payroll tax, health insurance and pension contributions.

If your loved one resides in a facility where nursing staffers work a great deal of overtime, this may be a red flag that quality of care could be compromised.

Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights.

Additional Resources:

A flood of overtime for nurses at county nursing homes, Jan. 28, 2015, By Hall Stockton and Eric Holmberg, PublicSource

More Blog Entries:

Florida Nursing Home Secures Ch. 11 Bankruptcy to Avoid Regulators, Jan. 29, 2015, West Palm Beach Nursing Home Abuse Lawyer Blog

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