Provisions included in a must-pass finances invoice will make vital adjustments for Connecticut hospitals. These adjustments, which have been embedded within the almost 900-page Public Act 23-204 signed into legislation on June 12, 2023,1 revise present legislation relating to necessary extra time for registered nurses, and relieve unions and RNs from complying with longstanding contracts about scheduling and extra time. The adjustments take impact October 1, 2023.
Present Regulation
Connecticut Basic Statute 19a-490l at the moment limits necessary extra time however permits hospitals to require nurses to work extra time or further shifts in 5 circumstances:
When nurses are collaborating in a surgical process, till it’s accomplished;
When nurses are working in important care models, till they’re relieved by one other nurse beginning a scheduled work shift;
Throughout public well being emergencies;
Throughout institutional emergencies, akin to opposed climate situations or widespread sickness, that the hospital administrator determines will considerably scale back the variety of nurses obtainable to work; and
When nurses are lined by a collective bargaining settlement that addresses necessary extra time.
Primarily based on the final bullet level, numerous Connecticut hospitals have collective bargaining agreements with RN unions that authorize necessary extra time both when the hospital determines it’s mandatory for affected person care or underneath different circumstances particularly outlined within the contract.
Expanded Definition of Extra time
Present legislation defines extra time as work exceeding scheduled shifts, no matter size, if the shift was decided and communicated to the RN no less than 48 hours upfront. The revised legislation expands this definition of extra time to incorporate any scenario the place a nurse works greater than 12 hours in a 24-hour interval or greater than 48 hours in any hospital-defined work week.
New Threshold Necessities for RN Extra time
Revising part 19a-490l, the brand new legislation supplies that not one of the statutory exceptions applies until affected person security requires necessary extra time and there’s no cheap different. The revision additionally supplies that to justify required extra time a hospital should first “make a very good religion effort to have such extra time hours lined on a voluntary foundation.”
As well as, the brand new legislation bars hospitals from mandating extra time as a daily follow to satisfy staffing ranges mandatory for affected person care or to deal with routine staffing wants brought on by typical staffing patterns, anticipated ranges of absenteeism, or day without work usually authorised by the hospital for trip, holidays, sick go away and private go away.
Results on Collectively Bargained Agreements
Maybe probably the most notable impact of the brand new legislation is its limitation on the best of private-sector hospitals to succeed in agreements about necessary extra time in union negotiations or to implement contract provisions to which RN unions beforehand agreed. As revised, the statutory exception allowing necessary extra time pursuant to a collectively bargained settlement shall be restricted to nurses “employed at a behavioral well being facility operated by a state company.” Non-public-sector hospitals will now not have the ability to cut price for necessary extra time in future contracts, however will have the ability to implement present rights to mandate extra time in contracts that take impact earlier than October 1, 2023.2 Such contractual rights to mandate extra time will stop, nevertheless, on the expiration date of the settlement. The revised legislation expressly preserves any contract provision that locations further restrictions or limitations on the usage of necessary extra time in extra of these within the statute.
New Prohibition Towards Retaliation
The laws provides new prohibitions stating that no hospital shall discriminate in opposition to, self-discipline, threaten to self-discipline or discharge, or in any other case retaliate in opposition to a nurse for refusing to work extra time. The invoice doesn’t expressly create a personal proper of motion for a nurse who claims retaliation, nevertheless, or designate a state company to obtain complaints of alleged violations.
Takeaways: Future Collective Bargaining
Hospitals whose present union contracts embrace necessary extra time as a part of general scheduling and compensation techniques have to rethink scheduling logistics, significantly alter staffing on quick discover to satisfy adjustments in affected person census and acuity when necessary RN extra time is now not obtainable. Any vital scheduling adjustment must be bargained for with the RN union, and the hospital ought to count on the dynamics of such bargaining to vary from previous negotiations. Beforehand, a union would have needed to commerce one thing of worth to acquire the restrictions on mandation that the legislature has now offered as a matter of legislation. Creativity, cooperation and a joint dedication to sufferers by hospitals and RN unions shall be wanted to develop techniques that entice RNs to work extra time “voluntarily” when required by affected person wants. To perform this with out severe finances repercussions could possibly be a formidable problem. With the statutory efficient date of October 1, 2023, looming, hospitals that haven’t achieved so already ought to flip their consideration to those issues promptly.
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