YOUNGSTOWN HMHP nurses say system limits overtime

HMHP nurses tell how their employer handles a problem that's been a key issue in a competitor's strike.
YOUNGSTOWN -- "No more mandatory overtime!" The words have become a rallying cry for striking Forum Health nurses, now in their sixth week on the picket line.
But a few blocks away at St. Elizabeth Health Center, run by Forum's chief competitor, a nurses advocate group says efforts to recruit and retain nurses are helping to keep forced overtime to a minimum.
In some areas where staff nurses have agreed to experiment with a new, closed-unit staffing policy, group leaders say, mandatory overtime has been nearly eliminated.
Chris McCarty, spokesman for Humility of Mary Health Partners, which owns St. Elizabeth's and St. Joseph Health Center in Warren, said mandatory overtime made up just three-tenths of one percent of all the hours worked by HM employees so far this year.
Key issue in Forum strike: Striking members of the Youngstown General Duty Nurses Association, representing 771 Forum Health registered nurses, are demanding an end to forced overtime at Forum, calling it unsafe for patients and unfair to workers. They complain that nurses often work 16 hours at a stretch, sometimes with little advance notice.
Forum has proposed using agency nurses, temporary employees supplied by an outside company, to help bolster staff and reduce the need for mandatory overtime.
New talks are scheduled to begin Monday morning in Cleveland, but so far YGDNA has insisted that agency nurses be used only through Feb. 1.
HMHP policy: HMHP has a policy limiting mandatory overtime for nurses to no more than eight hours in a two-week pay period. The policy also gives nurses the right to request a 10-hour break between work shifts. A computer scheduling system makes it possible to track all overtime worked.
Laurie Flowers and Kim Sefcik, leaders of the HMHP nursing group Powershots, said the mandatory overtime limits are strictly followed. They said managers supplement staff with float nurses -- regular staff nurses whose job is to fill in where needed, and per diem nurses -- nurses who are scheduled a day at a time when needed.
Agency nurses are used only when staff nurses have reached their quota for mandatory overtime in the pay period and no per diem or float nurses are available, they said.
Closed units: Sefcik said the closed-unit staffing method that some St. Joseph and St. Elizabeth departments have adopted has nearly eliminated mandatory overtime in those areas. Closed-unit participation is optional and is decided by consensus of the employees in the unit.
In a closed unit, she explained, employees agree to work only in that location, take an active role in scheduling, and take turns in an on-call rotation. That way, when one unit nurse calls off, the on-call person fills in, preventing managers from having to force other workers to stay past their regular shifts.
"They develop their own scheduling. The key is flexibility," said Sefcik. "In essence, those units don't have mandatory overtime. It gives the staff a voice."
Recruiting: Flowers said HM Health Partners also works hard at nurse recruitment and retention. The system hired a nurse recruitment and retention coordinator in August and has conducted career fairs in Boardman, Kent and West Middlesex, Pa., so far this year.
Sign-on bonuses are used to attract new employees, but HM also rewards its staff for referrals and for mentoring new employees. "Your own employees are your best recruiters," Flowers said.
Another important recruiting tool, Flowers and Sefcik said, is in the works for HMHP. The system is working toward a Magnet Certification from the American Nurses Credentialing Center, a designation of excellence achieved by only 23 hospitals in the United States.
Officials expect to get approval for the certification by year's end, an achievement the nurses believe would serve to attract more medical professionals to St. Elizabeth's and St. Joseph's.
Finally, the hospital is using employee surveys to find and solve the problems its workers face. For example, results of a "hassle-factor" survey will help managers find ways to make nurses more efficient in patient care, and a survey on overtime will help gauge employees' views on that topic.
"The key thing is, two years ago no one would have even asked nurses what they thought," Sefcik said.

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