You’ve looked forward to the end of the day. A patient punched you. Others were so weak that you lifted them from beds or wheelchairs and then cleaned them after they went to the bathroom. If they made it there.
You want to go home. Barbecue. The kids. A Netflix binge.
Then your supervisor drops the news: You’re staying for another 8-hour shift. Again.
It happens all the time every year to nurses and psychiatric technicians who work in state hospitals, veterans homes and prison medical facilities. Those jobs logged 3.75 million overtime hours in fiscal 2014-15, according to a new report by a bipartisan state commission, and taxpayers spent $179 million to cover it.
The Little Hoover Commission found that the state’s mental and health care services rely “so heavily on overtime as a staffing tool, that at times there are not enough volunteers to staff every shift.” So employees were ordered to work more than 417,000 overtime hours last year. One Tennessee health administrator told the commission that forced overtime amounts to “indentured servitude.”
Sylvia Hernandez, a psychiatric technician at San Bernardino’s Patton State Hospital, said, “It gets hard to stay focused on that second shift. That puts us, our peers and our patients at risk.”
Her union, the California Association of Psychiatric Technicians, figures its 3,500 members in state medical facilities worked 1.2 million hours of overtime last year at a cost of $54 million. That’s enough money to hire another 600 psych techs. So why not?
State Hospitals spokesman Ralph Montaño said in a email that, “While hiring more staff may sound like a simple solution,” some facilities struggle to recruit and retain staff and there is stiff competition for health workers.
Not only does excess overtime take a toll on the health of state employees, it also is expensive and may leave the state vulnerable to lawsuits resulting from health care errors.
From the Little Hoover Commission’s report, “Time and Again: Overtime in State Facilities”
The state enters the chase with a limp. Midrange pay for a state hospital registered nurse is $96,000 per year. Kaiser and the UC Medical System pay from $17,000 to $30,000 more. It takes just a few weeks to get a private-sector hospital job, but months to navigate the state’s hiring maze.
State facilities house violent offenders incompetent to stand trial or inmates not mentally fit to be set free. After California shifted low-level convicts (who tend to be younger) from state prison to local jails, the state was left with caring for older and less healthy inmates who need more individual attention. Private-sector patients are less threatening and often are less acute.
And state law restricts overtime in California’s private-sector hospitals, but not for state facilities. Gov. Jerry Brown last year vetoed a bill that would have changed that because, he said, the matter should be collectively bargained. Brown and the union are bargaining a new contract now.
Despite those hurdles, the Little Hoover report encourages lawmakers to require facilities to cut overtime by 50 percent within two years, eliminate mandatory overtime with few exceptions, streamline hiring and set up “on call” staffing.
After all, if state patient care is important enough to force employees to work against their will, doesn’t it deserve better planning so they don’t have to?