By Todd Stein
March 2, 2000
Photo: Corbis/Photodisc/Michael Morales

Nurses’ unions and hospitals are uniting in an unlikely partnership to restore 12-hour shifts for nurses and repeal state rules that will soon make the alternative work schedules illegal. Sources told NurseWeek that negotiations are under way behind closed doors with members of the state Industrial Welfare Commission (IWC), which oversees California’s wage rules. At least three unions representing more than 80,000 California nurses are involved in the negotiations, according to sources, some of whom asked to remain anonymous.

"I’ve got plenty of assurances from the IWC that they’ll approve [the restoration of 12-hour shifts]," said Sonia Moseley, RN, executive vice president and chief lobbyist for the United Nurses Associations of California (UNAC), a union affiliated with the AFL-CIO. "Hospitals are pushing for it and unions are pushing for it, so I don’t see any reason for them not to approve it."

Andrew Baron, the IWC’s executive officer, said his office is not involved in negotiations on the 12-hour shift rule. But he added, "This is sitting prominently on the table and discussions may be under way with individual commissioners." Hearings to consider changes in the wage-order rules for health care will be held before July 1, when a six-month grace period for hospitals to end all non-emergency 12-hour shifts expires, Baron said. A date for the hearings has not been set.

No alternative shifts

The new law, signed by Gov. Gray Davis in July, restored California’s 8-hour day rule with overtime guarantees while outlawing alternative work schedules of more than 10 hours per day. The legislation, sponsored largely by organized labor entities, applies only to nonunion workers, including the state’s 90,000 nonunion nurses. Unionized workers have collective bargaining agreements that determine their pay and work schedules and thus are traditionally exempt from state wage orders.

That loophole has led some to charge the nurses’ unions with using the law as a tool to attract new members. "This [law] was written by union lawyers and gives unions advantages in organizing employees," said Richard J. Simmons, a Los Angeles wage-law attorney whose clients include several hospitals. "They’re trying to become the only game in town for 12-hours shifts."

Such charges have touched a nerve with unions. "It’s not good reasoning to suppose that misery breeds unions," responded one labor representative. Beth Kean, RN, organizing director of the California Nurses Association (CNA) added, "We are trying to represent and support the interests of nurses throughout the state whether they’re unionized or not."

Both nurses and hospitals have suffered under the new law. Many nurses prefer working 12-hour shifts to the traditional 8-hour day because they can work two jobs, or have more days off to spend with their families. And hospitals have come to depend on the longer shifts, which allow them to staff a complete 24-hour cycle with only two nurses, at a time when nurses are in short supply.

"If the grace period for [non-emergency] 12-hour shifts comes to an end June 30 and is not renewed, hospitals that have those shifts will face huge recruiting challenges," said Art Sponseller, chief operating officer for the California Healthcare Association (CHA), which represents most of the state’s hospitals and which fought to have the 12-hour shift approved in the late ’80s. "Because 10-hour shifts don’t work well in 24-hour units, they will have to revert to 8-hour shifts and face the staffing and recruitment challenges of three eights [per day]."

Not a crowd pleaser

Thousands of nonunion nurses have had their wages reduced up to 15 percent in recent months by hospital administrators, who say a pay cut is the only way they can afford the overtime rate the new law requires for 12-hour shifts during the grace period. While no one has tracked how many hospitals have cut wages, Baron said the IWC has received more letters from nurses complaining about the wage cuts "than from any other workers dealing with any other issue."

"There has been a huge uproar from nurses all over the state," CNA’s Kean said. "In their rush to avoid paying nurses more, hospitals have handled this very unwisely. Some nurses only heard about the pay cut when they got their paychecks, some on Christmas Eve."

For their part, hospital officials say they are only trying to keep nurses happy. "We don’t want our employees to be adversely affected because of something that’s happening legislatively," said one administrator of a Los Angeles-area hospital.

Even the unions agree the pay cuts were carefully designed to keep the total pay of nurses on 12-hour shifts the same, even though they must now be paid overtime.

Still, both nurses and hospitals are unhappy with the outcome. Nurses’ new paychecks have become complex and confusing, and hospitals have had to reprogram computers in their payroll and finance departments and train employees to use the new systems.

With discontent on both sides, many support restoring the old rules allowing nurses to work 12-hour shifts without overtime pay. Nursing and hospital representatives support the pre-1997 rule that two-thirds of the nurses in a unit must vote for the shifts and that employers must reassign nurses who object to longer hours. And while no IWC commissioner would go on the record about the negotiations, observers said the commission is unlikely to object to a compromise supported by both labor unions and employers.

A question of safety

But even if the IWC approves the repeal, there is at least one sticking point. Unions intend to push the IWC to prohibit mandatory overtime of more than 12 hours in one day, sources said. "We feel nurses should not be forced to work more than 12 hours at a stretch unless they feel they can do so without jeopardizing the patient’s safety and their own license," said one union source.

Hospitals are unlikely to give on that issue. "The tradition in California wage-order law, with the exception of the last three years, has been to provide for premium rates of pay for hours worked over 12," said CHA’s Sponseller. "We think that is a better approach than regulating the time worked."

One final solution would be for the IWC to rule that nurses—especially advanced practice nurses and RNs—qualify as "professionals" so they are exempt from the wage-order rules under federal law. But California unions are unlikely to support a white-collar category for nurses, which would amount to saying good-bye to most of their members. "Nurses don’t realize that [hourly pay] is really for their protection," said Moseley of UNAC. "I’ve been a nurse for 30 years and I think it’s the only thing that protected me from being worked to death."