By Stanley Tromp and Elaine O’Connor, The Province [Vancouver, B.C.], 28 Nov.
2013
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Fraser Health spent $43.3 million on overtime this past year, up nearly $5 million from the
previous year.
The findings come from an
internal audit on OT for the health
region, which has been lambasted by Health
Minister Terry Lake for failing to meet its budget three years in a row despite
funding increases that outpace its population growth.
The audit showed that two
staffers were found to have worked astonishing amounts of overtime:
one employee worked 1,358 hours of
OT, the other, 1,075 hours, so each worked more than 3,000 hours a year total.
The auditors recommended
management "should consider setting limits on overtime that employees may work to reduce
patient-care risks and reduce (staff ) sick
time," and also put "anti-fatigue" work policies in place.
The audit revealed
"there is currently no policy that limits the amount of overtime that an employee may work."
Units with the highest levels
of OT included emergency
departments at both Royal Columbian and Surrey Memorial hospitals, Abbotsford
Regional Hospital and Cancer Centre, and the hemo-dialysis
unit at Royal Columbian.
The audit reviewed nurse, careaide and technician staffing at the four facilities.
Payroll data revealed in 2011-12 that 30 employees accrued an average of 653 overtime hours - more than a third of their annual regular work
hours.
Vivian Giglio, Fraser Health's vicepresident of clinical operations,
attributed the rise in OT to staff pay increases over time and the hiring of 1,000 new nursing positions in
the past few years.
Giglio said the health authority has made
reducing overtime a
priority since the audit.
"We are concerned about
the wellbeing of our staff
and do recognize that working too much overtime is not in their best interest," she said.
However, OT caps weren't on
the table. Instead, the health
authority requests management pay more attention to overtime, and is working on recruiting staff and
training existing workers to cover in the ER.
"Overtime will always be a part of health care because of the nature of the care we provide," Giglio said.
B.C. Nurses
Union vice-president Christine Sorensen countered that overuse of OT was due to bad management
and that overworked nurses were at risk of injury, of
making errors and ultimately of
suffering burnout and leaving the profession.
Sorensen challenged the idea
there were no nurses for hire - B.C. graduates about 1,000 new nurses a year.
But she explained there are few fulltime openings for general nurses: what is
needed is for the health
system to train established nurses in specialties to make room for new hires to
help relieve the pressure on staff.
"At the end of the day it is about health-care mismanagement and the
failure to invest early on in prevention strategies to avoid overtime costs," Sorensen said.
Sabrina Wong, University of B.C. associate professor of nursing, said extensive OT
among nursing and care staff could impact patient care.
"Clearly, there are
concerns about things like patient safety and medication errors," said
Wong of the university's
Centre for Health Services
and Policy Research.
The audit noted Fraser Health has been working to reduce overtime, providing managers with
scheduling guidelines and conducting a staffing systems
review. These measures have helped reduce costs 15 per cent, or $553,000, this year over last.
_____________________
By
David Carrigg, The
Province [Vancouver, B.C.], July 7, 2014
Shocking overtime figures released under
the Freedom of Information Act reveal Vancouver Coastal Health paid nearly
$600,000 to three nurses
over a 27-month period to
April this year.
The top overtime-earning nurse, Jinu
Joseph, netted a whopping
$210,594 in overtime
between January 2012, and April 2014 for 2,565 hours of work. That's an average
95 hours a month, on top of
a required workload of 150
hours a month. Joseph
earned $190,395 in total income for the financial year ending March 2013.
That puts Joseph's earnings
on par with those of some
doctors.
The second and third big overtime earners in VCH for the
same period were Rose Avisa Wamunga
at $195,517 and Irene Queh at $182,981.
B.C. Nurses Union president
Debra McPherson said the overtime
load highlights the shortage of specialty nurses in the province. Examples of specialty nurses are those who work in
intensive-care units, operating rooms and trauma and cardiac wards.
"Right now we have a
shortage of specialty nurses,"
McPherson said. "Staffing levels are low so they have to go to overtime."
She said specialty nurses are often called once or
twice a day on their days
off, and sometimes when they are at work, to fill shifts.
"It's not something we
encourage. Fatigue builds up, which can lead to error," McPherson said.
Health authority spokeswoman
Anna Marie D'Angelo confirmed all three workers were specialized nurses.
She said the authority could
not speak about the individuals mentioned in this news article, but confirmed
the three "worked in multiple hospital units and worked on their days
off."
"Managers approve overtime and managers are
responsible for their budgets," D'Angelo said. "There are many
reasons to ask for overtime,
but overall it's to meet the operating needs of each unit."
The health authority's
director of public affairs, Gavin Wilson, said overtime comprises straight time, followed by a premium that is time and a half or double time.
Wilson said the most senior nurses are offered overtime first and emphasized
that overtime cannot be
stopped.
"It's important to
remember that in a health
care setting, if someone calls in sick, they have to be replaced to meet
mandated staffing levels and ensure patient safety is maintained," Wilson
said in a prepared
statement.
"And that often requires
asking a co-worker to stay
and work an additional shift."
Wilson said the authority is
having some success cutting
back on overtime costs. He
attributed that to an attendance wellness program to reduce sick time, and a 37 1/2-hour work week schedule
implemented last year as part of the new collective agreement.
"We have also hired for
vacation relief positions to avoid staff working overtime to cover their co-workers' shifts," he
said. "We've also recently added an electronic scheduling and timekeeping
system that's helped managers get better access to real-time information to
help inform decisions about scheduling. That has reduced overtime as well."
The authority also has a policy that ensures an employee
has a day off after working
an overtime shift to limit
excessive numbers of shifts in a
row.
The B.C. Nurses
Union is currently negotiating another collective agreement with the provincial
government after its previous agreement expired in March.
Joseph and Queh could not be reached for comment and Wamunga did not return The Province's calls.
With files from Stanley Tromp
The five top overtime earners
Vancouver Coastal Health
Authority top overtime
earners, Jan. 6, 2012 to April 10, 2014:
1. Jinu
Joseph - 2,565 hours, earned $210,594.
2. Rose Avisa
Wamunga - 2,385 hours, earned $195,517.
3. Irene Queh
- 2,236 hours, earned $182,981.
4. Gwendolyn Farrell - 2,084
hours, earned $170,791.
5. Barbara Janus - 1,832
hours, earned $149,768.
Nurses in B.C. currently earn between $31.71 an hour and $50.21
an hour, depending on experience. Nurses
are paid a premium for
working nights and public holidays.
______________________
By
Susan Lazaruk, The Province [Vancouver, B.C.], 26 Aug. 2015
A chronic shortage of specially
trained nurses kept overtime costs for B.C.'s two largest health
authorities at more than $70 million a year, with the two hardest-working nurses taking home an astounding
$125,000 in overtime pay.
"The health care system
is running on nursing
overtime, it depends on nurses working the
overtime," B.C. Nurses Union president Gayle Duteil said. "Sixteen-hour shifts are the new
norm."
Data provided by Vancouver
Coastal Health listing the top 10 overtime earners showed employee Peggy Holton
worked an additional 1,541 hours and was paid, at $81 an hour on average, $124,865 in overtime pay for 2014.
Staffers Francis Tiuseco, who worked 1,172 additional hours at $84 an hour
and took home $98,512 in
extra pay, and Mary Hooi, who worked 1,117 hours of overtime to earn an extra
$91,989 at $82 an hour, were the other top two earners.
The top earners for Fraser
Health for the 2014-2015 fiscal year were Minecar Li, who had 1,469 hours of overtime at $124,078, Irene Queh, who worked 1,021 hours for an extra $85,820, and Mary
Morishita, with 959 hours for $79,740 OT pay.
The six staffers would also
have worked about 2,000 hours at their regular shifts at an average wage of $30 to $50 an hour. Median pay
for a Vancouver registered nurse
is $75,000 a year, according to payscale.com.
Duteil said the staff shortage isn't confined to big
city hospitals, with specialty nurses
in particularly short
supply in Fraser Health,
Interior Health and the Provincial Health Services authorities.
"I just got back from
Kelowna emergency where the hospital is regularly posting five shifts of overtime a day," Duteil said.
She knows of two nurses in
Vancouver long-term care residences who worked 20-hour shifts last week.
"We're concerned about
(burnout and sickness for) the nurses,
but we're also concerned about the safety of the patients," Duteil
said.
And the money paid for
overtime could be used to hire an additional 1,000 nurses, she said.
Most of the shortages
involve specially trained nurses in
intensive care and critical care units, as well as emergency and operating
rooms, Duteil said.
BCIT trains 400 nurses for those specialty
positions every year and the BCNU negotiated with the health ministry for $5
million for an extra 60 seats for this year. But the nurses on
training will be taken out of
rotation for six months, to be replaced by nurses working overtime, then will be mentored into
positions, she said.
"It's not a quick
fix."
She blamed poor forecasting by health authorities for the shortages.
She said policies to limit
overtime don't always work to limit shifts because nurses don't want to say no and leave co-workers in the lurch.
"We are concerned about
any staff member working high numbers of overtime hours," Vancouver Coastal Health spokeswoman
Anna Marie D'Angelo said in
an email.
VCH limits the number of consecutive shifts under its
Reducing Consecutive Shifts to Minimize Fatigue, Errors and Injuries Policy,
but can't cap hours because of
the union contract.
D'Angelo said the average
number of OT hours worked in a year by 4,400 full-and
part-time RNs in VCH is
511/2, about four hours a month.
The overall staff overtime
costs for FHA were up six per cent to $43.5 million for the 2014-15 year from
the previous fiscal year. The overall staff OT rate fell 21/2per cent to $30.2
million for VCH for the 2014 calendar year.
At VCH, "less than
21/2per cent of hours
worked" is paid at overtime rates, D'Angelo said.
FHA spokeswoman Tasleem Juma said the OT total
was up, but because of
several new hires for Surrey Memorial's new emergency department and critical
care tower, the percentage of
overtime paid out in
relation to worked hours remained stable, at 2.7 per cent.
Both VCH and FHA said they
are hiring more staff.
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