Eastern Health says there are a number of factors that contribute to overtime use in any particular program area, in any fiscal year.
That includes scenarios that require relief staff to be called in to maintain safe staffing levels — such as unanticipated absences from the workplace (due to sick leave or other reasons), vacancies created by nurses moving from one program to another, and periods of increased demand.
The health authority was responding to a story in Friday’s Telegram about how overtime worked by registered nurses at St. John's four hospitals exploded in 2019, after a couple of years when
Eastern Health managed to get the numbers down, according to data obtained by The Telegram.
Through access to information legislation, The Telegram pulled the nurse overtime for four facilities: the Health Sciences Centre General Hospital, the Janeway children's hospital, which is part of Health Sciences Centre, the Waterford Hospital and St. Clare's Hospital.
Across those four hospitals, nurses worked a total of 131,836.12 overtime hours in fiscal 2018-19 - the year ends March 31.
That total is equivalent to what 67.6 extra nurses would log, based on a regular 37.5-hour work week.
The nurses' overtime was almost as high in 2014-15, but then it began to trend down — in 2015-16 to 123,331.38 hours, 102,475.90 in 2016-17 and up slightly to 105,909.40 in 2017-18.
The highest jump by far in fiscal 2019 over fiscal 2018 was at the Janeway, where nurses' overtime hours skyrocketed by 59 per cent - from 14,829.88 hours to 23,703.84.
The most frantic time this past year ended Feb. 9, 2019 - 168 Janeway nurses logged overtime that pay period.
The Health Sciences Centre, which understandably logs the most overtime every year, as it is the province's trauma centre, saw a 12 per cent increase, from 58,530.44 to 66,016.69 hours of overtime.
St. Clare's saw a 26 per cent hike in nurses' overtime hours over the two most recent years, and the Waterford, 33 per cent.
In an emailed statement to The Telegram, Eastern Health stated the total cost to Eastern Health for overtime paid to Registered Nurses’ Union Newfoundland and Labrador nurses at the Health Sciences Centre, St. Clare’s Mercy Hospital, the Janeway and the Waterford Hospital in 2018/19 was approximately $5.5 million.
“It is important to note that instead of receiving pay, employees may choose to bank their overtime hours for future time off work. Banked hours are not included in the overtime cost,” it stated.
“We recognize the ongoing challenge of overtime use for nurses and other health-care professionals who serve within our organization, and we are continuing to work to address it as effectively as possible.
“While we acknowledge that overtime use increased during fiscal year 2018-19 at the Health Sciences Centre, St. Clare’s Mercy Hospital, the Janeway and the Waterford Hospital, Eastern Health assures the public that we have appropriate safeguards in place to ensure that safe staffing levels are always maintained at our facilities, even in situations where all employees available for overtime on a particular unit have been called in.”
"Eastern Health assures the public that we have appropriate safeguards in place to ensure that safe staffing levels are always maintained at our facilities, even in situations where all employees available for overtime on a particular unit have been called in.”
The statement further notes that Eastern Health recognizes and shares the challenge of nursing recruitment with health authorities across Canada and around the world.
“Addressing this challenge is one of our measures to address the challenge of overtime,” the statement said. “We continue to hire nurses directly from local graduating classes, as well as experienced nurses seeking employment. We also offer bursaries for some of the more difficult-to-recruit nursing positions. Further, we have been working with the nurses’ union on measures to more effectively make use of our casual nursing workforce.
“We are also working closely with union representatives and individual program areas to develop other measures to meet the overtime challenge, including exploring the creation of nurse float pools in order to more effectively schedule relief coverage at regular, non-overtime rates.”
Eastern Health, together with the province’s other regional health authorities, has been working with the provincial government to explore the potential for a new workforce management system that will assist with optimization of staff schedules based on patient acuity and other demand factors using predictive scheduling technologies, it reads.
Debbie Forward, president of the Registered Nurses Union of Newfoundland and Labrador, noted the high overtime trend went down following 2015 and that reflects an effort by Eastern Health to control overtime, a plan that has since faltered with the rise in overtime again.
One example of a “band-aid” measure, she noted in the previous story, was that Eastern Health wasn't going to replace the first shift of a sick call, which worked for only a short time.
Eastern Health admitted the measure was brought in several years ago.
“It is important to note that this is always done in consultation with unit team managers and is only approved in cases where it can be confirmed that patient safety will not be compromised as a result,” the statement said.
“We believe that this has had a positive impact for reducing overtime use, but we acknowledge there is still much more progress to be made.”