Administration and Leadership, Patient Care, Training

Tackling Mandatory Overtime

Issue 4 and Volume 35.

What’s an EMS manager to do when there are too many shifts to cover and not enough employees to cover them? You’re tasked with keeping the trucks running on the street. You’ve got to staff the ambulance with someone. Your 9-1-1 system doesn’t shut down at a certain time or allow you to stop accepting emergency phone calls. Just how far can you push your employees? More importantly, how far do you want to push them?

If you’re like some EMS managers, you implement a policy of mandatory, or forced, overtime. Basically, this means forcing someone to work overtime against their will. Mandatory overtime includes calling someone at home on their day off and ordering them back into work or making someone stay later than their regular shift’s ending time.

Some services use mandatory overtime for training purposes, requiring employees to report for additional hours of training once a month. Other times, mandatory overtime is the result of some catastrophic event, and extra personnel are required to handle the extra call load. Typically, forcing someone to work mandatory overtime is making an employee work more than 40 hours in a given week if they’re not 207(k) exempt under the Fair Labor Standards Act (FLSA).

Negative Repercussions
Nothing will polarize you and your employees faster than forcing them to work overtime with little notice. This problem can divide you from your staff and may lead them dislike your EMS system.
Employees will accept mandatory overtime if a calamity hits a community, but forcing people to work mandatory overtime for day-to-day operations is usually a prescription for disaster when it comes to an employee’s morale and commitment to an organization.

Many employees in the EMS profession are young. I’ve found that many of these younger people are also single parents. Forcing them to work sudden, unexpected mandatory overtime truly challenges them to meet their child care needs and compromises their opportunity to spend free time with their children.
Other employees may have secondary jobs they’re already committed to. Not showing up for the second job compromises the employee’s relationship with their other employer.

Legal Restrictions
No federal laws govern employers in the area of forced overtime, but, some pertain to the number of hours an employee can work before they get paid overtime. You can reference these laws under the FLSA. Yet, even under the FLSA, there’s little definition of how many hours an employee can work. To further complicate the matter, no federal laws restrict how long an employee can be forced to work overtime. Be aware that some states have more restrictive laws than the FLSA.

With the ambiguity of current labor laws, you may wonder what kind of information will help you decide what your agency’s mandatory overtime policy should be. Other organizations that care for patients have taken positions on mandatory overtime. As of November, 15 states have laws restricting the amount of overtime nurses can be forced to work.1 According to the position statement of the American Nurses Association, “regardless of the number of hours worked, each registered nurse has an ethical responsibility to carefully consider her/his level of fatigue when deciding whether to accept any assignment extending beyond the regularly scheduled work day or week, including a mandatory or voluntary overtime assignment.”

Factors to Consider
Forcing people to work mandatory overtime can be detrimental because of fatigue, which can cause increased crashes and medical mistakes. Search the Internet, and you’ll find plenty of lawsuits regarding accidents that were attributed to fatigue (many related to transportation). Other online articles speak to medical mistakes made as a result of fatigue. The EMS profession involves both of these areas—transportation and medical decisions.
Approximately 100,000 people in the U.S. die each year from preventable medical mistakes.2 It would be interesting to know the statistics if a similar study were conducted with EMS patients, especially because EMS personnel often provide patient care in less than ideal conditions.

Typically, people are forced to work overtime because their EMS organization has a shortage of employees. Your shortage problem may be difficult to solve, but perpetual mandatory overtime is not a solution. EMS managers should solve their staff shortage problem before resorting to forced overtime. You’ll see higher morale and stronger organizational commitment. JEMS

1. American Nurses Association.
2. Agency for Healthcare Research and Quality.