Starting Jan. 1, 2020, changes to the existing mandatory nurses’ overtime law will begin, along with changes in meal and rest periods for certain health care workers. This page tells you who’s included and details the new requirements under law.

Mandatory nurses overtime law

Certain employees of health care facilities may not be required to work overtime, and cannot be compelled or forced to work beyond their regularly scheduled shift. Employees who work more than 12 consecutive hours must be given the option to have at least eight consecutive hours of uninterrupted time off.

Employees included are Licensed Practical Nurses (LPNs) and Registered Nurses (RNs) who are:

  • Employed by a health care facility and involved in direct patient care.
  • Paid an hourly wage or covered by a Collective Bargaining Agreement.

Employees included after July 1, 2020:

  • Surgical Technologist.
  • Diagnostic Radiologic Technologist.
  • Cardiovascular Invasive Specialist.
  • Respiratory Care Practitioner.
  • Certified Nursing Assistants.

There are still circumstances where, under law, overtime can still be required:

  • In an unforeseeable emergent circumstance
  • Because of prescheduled on-call time, as long as the on call time is not used to replace employees who work regularly scheduled shifts or to cover changes in patient census
  • If an employer documents its use of all reasonable efforts to obtain staffing and is not using it to fill vacancies resulting from a chronic short staffing situation
  • When an employee is completing a patient care procedure already in progress

The Reasonable Effort Exception

Employers who are chronically short staffed cannot use the “reasonable effort” exception. To use this exemption, the employer must document that they have done all of the following:

  • Sought volunteer nurses to work from those already working.
  • Contacted qualified nurses who made themselves available to work.
  • Sought the use of per diem staff.
  • Sought nurses from a contracted temporary agency if the employer regularly uses one, if permitted by law or a collective bargaining agreement.

About chronic short staffing

Multiple factors determine whether there’s enough staff, and this will vary among health care facilities. Chronic short staffing is the primary reason employers fail to qualify for the Reasonable Effort Exception. This is the law currently and will go on in 2020.

Is short staffing chronic?

The following questions can help nurses and employers determine if short staffing is chronic. Answer “yes” or “no” to the following:

  • Have shift vacancies been a long-standing issue?
    • A long-standing vacancy is an open position that is unfilled within a reasonable period of time.
  • Is the facility understaffed?
    • For example, there is regularly more work (census increases, etc.) than can reasonably be done with existing staff, and the employer is not taking reasonable steps to address the staffing issue.
  • Are there frequent “holes” in the schedule?
    • Frequent absences or leaves occurring because of staff vacations, medical leave, or other planned absences should be readily anticipated by the facility and scheduled around.

If you answered yes to any of these questions, then the employer cannot use the Reasonable Effort Exemption to mandate overtime.

If you answer no to all of the questions, then the employer must try to fill shifts without mandating overtime by completing all of the following:

  • Asking volunteer nurses to work from those already working.
  • Contacting qualified nurses who make themselves available to work.
  • Calling in per diem staff.
  • Hiring nurses from a contracted temporary agency if the employer regularly uses one, if permitted by law or a collective bargaining agreement.

Excluded Employees: Employees working for the Washington State Department of Corrections who are surgical technologists, diagnostic radiologic technologist, cardiovascular invasive specialist, respiratory care practitioner, and certified nursing assistants are excluded from coverage.

Health Care Facilities

Certain hospitals will have time to prepare for the new overtime law. The following hospitals must follow the overtime law starting July 1, 2021:

  • Hospitals certified as critical access.
  • Hospitals with fewer than 25 acute care beds in operation.
  • Hospitals certified for Medicare and Medicaid services with less than 150 acute care beds and operated by the state or a political subdivision.

Meal and rest periods for certain healthcare employees

Starting Jan. 1, 2020, certain hospitals should be aware that some of their employees will have different requirements relating to meal and rest periods.

Affected Employees Include:

  • Registered Nurses or Licensed Practical Nurses (RNs and LPNs).
  • Surgical Technologists.
  • Diagnostic Radiologic Technologists.
  • Cardiovascular Invasive Specialists.
  • Respiratory Care Practitioners.
  • Certified Nursing Assistants.

Who are employed by a health care facility and involved in direct patient care, receiving an hourly wage or are covered by a union contract.

The new requirements:

  • Rest periods must be scheduled and uninterrupted unless:
    1. There is an unforeseeable emergent circumstance, or;
    2. A situation that could lead to an adverse effect on a patient.
  • Interrupted rest breaks must include an additional 10 minutes of uninterrupted time and be given as early as possible.
  • Employer must record all missed meal or rest periods and keep these records on file.

Note: Certain hospitals will have time to prepare for the new meal and rest period requirements. The following hospitals must follow these new requirements starting July 1, 2021:

  • Hospitals certified as critical access.
  • Hospitals with fewer than 25 acute care beds in operation.
  • Hospitals certified for Medicare and Medicaid services with less than 150 acute care beds and operated by the state or a political subdivision.