Las Vegas hospital memo about mandating overtime sparks pushback from nurses

An internal memo used to communicate the University Medical Center of Southern Nevada's plan to mandate overtime sparked pushback from nurses followed by expressions of remorse from the Las Vegas-based facility.

The March 7 memo, which was shared with Becker's, came from chief nursing officer Debra Fox, MSN, RN, about two weeks after UMC discontinued crisis incentive pay Feb. 22.

In the memo, Ms. Fox said the "actions demonstrated by some of our nursing department members [in response to the discontinuation of crisis incentive pay] surprised and saddened me."

Southern Nevada's only public hospital made the decision to end the pay for three reasons, according to Ms. Fox. 

"First, there was no longer a need to continue this expense when our dynamic staffing needs could have been managed using voluntary standby and extra shifts/overtime shifts. Second, every hospital in our community offering incentives has discontinued them. Third, it was apparent that the crisis incentive pay option was no longer being valued as a short-term way of recognizing those going above and beyond, but rather as an expectation of entitlement," she wrote. 

The memo went on to say that UMC met with the Service Employees International Union Nevada Local 1107, which represents nurses at the facility, about the need to enact mandatory extra shifts/overtime. Ms. Fox said mandatory extra shifts/overtime will begin March 16, and the sign-up process will begin March 14.  

"Mandatory extra shifts/overtime will last for an initial period of 60 days," she wrote, adding that "nurses can positively affect the duration of mandatory extra shifts/overtime by voluntarily collaborating with us to address various unit staffing needs by signing up voluntarily for extra shifts. I am open to reconsidering executing the mandatory extra shift plan, but that is predicated on the actions of UMC nurses moving forward."

After Ms. Fox sent the memo, it was posted on Reddit, TikTok and other social media sites, where it sparked critical comments.

Additionally, Elizabeth Bolhouse, SEIU chief nursing steward for UMC, told NBC affiliate KSNV the union met with UMC executives March 10 to address concerns and grievances filed on behalf of nurses in response to the memo. Among the grievances is the lack of a provision for a reasonable review of employees' requests to be excused from mandatory overtime or portions of it, she told the station. 

The union and hospital plan to meet again later in March. Meanwhile, the union remains opposed to mandatory overtime. 

"We do need a work-life balance as well," Ms. Bolhouse told KSNV.

In a statement shared with Becker's March 10, the hospital said it decided to use the mandatory overtime as a "precautionary measure to ensure appropriate nurse-to-patient ratios," per a previously agreed upon union contract. The hospital added that the plan to introduce additional shifts serves as a short-term measure, and it is certain many of these shifts won't be necessary.

"While this decision is a necessary step to ensure appropriate staffing levels, we sincerely regret the overall tone of the internal memo used to communicate this news to our nurses. We are taking important steps to further improve patient throughput and limit the need for additional overtime shifts," the statement said.

The hospital also emphasized its commitment to hiring more nurses, saying, "Since January, UMC has hired 41 additional nurses, and we expect this trend to continue in the coming months as our team members work diligently to recruit highly qualified candidates amid a nationwide shortage of nurses." 


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