Findings

Congress finds as follows: (1) The Federal Government has a substantial interest in assuring that the delivery of health care services to patients in health care facilities is adequate and safe. (2) Research, including a study published in the Health Services Research in October 2014 and a 2019 study from New York University, document the following: (A) Limits on work hours have long been found in high-risk occupational settings where long work hours can adversely affect safety and performance as well as job satisfaction and quality of life. (B) Regulations limiting work hours were first instituted in the 1930s. (C) Adoption of work hour regulations has been slower in the health care sector. (D) A review of the current literature indicates that despite potential pitfalls of discontinuity in care, regulated work hours for nurses improve occupational and patient safety. (E) The work year for registered nurses is substantially longer than the national average by 200 work hours. (F) When nurses with more than one position of employment are taken into account, total nurse work hours may be greater than the estimate above. (G) Furthermore, because nurses frequently work under a 12-hour shift schedule, they not only work extended hours but also return to work often without sufficient time for rest. (H) Newly licensed nurses work an average of 39.4 hours a week, predominantly in 12-hour shifts. (I) More than 13 percent of newly licensed nurses report having a second paid job. (J) New nurses prefer working the day shift, and the preferred shift length is 12 hours. (K) Twelve percent of nurses report working mandatory overtime, and nearly half work voluntary overtime at an average of three hours in a workweek. (3) Nurses working long hours often experience fatigue, poor sleep quality, impaired vigilance, and lack of alertness, which contributes to medical errors and results in other consequences that compromise patient safety, even after controlling for staffing levels and hospital characteristics. (4) 18 States have passed legislation or promulgated regulations restricting mandatory overtime for nurses.