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Legislative Corner  

with Kay Ball, PhD, RN, CNOR, CMLSO,FAAN

AORN of Central Ohio

May 2019

Ohio Legislation:  Prohibit Overtime Work for Nurses

House Bill 144 entitled “Prohibit overtime work for nurses as a condition of employment” was introduced by Representative Don Manning  (Rep.-pictured below) on March 19, 2019 at the 133rd General Assembly. The other sponsors were Representative Craig Riedel (Rep.) and Representative Allison Russo (Dem.) so this is a bipartisan bill.  This bill “Prohibits a hospital from requiring a nurse to work beyond the nurse’s shift as a condition of continued employment except in certain urgent circumstances and during ongoing medical treatment or a surgical procedure” (file:///C:/Users/Owner/Desktop/Pres%20message/hb144_analysis_11561.pdf).  On March 26th, the bill was referred to the Commerce and Labor Committee. 

http://www.ohiohouse.gov/Assets/Headshots/Full/59.jpg          

Since there is an exception for “surgical procedures,” the perioperative nurse must be cognizant that this bill wouldn’t cover overtime in surgery for certain situations.  As perioperative nurses, we take call, meaning that after working a full eight to ten hour shift, we are called upon to work to cover “late in the day” surgeries and emergency cases.  A nurse could potentially work way past his or her shift and into the “wee” hours of the morning.  Then when the next day’s shift begins, that same nurse could be expected to work his or her regular shift so that surgery rooms can remain open.  The nurse needs to recognize when he or she is too exhausted to work and must realize that patient safety is a huge concern when a nurse is fatigued.  The hospital also must understand that mandating overtime should not be tied to further employment if the nurse rejects the mandated overtime for this type of situation.  The nursing voice must be heard in support of this bill but also the exceptions to the bill must be addressed and reworded.

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April 2019

Laws Mandating Smoke Evacuation in Surgery

Do you truly understand the health effects of surgical smoke exposure?  The nurses of Colorado do!  They  successfully lobbied for the passage of a bill in their State House and Senate.  At the time of this publication, it’s on the Governor’s desk for a signature that will require healthcare facilities to rid the air of surgical smoke.  Kudos to the Colorado perioperative nurses and AORN (our national headquarters is located in Denver, CO) for passionately supporting this workplace safety issue!  Rhode Island was the first state in the USA to pass legislation (June 1, 2018) that mandates healthcare facilities have policies in place to evacuate all surgical smoke.  Denmark has a country law requiring the use of smoke evacuation devices when energy devices are used in surgery.

We all understand the hazards associated with surgical smoke.  The odor (formed when tissue is pyrolized, ablated, coagulated) is caused from the formation of toxic gases (over 150 chemical compounds have been identified - many of them are the same toxins found in cigarette smoke), while the particles are ultrafine in size (77% is less than 1.1 microns in size), and the potential chance of viable spread of pathogens within surgical smoke has been repeatedly demonstrated in research studies.  Surgical smoke is a patient safety hazard as patients can absorb the plume contaminants during endoscopic procedures.  Our AORN Guidelines on Surgical Smoke Safety includes 223 references to powerful research studies and other evidence.  So are you evacuating all surgical smoke or are you waiting for a mandate by a state law.  By the way, OSHA already mandates that your employer must provide a safe workplace environment.  Being forced to work in a smoky environment is against OSHA regulations and the General Duty Clause.  Be part of the solution and don’t filter surgical smoke through your lungs!  We must have clean air in the OR so we can be part of our facility’s smoke-free campus.