LANSING, Mich. — About a quarter of the nursing staff at a state-run psychiatric hospital worked an average of at least 12 hours of overtime a week over a two-year period, leading auditors to express alarm Tuesday about worker burnout and the potential risk to patient and staff safety.
The state audit covered the 2015 and 2016 fiscal years and issued two “material” findings for the Walter P. Reuther Psychiatric Hospital in Westland in the Detroit area, the most serious that can be levied.
Auditors said 52 nurses each worked at least 1,000 hours of overtime in that period. Eighteen of them had at least 1,500 hours of overtime, including one nurse with 4,724 hours — or 45 hours a week. The facility is one of five state-operated psychiatric hospitals and houses 173 adult patients.
“Although we did not identify specific examples impacting the quality of care, the significant amount of overtime hours would likely have a negative impact on the staff’s ability to function effectively,” said Auditor General Doug Ringer’s report, which also flagged missing keys and more minor issues involving documentation, electronic medical records and security.
In a response to the audit, the state Department of Health and Human Services agreed to better monitor and reduce overtime hours. The hospital said all employees working overtime are closely watched for signs of fatigue.
“Patient safety and care are the top priorities at the hospital,” state spokesman Bob Wheaton said. “The department takes audit findings seriously, and has already taken numerous steps to address issues identified in the audit.”
The audit said overtime for direct care nursing staff cost $2.4 million and $3 million in the 2015 and 2016 budget years, the equivalent of about 22 and 28 full-time positions. The hospital may have been able to hire additional workers and reduce overtime, auditors said.
For overtime assignments, the hospital solicits volunteers but can require employees to work more hours in accordance with a union contract. Hospital administrators prefer direct care overtime to account for 5 percent of all hours worked, but it was 16.8 percent and 19.2 percent in the two years that were studied, according to the audit.
Auditors also flagged a material condition due to a “significant” number of missing keys. More than a third had been lost, stolen, destroyed or not retrieved from former employees.
In March, a patient at another state psychiatric hospital, the Caro Center in the Thumb region, sued the state in federal court to stop mandatory overtime — saying that overworked resident care aides’ “exhaustion threatens the lives of those involuntarily committed.” Allan Teasel is seeking class-action status on behalf of 600-plus Caro patients. The lawsuit says his constitutional right to safe conditions has been violated and alleges that similar practices have been adopted at other state-run hospitals, too.
The state, in seeking to dismiss the suit, says Teasel lacks standing to sue because he has sustained no injury. State attorneys allege that the “real goal” of the lawsuit is to “do an end-run around” collectively bargained agreements that allow overtime to be required.
U.S. District Judge Thomas Ludington in Bay City held a hearing last week, which is scheduled to continue in January.