The Reality of Patient Care and Meal Breaks
You are a medical assistant. You have a full schedule of patients who need lab draws, immunizations and follow-up appointments. Rooms need to be cleaned and Epic messages need to be processed. You were supposed to go to lunch 15 minutes ago, but your provider is behind due to a late patient. If you go to lunch as scheduled, your coworker will have to room and take care of the patients for their provider, for your provider who is running behind and for your afternoon provider who is now starting a full afternoon clinic with patients already in the waiting room. What do you do?
You are a respiratory therapist who works a 12-hour shift. You have 11 hours of patient-therapy work. On top of this, you also have charts to review for each patient, huddles to attend and charting to do for all the treatments you provided. Somewhere in all of that you are told by your manager to find the time to fit in your rest breaks and a meal period. When?
These scenarios will sound familiar to those of us who work in patient care. We want to take our rest and meal breaks — we deserve to take these breaks and we do our best to take them. OHSU is legally required to provide these rest and meal breaks. Most employees know this. We also know that a break schedule can be blown up by any number of things: a coworker who calls in sick or had to leave early to pick up an ill child from daycare, a provider who falls behind in clinic, a patient who stops to ask you questions right as you were heading out for your break.
During bargaining this year, OHSU’s team has insisted that ensuring employees get their rest and meal breaks is a responsibility shared by both employer and employee, regardless of what the Oregon Bureau of Labor and Industries says. The employer’s latest proposal states:
“Providing meal and rest breaks is the Employer’s responsibility and taking meal and rest breaks when scheduled or asked to do so is the employee’s responsibility. If an employee becomes aware that they may miss a meal or rest break, the employee must notify their manager as soon as possible, so that the manager can attempt to rectify the situation. Employees must go on a meal or rest break when directed to do so by their manager, and will not be retaliated against for doing so. Employees must accurately record any missed meal/rest periods in the Employer’s designated timekeeping records/system, and there shall be no retaliation therefor. Employees who miss a meal break will be paid.”
Management seems to think “If employees just tell their managers when the schedule goes awry or just take their breaks when told to do so, there won’t be a problem.” We know that this isn’t how it plays out in reality. If we’re in the middle of a conversation with an upset patient, we can’t say “Hang on, I need to let my supervisor know I’m about to miss my rest break.” If a provider asks for our immediate assistance with an urgent need, we can’t say “I’ll get to this in 30 minutes, after my meal break.” Even if we could do this without facing discipline, none of us wants to leave our patients, coworkers or providers in the lurch.
Our bargaining team doesn’t believe OHSU’s meal-period proposal is a sincere attempt to solve a problem. We believe it is intended to shift responsibility for break scheduling from managers to employees, possibly in order to lower OHSU’s risk of fines (in 2018, Legacy was fined $5 million for denying breaks and lunches). Moreover, we believe that it won’t actually be functional in real-life scenarios in the patient-care setting, especially in the face of severe understaffing at OHSU.
What are your thoughts about OHSU’s proposal?
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