By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
A nurse manager recently asked me on a program why no one talks about the impact of FMLA use on nurse staffing. She reported the following problem:
“Twenty percent of my full-time staff are out right now on FMLA, and most plan to take the entire three months. By union contract, these staff keep all their benefits during this time but we don’t pay their salaries. One staff member has taken three months of FMLA each year during the past three years. All were to care for a family member in another state. Our HR certified that all were legitimate but highly disruptive to staffing on the unit. Several of my staff took their full FMLA time and never came back – I later learned that they were trying out new jobs in other organizations. I feel like our hands are tied, and this law is being abused today. I am using an absurd amount of overtime to cover these staff and often cannot backfill their positions, jeopardizing patient care.”
Congress passed the Family and Medical Leave Act (FMLA) in 1993. This act entitles employees to take unpaid leave for family and medical reasons while protecting their ability to remain employed. It is a very well-intentioned law designed to protect staff in vulnerable situations with family members. As a profession, nursing has been impacted more than others. Most nurses are expected to be the caretakers in their families, and family members want their support when they become ill.
The FMLA entitles employees to take leave for the following reasons:
- Treatment of a serious health condition
- Birth of a child
- Caring for a newborn child within one year of birth
- Adopting or fostering a child within one year of placement
- Caring for a family member with a serious health condition
- Certain situations related to a family member who is a member of the military on covered active duty
The FMLA applies to all public agencies and private sector employers with at least 50 employees for at least 20 weeks of the year. To qualify for leave under the FMLA, an employee must have worked for the employer for at least 12 months and 1,250 hours within the year before the start of the leave. The FMLA also allows states to set more expansive standards than the federal law, and many states, such as California, have chosen to do so. Employers must hold comparable positions for staff when out on FMLA, and their health benefits continue during their leave use.
We don’t have national data or organizational benchmarking on this challenge, but CNOs tell me that FMLA usage is very high and impacts staffing and their bottom line. It is the law, so compliance is needed, but we also need to understand better how this leave usage impacts nursing productivity and nurse leaders’ work.
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