AGREEMENT BETWEEN BERKSHIRE MEDICAL CENTER AND MASSACHUSETTS NURSES ASSOCIATION

Transcription

1 AGREEMENT BETWEEN BERKSHIRE MEDICAL CENTER AND MASSACHUSETTS NURSES ASSOCIATION

2 T A B L E O F C O N T E N T S PAGE ARTICLE I...1 Section 1.1. Recognition...1 Section 1.2. Participation in Professional Association...1 Section 1.3. Dues Checkoff...2 ARTICLE II...2 Section 2.1. Definitions...2 Section 2.2. Change in Scheduled Hours...4 ARTICLE III...4 Section 3.1. Regular Salaries...4 Section 3.2. Shift Differentials...5 Section 3.3. Permanent Evening Shift Bonus and Permanent Night Shift Bonus...6 Section 3.4. Weekend Differential...6 Section 3.5. On-Call and Call-Back...7 Section 3.6. Charge Nurse and Clinical Leaders...7 Section 3.7. Rate After Promotion...8 Section 3.8. Appointment to Temporary Supervisory Position...8 Section 3.9. Certification/Recertification...8 Section Benefits for Per Diem Nurses...10 Section First Assistant in the Operating Room...10 Section Payroll...10 ARTICLE IV...11 Section 4.1. Hours of Work...11 Section 4.2. Overtime/Mandatory Overtime...11 Section 4.3. Schedules...13 Section 4.4. Weekends...13 Section 4.5. Rotation...14 Section 4.6. Access to Chief Nursing Officer...14 Section 4.7. Principles Concerning Nursing and Quality Patient/Family Care...14 Section 4.8. Temporary Reassignment...15 Section 4.9. Four-Day 36-Hour Night Shift...15 Section Hour Shift Positions...16 Section Hour Shift Positions...17 Section Clinical Development Program...18 Section Master Schedule Program ARTICLE V...22 Section 5.1. Holidays i-

3 ARTICLE PAGE ARTICLE VI...22 Section 6.1. Applicability of Earned Time Program...22 Section 6.2. Accrual of Earned Time...22 Section 6.3. Use of Earned Time...23 Section 6.4. Pay for Earned Time...26 Section 6.5. Earned Time Accrual in Excess of the Maximum...27 Section 6.6. Annual Conversion of Earned Time to Long-Term Illness Bank Hours...27 Section 6.7. Cash Surrender of Earned Time...27 Section 6.8. Long-Term Illness Bank...28 ARTICLE VII...28 Section 7.1. Medical Insurance...28 Section 7.2. Pre-Employment and Periodic Physical Examination...29 Section 7.3. Life Insurance...29 Section 7.4. Dental Insurance...29 Section 7.5. X-Ray Badges...30 Section 7.6. Information on Pay Stubs...30 Section 7.7. Long-Term Disability Insurance...30 Section 7.8. Pre-Tax Programs...30 Section 7.9. Mandated Treatment While On Duty...30 Section Short-Term Disability Insurance...30 Section Special Benefit Program for Senior Nurses...30 ARTICLE VIII...31 Section 8.1. Leaves of Absences...31 Section 8.2. Accrual of Benefits...33 Section 8.3. Payment of Benefits to Nurses on Leave...33 ARTICLE IX...33 Section 9.1. Seniority - Full-Time and Scheduled Part Time Nurses...33 Section 9.2. Seniority - Per Diem Nurses...35 Section 9.3. Loss of Seniority...35 Section 9.4. Reduction in Force...36 Section 9.5. Work Location...40 Section 9.6. Association Representatives...40 Section 9.7. Non-Discrimination...41 Section 9.8. Performance Evaluation...41 Section 9.9. Jury Duty and Court Appearances...41 Section Discipline...41 Section Promotions/Vacancies/Transfers...41 Section Personnel Files...42 ARTICLE X...42 Section Bereavement Leave...42 Section Liability Insurance...43 Section Workers Compensation...43 Section Orientation ii-

4 ARTICLE PAGE Section Bulletin Boards...43 Section Pension Plan...43 Section Notice of Resignation...44 Section Mileage...44 Section Professional Activities...44 Section Tuition Reimbursement...44 Section Continuing Education Units...45 Section Preceptor Pay...45 Section Safety Committee...45 Section Latex Sensitivity...46 Section Health and Safety...46 ARTICLE XI...46 Section Nurses Committee...46 Section Grievances...47 Section Arbitration...48 Section Association Grievances...48 Section Other...48 ARTICLE XII...48 Section Strikes and Lockouts...48 ARTICLE XIII...48 Section Management Rights...48 ARTICLE XIV...49 Section Duration...49 ARTICLE XV...49 Section Successorship iii-

5 (d) The Medical Center shall grant time off without loss of pay for a nurse who is elected to the Association s Board of Directors in order to attend meetings of such -1- AGREEMENT AGREEMENT made and entered into this 22d day of July, 2011, by and between the Berkshire Medical Center (the Medical Center ) and the Massachusetts Nurses Association (the Association ). Section 1.1. Recognition ARTICLE I The Medical Center recognizes the Association as the sole and exclusive bargaining representative for all of its Registered Nurses employed at both its BMC campus and its Hillcrest campus, excluding the Chief Nursing Officer; Vice President, Medical/Surgical Nursing; Division Administrator, Specialty Services; Division Administrator, Maternal and Child Health; Department Directors/Weekend & Off-Shift Directors; Clinical Development Specialist; Assistant Administrator -- Nursing Systems; Coordinator of Medical/Nursing Quality Assurance; Assistant Department Directors; Neonatal Nurse Practitioner -- Clinical Director; Director of Berkshire Healthworks; Cardiac Rehabilitation Coordinator; Director, Education; Manager, Utilization Review; Coordinator of Nursing Finance; members of religious orders, confidential employees, managerial employees, guards and supervisors as defined in the National Labor Relations Act, and all other employees of the Medical Center. Section 1.2. Participation in Professional Association (a) The Medical Center will advise all new nurses at the time of employment that the Association is their bargaining representative. The Medical Center will notify the Association in writing on a monthly basis of the name, address, pay rate at hire, and classification of each newly-hired registered nurse, and the names of those nurses who have terminated, been promoted, had their scheduled hours changed, or go on a leave of absence. (b) The Medical Center will provide the Association on a quarterly basis (on or about January 1, April 1, July 1 and October 1) with a list of all registered nurses in the bargaining unit with their dates of hire and their addresses. (c) All full-time and scheduled part-time nurses hired after December 31, 1981, upon completion of 30 days of employment, shall as a condition of continued employment become a member of the Association or pay an Association Service Fee in such amounts as may be required by the Association, not in excess of its normal periodic dues. The Medical Center will not discourage, discriminate or in any other way interfere with the right of any nurse to become and remain a member of the Association. Any full-time or scheduled part-time nurse who was hired before January 1, 1982, and who is currently a member of the Association shall, as a condition of continued employment, remain a member for the term of this Agreement.

6 Board that are held on a day on which the nurse is scheduled to work, which shall be limited to one day per quarter and to one nurse per quarter. Any such paid time off will not count as time worked for purposes of the overtime calculation pursuant to Section 4.2. Section 1.3. Dues Checkoff The Medical Center agrees to deduct (i) annual Association membership dues or Association Service Fees and (ii) any monies voluntarily authorized by a nurse as local dues, on a monthly basis from the salary of the nurses and to remit the same to the Association on the following basis: (a) Each individual nurse must sign and have on file with the Medical Center Payroll Department a dues or agency fee check-off authorization card which authorizes such deduction. The authorization can be revoked by terminating employment. Such revocation shall become effective on the first payroll period of the month following the termination. (b) The Medical Center will remit to the Association the total sums so deducted together with (i) the list of the names of the nurses from whom the deductions were made and (ii) a breakdown of local and other dues and service fees, no later than the end of the month in which the deductions were made. Local dues will be remitted to the local Association Treasurer whose name shall be certified in writing by the Association to the Medical Center. (c) The Association shall indemnify and save the Medical Center harmless against any and all claims, demands, suits, or other forms of liabilities that shall arise out of or by reason of action taken or not taken by the Medical Center, for the purposes of complying with any of the provisions of this Article, or in reliance on any authorization, revocation, list, notice, or assignment furnished under any of such provisions. Section 2.1. Definitions ARTICLE II (a) Probationary Period - The first three months of employment or reemployment shall be the probationary period for full-time nurses, and the first 400 hours of employment or reemployment shall be the probationary period for part-time nurses (provided that, for a per diem nurse, such 400-hour probationary period shall in no event be less than three months or more than one year). In the event that a per diem registered nurse transfers to a full-time or to a scheduled part-time bargaining unit position without a break in service, such a nurse shall commence a new probationary period in accordance with the preceding sentence; provided, however, that this sentence shall not apply to a per diem registered nurse who has been in a full-time or scheduled part-time bargaining unit position within the 15 months preceding such transfer. Discharge will be at the sole discretion of the Medical Center. (b) Full-Time Registered Nurses are those hired to work a full schedule on a permanent basis. -2-

7 (c) Scheduled Part-Time Registered Nurses are those hired to work on a permanent basis to fill a regularly scheduled position of not less than 16 hours per week and who work in the same pattern as full-time registered nurses. Nurses who are hired to, and regularly scheduled to, work at least eight hours per week but less than 16 hours per week shall also be considered scheduled part-time registered nurses, but shall not be eligible for any economic benefits under this Agreement except for those described in Article VI (but at an accrual rate that is 50% of the accrual rate for other scheduled parttime nurses) and Section 3.9 ( Certification/Recertification ). (d) Per Diem Registered Nurses (also sometimes referred to as nonscheduled part-time nurses ) are those hired to work on a permanent or limited basis as fill-in or relief personnel but who do not work, normally, in the same pattern as full-time registered nurses within their department. As a condition of continued employment, a per diem nurse must work (i) at least 96 hours per calendar year, except to the extent that such nurse is unable to do so because of temporary medical incapacity (which shall be subject to verification that is reasonably satisfactory to the Medical Center) or because the Medical Center does not provide such nurse an opportunity to work, (ii) four weekend shifts during the period from June 1 through Labor Day week of any calendar year, and (iii) four additional weekend shifts during the calendar year; a per diem nurse must also commit to a particular service (which for the purpose of this Section 2.1(d) shall be the same as the units listed in Section 9.4(b) below), and (except for 15-year nurses to whom Section 4.5 applied immediately prior to their becoming per diem) must also be available to work for that particular service on at least two eight-hour alternate shifts during a calendar year, at least one of which will be during the period June 1 through Labor Day week. (e) Temporary Employees and Temporary Positions. (1) Temporary Employees are employed for positions that shall normally last no longer than six months. The termination of such an employee s temporary employment is at the discretion of the Medical Center and is not subject to grievance and arbitration under Article XI. (2) Temporary Positions. If the Medical Center determines that a temporary position will extend beyond six months, it will so inform the Association before such extension and will provide it with an opportunity to discuss such extension. A per diem nurse who is employed in a temporary position does not receive benefits, but a regularly-scheduled nurse who is employed in a temporary position will continue to receive benefits at the level determined by her/his regular commitment while so employed. A regularly-scheduled nurse whose application for a temporary position is approved and who is then employed in such a temporary position shall return to her/his regular position at the end of such a temporary position. -3-

8 A nurse on the recall list who assumes a temporary position shall remain on the recall list to the extent set forth in Section 9.4(f), and her/his having assumed a temporary position shall not adversely affect the duration of her/his recall rights. (f) Casual Employees are not covered by this contract and are used on an emergency basis. Section 2.2. Change in Scheduled Hours (a) Temporary overtime or a temporary reduction in hours worked shall not affect the category in which the nurse is classified hereunder, unless such change in hours is of such duration as to become part of the nurse s normally scheduled work week. (b) A nurse who desires a permanent change in scheduled hours because she/he has been regularly scheduled for and has worked such increased hours should submit a written request to the appropriate nursing director. Upon such written request, the hours worked by such nurse over the preceding six months shall be checked by the Medical Center. If an increased schedule, as set forth in the first sentence of this Section 2.2, is verified by the Medical Center, such nurse s request shall be approved to the extent necessary to conform to such verified schedule. In the event of such approval, all benefits to which a nurse having such approved schedule is entitled shall be made retroactive to the date of application for change in status. Notwithstanding anything else in this Section 2.2, a request for an increased schedule shall not be approved if the increase in scheduled hours during the six-month base period is due to other nurses temporary leaves of absences. (c) A nurse who wishes to reduce her/his scheduled hours on a permanent basis because of a medical condition that prevents her/his working her/his full regular schedule may submit a request to such effect, in writing, to the Chief Nursing Officer. In order to be eligible for approval of such request, such nurse (i) must have at least one year of continuous employment, at the time of such request, in her/his current position, (ii) must submit satisfactory medical verification in support of such request, (iii) may not request a reduction exceeding 16 hours per week, and (iv) may not request a reduction to a regular schedule of fewer than eight hours per week. Such request shall not be unreasonably denied. Section 3.1. Regular Salaries ARTICLE III The regular hourly salaries for nurses in the bargaining unit shall be as set forth in Appendices A, B, and C, which will incorporate the following; Effective October 2, 2011, each step of the salary grades will be increased by 2.0% Effective October 7, 2012, each step of the salary grades will be increased by 2.0% -4-

9 Nurses who have been at the top of their salary scale for at least one year as of October 1, 2010, or will reach one year at the top of their salary scale between October 1, 2010 and the ratification date, will receive a one-time, lump sum payment of 2.0% of their 2010 W-2 wages on the next payroll date that is two (2) weeks following the ratification of this agreement. Nurses having anniversary dates between the ratification date and September 30, 2011, and who will have been at the top of their salary scale for one (1) year as of their anniversary date will receive a one-time, lump sum payment of 2.0% of their 2010 W-2 wages on their anniversary dates as they occur between the ratification date and September 30, (a) A nurse with a baccalaureate degree in nursing from an accredited institution and a nurse with a master s degree in nursing from an accredited institution shall receive an additional differential of $1.00 per hour. This Section 3.1(a) shall apply only to nurses in classifications A and B. A nurse who would otherwise have her/his pay rate reduced as a result of the preceding sentence shall be red circled. Those nurses who, as of the execution date of this Agreement, were receiving a differential for degrees other than nursing degrees shall continue to receive such differential. (b) Part-time nurses will be paid at the hourly rate set forth in the applicable Appendix, plus any differentials. (c) Newly-employed nurses will be placed in a step in the above rate range in accordance with their prior experience as determined by the Chief Nursing Officer or designee. (d) A nurse who transfers to per diem status shall remain on the step in the salary schedule which she/he was on at the time of the transfer. (e) Full-time and scheduled part-time nurses will advance on the salary schedule as follows: in order to advance to each step, such a nurse must complete 12 months of continuous employment at the immediately preceding step. (f) Per diem nurses will advance on the salary schedule as follows: in order to advance to each step, such a nurse must complete (i) at least 12 months of continuous employment since her/his last step increase and (ii) 800 hours of work since her/his last step increase. Section 3.2. Shift Differentials Nurses working between the hours of 3:00 p.m. and 11:30 p.m. shall receive $1.25 per hour for each hour worked during such period, provided that at least one such hour is worked and further provided that said differential shall not be applicable to any shift commencing prior to 10:00 a.m. Nurses working between the hours 11:00 p.m. and -5-

10 7:00 a.m. shall receive $2.00 per hour for each hour worked during such period, provided that at least one such hour is worked. A day shift nurse who is requested by the Medical Center to work prior to 7:00 a.m. shall receive the night shift differential, provided that at least one such hour is so worked in excess of her/his full shift; a day shift nurse who is requested by the Medical Center to work beyond 3:30 p.m. shall receive the evening shift differential, provided that at least one such hour is so worked beyond her/his full shift; and evening shift nurse who is requested by the Medical Center to work before the start of her/his shift or beyond 11:30 p.m. shall receive the night shift differential, provided that at least one such hour is so worked beyond her/his full shift; and a night shift nurse who is requested by the Medical Center to work before the start of her/his shift or beyond 7:00 a.m. shall continue to receive the night shift differential for the hours that she/he works beyond her/his full shift. Full-time and scheduled part-time nurses will have the shift differential computed into vacation pay, pay for Long-Term Illness Bank usage, and pay for Bereavement Leave, when the nurse has for a period of at least three months regularly worked on the evening or night shift. Section 3.3. Permanent Evening Shift Bonus and Permanent Night Shift Bonus (a) Each full-time nurse who permanently works on the evening shift (3:00 p.m. - 11:30 p.m.) for three consecutive months shall receive a bonus of $300 for each consecutive three-month period. Any scheduled part-time evening nurse and any full-time evening nurse on unpaid leave of absence during any three-month period shall receive the payment pro-rata for each period based on their paid hours during the period (excluding hours in excess of 48 paid out of the nurse s Long-Term Illness Bank pursuant to Section 6.8). The bonus described in this Section 3.3(a) shall be paid for eligible work through September 30 on a pro rata basis if fewer than three consecutive months have then been worked and a new three-month period shall commence October 1. (b) Each full-time nurse who permanently works on the night shift (11:00 p.m. to 7:00 a.m.) for three consecutive months shall receive a bonus of $500 for each consecutive three-month period. Any scheduled part-time nurse and any full-time night nurse on unpaid leave of absence during any three-month period shall receive the payment pro-rata for each period based on their paid hours during the period (excluding hours in excess of 48 paid for out of the nurse s Long-Term Illness Bank pursuant to Section 6.8). The bonus described in this Section 3.3(b) shall be paid for eligible work through September 30 on a pro rata basis if fewer than three consecutive months have then been worked, and a new three-month period shall commence October 1. Section 3.4. Weekend Differential Nurses working on weekend shifts (which for the purposes of this section shall mean all shifts starting with the tour of duty beginning with the night shift on Friday through the tour of duty ending with the evening shift on Sunday) shall receive additional compensation of $1.25 per hour for each hour worked during said period. -6-

11 Section 3.5. On-Call and Call-Back Nurses on-call shall be paid at the rate of $2.75 per hour for on-call on nonholidays or $4.10 per hour for on-call on holidays listed in Section 5.1(a). Each time they are called back to the Medical Center from on-call status, they shall be paid their on-call pay plus their regular rate of pay for all time worked, but in no event for less than two hours at the applicable rate. A nurse who is called in to work from on-call and who works any time between the hours of 11:00 p.m. and 4:00 a.m. will be given eight hours off without loss of pay before being required to report for a scheduled shift. When a nurse is called in to work from on-call and works between the hours of 11:00 p.m. and 4:00 a.m., and is later called in again on the same night between the hours of 4:00 a.m. and 7:00 a.m., such nurse will be eligible for eight hours off without loss of pay before being required to report for a scheduled day shift. If, as a result of this time off, the nurse would be required to report very close to the end of the scheduled day shift, she/he should consult with her/his supervisor concerning the advisability of reporting at that time. If the nurse and the supervisor agree that it is not desirable for the nurse to report at that time, the nurse may utilize Earned Time for the remainder of the shift or may take the time off without pay. If they do not so agree, the nurse will report for the balance of the shift. OR nurses who are assigned in-house call shall be provided with a private room with lock, which shall have a private bathroom, television and telephone for local calls; security rounds will be provided; family and significant others may visit; linen will be changed upon notification to Housekeeping by the nurse; and a meal ticket for each eight hour shift (having the same maximum as meal tickets provided to non-bargaining-unit on call employees) will be provided for the nurse. If a nurse is regularly scheduled for the day shift on Saturday, she/he shall be granted the preceding Friday off unless she/he requests otherwise. The in-house on-call rate for a nurse shall be her/his regular rate of pay, except that when assigned to in-house on-call on a holiday listed in Section 5.1(a), a nurse shall receive one-and-one-half times such rate. OR staff will have a day/evening alternative to provide relief for evenings (except for 15-year nurses subject to Section 4.5). An OR nurse who is assigned in-house call shall report her/his absence to the Nursing Service Office as soon as possible in accordance with Section 6.3(f), and the Nursing Service Office shall then be responsible for endeavoring to replace the ill nurse. The provisions of this paragraph are subject to the Medical Center s remaining a Trauma Center and shall become void if the Medical Center does not so remain. Section 3.6. Charge Nurse and Clinical Leaders Any staff nurse who is in charge of a floor for two hours or more shall receive an additional $1.50 per hour. A Clinical Leader shall also receive an additional $1.50 per hour. The Hospital and the Association agree that neither will assert in any proceeding that a nurse performing the duties of a charge nurse or clinical leader should be excluded from the bargaining unit on the asserted basis that such a nurse is supervisory. -7-

12 Section 3.7. Rate After Promotion Any nurse who is promoted from one classification to another will be placed in the step in said classification which will provide not less than $0.25 per hour increase over her/his previous salary and will thereafter receive appropriate length of service increases within the classification to which she/he has been promoted. Section 3.8. Appointment to Temporary Supervisory Position No staff nurse shall be appointed to a temporary supervisory position without her/his agreement. No such nurse who is so appointed shall be expected to exercise independent disciplinary authority to an extent greater than is expected of a charge nurse. Section 3.9. Certification/Recertification (a) A full-time or scheduled part-time nurse who successfully completes a certification/recertification examination in the specialty area in which she/he is working will be reimbursed for the cost of the examination fee. (b) A certification differential of $0.35 per hour (for not more than one such certification) will be paid to a full-time nurse, scheduled part-time nurse or per diem nurse who is working in a specialty nursing practice in which she/he is certified. (c) For the purposes of this Section 3.9, only those certification programs listed below (as well as all certification programs approved by the ANA) and the correspondingly listed Medical Center areas shall be applicable: Certification program Medical Center area ANA Adult/Family Nurse Practitioner Gerontological Nurse Practitioner Maternal Child Health Nurse Child and Adolescent Nurse High Risk Perinatal Nurse Pediatric Nurse Practitioner Medical/Surgical Nurse Neighborhood Health Center Employee Health Service Geriatric Nurse Clinical Coordinator Medical/Surgical nurses Neighborhood Health Center Maternity/Labor & Delivery/ Nursery/Pediatrics Pediatrics Nursery Pediatrics Medical/Surgical Respiratory Education -8-

13 X-Ray Nurse/Radiation Oncology Clinical Specialist-Medical/Surgical Nursing Psychiatric and Mental Health Clinical Specialist in Psychiatric/Mental Health Nursing, Adult, Child, Adolescent NAACOG National Association of American College of Obstetrics AACN Critical Care Association American Society of Post Anesthesia Nurses NAON National Association of Orthopedic Nursing Emergency Nursing E.T. (Enterostomal Therapist) CHN (Renal Dialysis) American Nephrology Nurses Association INS Intravenous Nursing Society CIC (Infection Control) CNRN (Neurosurgical Nursing) COHN Occupational Health Nursing -9- Medical/Surgical Education Psychiatric Registered Nurse Psychiatric Maternity Labor and Delivery Nursery Inpatient Obstetrical Nursing Neonatal Intensive Care Nursing Ambulatory Women s Health Care Nursing OB-GYN Nurse Practitioner Maternal/Newborn Intensive Care Unit Coronary Care Unit PACU Emergency Department Telemetry Respiratory Care Unit Education (if a Critical Care instructor) Cardiac Rehabilitation PACU Crane Center Orthopedic Unit Emergency Department nurse Enterostomal Therapy nurse Renal Dialysis nurses Renal Dialysis nurses I.V. Therapy registered nurse Infection Control nurse 2 East Neuro staff Intensive Care Unit registered nurse Rehab. registered nurses Employee Health registered nurse

14 CNOR Certified Nurse of the Operating Room Rehabilitation Nurse CRRN Certified Oncology Nurse ONS/ANA Operating Room registered nurses Crane Center Rehab. registered nurse Radiation Oncology Certified Diabetic Educator Certified Addictions RN (C.A.R.N.) Staff Development RNC Gerontological Nursing Certified Radiology Nurse (ARNA) Commission for Case Management Certification Behavioral sciences Staff Education Skilled Nursing Facility (SNF) Inpatient Rehab Unit Radiology Case Managers Section Benefits for Per Diem Nurses Per diem nurses shall receive the following benefits: shift differential, weekend differential, charge pay, holiday time-and-one-half (if worked), and pension (if eligible). Section First Assistant in the Operating Room A nurse assigned by the Medical Center to a position as a First Assistant in the Operating Room shall be paid at the Staff Nurse salary rate plus $0.60 per hour following completion of a formal program plus 120 hours of clinical training. Such a nurse shall initiate and continue progress toward certification and take the national certification examination when all practicum hours are completed. The Medical Center reserves the right, in its discretion, to determine the case types for which First Assistants will be assigned and to determine whether any such position will be continued. A nurse functioning as a First Assistant in the operating room will not combine that role with the role of scrub nurse on the same case. Section Payroll As of the first payroll period of calendar year 2011, all Nurses will be paid via direct deposit to a bank or credit union account (within the United States) chosen by the nurse. -10-

15 ARTICLE IV Section 4.1. Hours of Work The regular work week shall consist of 40 hours, Sunday through Saturday. The regular work day shall consist of eight consecutive hours with a one half hour meal period on the day and evening shifts. The regular day shift shall be 7:00 a.m. to 3:30 p.m., the regular evening shift shall be 3:00 p.m. to 11:30 p.m., and the regular night shift shall be 11:00 p.m. to 7:00 a.m. except for positions that require a different schedule. Before establishing any such positions having a different schedule, the Medical Center will negotiate with the Association to the extent required by law. Section 4.2. Overtime/Mandatory Overtime (a) All authorized work performed in excess of a nurse s regular length of shift or in excess of eight hours in a day, whichever is greater, or in excess of 40 hours in a week shall be paid for at 1.5 times the nurse s regular rate. Instructor categories and O.R. nurses will be paid at time and one half for all overtime worked unless they request to take compensatory time off in lieu of overtime pay and such request is approved. Requests for compensatory time off will be approved at the discretion of the manager and, if approved, must be taken during the same week in which the overtime was worked. When overtime is used in this manner, it should equal to time-and-one-half. Unworked hours for which the nurse has been paid as Earned Time shall be counted in the determination of whether subsequent or other hours worked in the same work week shall be paid as overtime under this Section 4.2. There shall be no pyramiding of overtime, except as follows: during a pay period that includes a holiday listed in Section 5.1(a), overtime pay pursuant to this paragraph will be paid after 40 hours of work in a week, without regard to whether any of the first 40 hours are paid at holiday time-and-one-half pursuant to Section 5.1(b), provided that the hours that follow the 40 th hour are not holiday hours (in which event the no pyramiding rule would apply). If any nurse works a full double shift of 15.5 hours consecutively, the Medical Center shall pay the nurse for 16 hours of work. No nurse shall work more than one such double shift (day/evening or evening/night) within the same pay period, nor shall any nurse work such a double shift from the night shift onto the day shift, except with the specific advance approval of the Chief Nursing Officer or a Director of Nursing. If any nurse works two consecutive eight-hour shifts and then works into a third shift, the Medical Center shall pay the nurse double time for any time worked in the third shift. (b) 1. Mandatory overtime shall not be the established practice for staffing the Medical Center (i.e., mandatory overtime will be the exception, not the rule). The Medical Center will exercise good faith and reasonable efforts in filling committed RN positions, thereby recognizing its goal to keep mandatory overtime to a minimum. -11-

16 2. Before assigning mandatory overtime within a nursing unit, the Medical Center will use its best efforts to fill its needs with volunteers as follows: (a) (b) (c) The Medical Center will contact (i) unit nurses who are on duty, (ii) nurses on duty who regularly float to said unit, and (iii) nurses on duty who have previously been permanently assigned to that unit within the last 90 days, in order to seek volunteers to cover the hours. The Medical Center will attempt to contact (i) unit nurses who are off duty, (ii) nurses off duty who regularly float to said unit, and (iii) nurses off duty who have previously been permanently assigned to that unit within the last 90 days, in order to seek volunteers to cover the hours. The Medical Center will attempt to contact qualified per diem nurses to see if they are available. 3. In the event that the applicable supervisor/manager determines that there is still a need to mandate overtime in a particular unit, she/he will utilize the following process, in the order of the steps listed, until she/he receives approval for mandating overtime or until another resolution is reached that does not involve mandated overtime: (a) (b) (c) Phone the Chief Nursing Officer. If she/he cannot be reached to suggest another solution or to authorize mandatory overtime, then Phone the Vice President for Human Resources. If he/she cannot be reached to suggest another solution or to authorize mandatory overtime, then Contact the Administrator On Call, who will either suggest another solution or authorize mandatory overtime. 4. The Medical Center will mandate from among those full-time, scheduled part-time and per diem nurses who are on duty in the unit 1, according to the computerized inverse seniority list for that unit and/or the per diem inverse seniority list. These lists will be kept updated by the Medical Center with the dates that each nurse has been mandated to work overtime. The least senior nurse who has not been so mandated shall be mandated to work overtime. If all nurses on duty in that unit have been so 1 A nurse who has regular assignment but who is floated to another unit shall not be included in that unit s rotation list, but will rather be part of the rotation of the unit to which she/he is regularly assigned. A nurse who is a nursing office float or a specialty float will be exempted from any mandatory overtime assignment. The seniority date of a per diem nurse shall be determined as set forth in Sections 9.2(a) and 9.2(d) for purposes of assignment of mandatory overtime. -12-

17 mandated, the nurse with the least recent mandation date shall be mandated to work overtime. 5. An off-going shift nurse whose shift was worked in excess of her/his committed hours shall not be assigned mandatory overtime from such shift. 6. If the Medical Center assigns mandatory overtime to a nurse, the Medical Center will continue to attempt to cover her/his mandated assignment with volunteer overtime, per diems, floats or other appropriate solutions, with a goal of keeping the mandatory overtime to as short a time period as possible. 7. A nurse may refuse overtime for personal fatigue or personal illness. In such event, the Medical Center will not make an adverse judgment or take disciplinary action against such nurse. If such overtime is so refused, the overtime will be assigned per Section 4.2(b)(4). A nurse may also refuse to continue to work a mandated overtime period that has already begun for such reasons, in which event the Medical Center will not make an adverse judgment or take disciplinary action against such nurse. 8. Following every occurrence of mandatory overtime worked under Section 4.2(b)(4) above, an occurrence report documenting all of the Medical Center s efforts pursuant to Section 4.2(b)(2) and 4.2(b)(3) shall be prepared by the applicable unit supervisor/manager and sent to the Chief Nursing Officer, the Vice President for Human Resources, and the MNA Unit Chairperson. Such supervisor/ manager will be present at the next scheduled labor/management meeting to review the conditions that led to such overtime. The nurse(s) assigned such overtime will have the option to be present at such meeting. 9. This Section 4.2(b) will not be applicable to an emergency in which the Medical Center s Emergency Operations Plan is activated, provided that such Plan will not be activated solely because of understaffing. Section 4.3. Schedules Under normal circumstances, time schedules and days off shall be posted 16 days in advance of the four-week time block to which they are to apply. Thereafter schedules may be revised in emergencies. Section 4.4. Weekends The Medical Center will continue its present practice of endeavoring to grant every other weekend off unless the nurse requests to work more frequent weekends. A nurse shall not be required to work more than two extra eight-hour weekend shifts during the period July 1 through Labor Day week. -13-

18 Section 4.5. Rotation A full-time or scheduled part-time nurse working on the day shift can be required to rotate to other shifts when necessary to provide coverage for patient care, except that nurse(s) with 15 years of service in full-time and/or scheduled part-time status shall not be required to rotate shifts except in emergencies. At the time of employment, such nurse will be given the opportunity to indicate a preference for day-evening or day-night rotation. Changes in preference may be requested in writing by the nurse to the Chief Nursing Officer or her designee. The Medical Center will develop and implement a centralized system for assigning rotation, which it will endeavor to apply equitably to nurses on each shift within each unit, provided that no claim for economic compensation may be made under this sentence pursuant to Article XI. If the Medical Center decides to offer the option to a nurse to leave work (or to remain away from work) for all or part of an evening or night shift because of overstaffing on a unit, such offer will first be made to a nurse on such unit and shift who is working her/his alternate shift before such offer is made to a nurse who is regularly scheduled for such shift. If the Medical Center decides to float a nurse from a unit during an evening or night shift, a nurse regularly scheduled for such unit and shift shall be floated prior to a nurse working her/his alternate shift, subject to the provisions of Section 4.8 below. For the purposes of Sections 4.4 ( Weekends ) and 4.5 ( Rotation ), the weekend will be the 48 hours beginning at the commencement of the Saturday day shift for day shift nurses, the 48 hours beginning at the commencement of the Saturday evening shift for evening shift nurses, and the 48 hours beginning at the commencement of the Friday night shift for night shift nurses. Section 4.6. Access to Chief Nursing Officer While certain nursing departments may not be directly assigned to the Nursing Division, nurses in such departments shall have access to the Chief Nursing Officer or designee with respect to nurse practice and related matters. This in no way limits the normal supervisory relationships in such departments. Section 4.7. Principles Concerning Nursing and Quality Patient/Family Care (a) The Medical Center and the nurses jointly recognize that they share a commitment to the provision of quality patient/family care, and affirm their commitment to professional collaboration on issues that impact that care. The Medical Center will make good faith efforts to implement and maintain a plan of nursing care consistent with applicable law and with applicable professionally recognized standards of nursing practice and directed to safe and effective patient care, and to ensure that its written policies, procedures and protocols to this end are available to nursing staff. The Medical Center will also provide opportunities for nurses to participate on Medical Center committees in order to review and improve quality, including unit staff meetings and -14-

19 quality improvement teams. In recognition of the necessarily broad, general and philosophical nature of the principles stated in this Section 4.7(a), it is understood and agreed that the provisions of this Section 4.7(a), in whole or in part, are not susceptible to, shall not be subject to, and shall not be the basis for, any grievance or arbitration pursuant to Article XI. Rather, concerns arising under this Section 4.7(a) may be raised in the Nurses Committee under Section (b) The Medical Center and the Association acknowledge the applicability of the Massachusetts Nurse Practice Act, Mass. G.L. ch. 112, 80B, and its lawful implementing regulations at 244 CMR Section Within the context of said Section 3.05 as a whole, no nurse shall be required or directed to delegate nursing activities to other personnel in a manner that is contrary to said regulations and the Massachusetts Nurse Practice Act or that is inconsistent with the judgment of a reasonable and prudent nurse, and a nurse shall be reasonable and prudent in her/his exercise of the judgment accorded her/him with respect to such delegation. (c) Nurses perform many duties that support the delivery of quality patient care. Nurses are not to be assigned clerical duties (except in instances of light duty assignments) that are inappropriate to their professional status (e.g., being assigned to be unit secretaries). In the event of any such inappropriate assignment, the Association will promptly notify the Chief Nursing Officer. The provisions of this Section 4.7(c) are not intended to affect past practices in units where the staffing pattern does not include a regularly-scheduled unit secretary on a particular shift. Section 4.8. Temporary Reassignment The parties recognize the education, expertise and commitment of nurses to specialty nursing practice. The parties agree that nurses will not be temporarily reassigned unless they have had sufficient, current orientation to provide them with the competency to provide safe patient care. Section 4.9. Four-Day 36-Hour Night Shift Permanent full-time night nurses will work four nine-hour (between 10:30 p.m. and 7:30 a.m.) shifts (36-hour week). This program will only affect nurses who elect to work a permanent full-time night shift commitment as outlined in the preceding sentence. Nurses working the four-day 36-hour week (i) will receive 40 hours pay at the nurses regular hourly rate; (ii) will receive overtime premium for authorized work performed in excess of nine hours in a day or 36 hours in a week (overtime premium pay will be at the rate of 1.5 times the nurse s regular rate of pay); (iii) will accrue the same benefits afforded to permanent full-time nurses working a 40 hour week (this will include shift differential and night bonus); and (iv) will accrue Earned Time at the rate of 10 hours for each day scheduled. Vacancies for permanent 36-hour night shift positions will be filled in accordance with contract language concerning transfers (Section 9.11). -15-

20 If a night shift nurse to whom this Section 4.9 applies is requested by the Medical Center to work an alternate eight-hour shift, she/he will be paid her/his normal 10 hours pay for such alternate shift. Section Hour Shift Positions (a) The regular 12-hour shifts shall be day (e.g., 7:00 a.m. to 7:30 p.m.) or night (e.g., 7:00 p.m. to 7:30 a.m.), excluding a 30-minute unpaid meal period. The number and location of 12-hour positions will be determined by the Chief Nursing Officer in her sole discretion. No position that is filled shall be eliminated and its incumbent displaced for the purpose of creating a 12-hour shift. Such 12-hour shift positions shall be posted and filled in accordance with Section (b) (1) Staff nurses whose regular weekly commitment is to work 12-hour day shifts will be paid based on their actual committed hours 2 and shall be eligible for weekend differential (subject to Section 3.4) and for evening shift differential (subject to Section 3.2, except that 12- hour shifts that commence prior to 10:00 a.m. shall not thereby be ineligible for evening shift differential, provided that the shift does not end before 7:00 p.m.). In addition, staff nurses whose regular weekly commitment is to work 12-hour day shifts that do not end before 7:00 p.m. shall be eligible for the evening shift bonus (subject to Section 3.3(a)), but pro rated on the basis of the number of such hours which the nurse actually works per week. If a nurse s regular committed 12-hour day shift ends at or after 7:00 p.m., she/he shall be eligible to receive evening shift differential for hours worked after 3:00 p.m. (subject to Section 3.2). A 12-hour day shift nurse who fails to work until at least 7:00 p.m. because (i) she/he is requested by the Medical Center to work a 12-hour day shift that ends before 7:00 p.m. instead of her/his regular committed shift, or (ii) she/he fails to complete her/his regular committed shift because of authorized paid time off (due, e.g., to illness or to absence on paid professional time pursuant to Section 10.9) will be eligible to receive evening differential for hours worked after 3:00pm. 2 Current nurses or nurses hired between the date of ratification and June 1, 2012 whose regular weekly commitment is to work three 12 hour shifts, and who are paid at the rate of 40 hours pay for those three 12 hour shifts, will continue to be paid on that basis until June 1, They will also continue until June 1, 2012 to be eligible for weekend differential (subject to Section 3.4), for night shift differential during their entire shift if they work three 12 hour night shifts (subject to Section 3.2), and for the night shift bonus (subject to Section 3.3(b)) but on a full-time basis. If they work shifts in addition to their 12 hour shifts, they will be paid for such work at straight time rates unless they work in excess of 12 hours in a day or have worked in excess of 36 hours in a week, in which case they shall be paid overtime in accordance with Section 4.2 for such excess. Such nurses will transition away from this premium pay arrangement in accordance with the side letter dated July 22, 2011 and attached hereto as Appendix D. -16-

21 (2) Staff nurses whose regular weekly commitment is to work one or two 12-hour night shifts will be paid based on their actual committed hours (e.g., a nurse who works two 12-hour night shifts shall be paid at the rate of 24 hours pay) and shall be eligible for weekend differential (subject to Section 3.4), for night shift differential during the entire shift (subject to Section 3.2) and for a pro-rata night shift bonus (subject to Section 3.3(b)). (c) Such nurses shall not be eligible for overtime pay pursuant to Section 4.2 during their 12-hour shifts. Such nurses who work shifts in addition to their 12-hour shifts will be paid for such work at straight time rates unless they work in excess of eight hours in the case of an eight-hour shift (or in excess of 12 hours in the case of a 12-hour shift) or have worked in excess of 40 hours in a week in which event they shall be paid overtime in accordance with Section 4.2 for such excess. (d) Such nurses shall be eligible for Earned Time pursuant to Article VI (not to accrue in excess of 12 hours in a day or 40 hours in a week), but pro rated on the basis of the number of hours which the nurse actually works per week. (e) In the event of a reduction in force, a nurse working a 12-hour shift commitment shall be considered to be working on the shift on which the majority of her/his scheduled hours fall. (E.g., a nurse working 7:00 a.m. to 7:30 p.m. shifts shall be considered to be working on the day shift, a nurse working 10:00 a.m. to 10:30 p.m. shifts shall be considered to be working on the evening shift, and a nurse working 7:00 p.m. to 7:30 a.m. shifts shall be considered to be working on the night shift.) (f) A 12-hour shift nurse who is requested by the Medical Center, for its convenience, to work a shift of fewer than 12 hours (instead of one of her/his 12-hour shifts) will be paid her/his normal 12 hours pay for such alternate shift. (g) An eight-hour shift nurse who is requested by the Medical Center to work a 12-hour shift for its convenience will be eligible for overtime in accordance with Section 4.2, but an eight-hour shift nurse who works a 12-hour shift other than by Medical Center request (e.g., at her/his own request or as the result of a switch with another nurse) will not be eligible for overtime pay during such 12-hour shift. Section Hour Shift Positions (a) The number and location of 10-hour shift positions will be determined by the Chief Nursing Officer in her sole discretion. No position that is filled shall be eliminated and its incumbent displaced for the purpose of creating a 10-hour shift position. Such 10-hour shift positions shall be posted and filled in accordance with Section (b) A staff nurse whose regular weekly commitment is to work three or four 10-hour shifts will be paid at straight time and will be eligible for a shift differential to the extent set forth in Section 3.2. Such a nurse whose regular 10-hour shifts begin at or -17-

22 after 10:00 a.m. shall be eligible for the evening shift bonus (subject to Section 3.3(a)), but pro rated on the basis of the number of such hours that the nurse actually works per week. (c) Such a nurse will not be eligible for overtime pay pursuant to Section 4.2 during their 10-hour shifts. (d) 10-hour shift nurse who is requested by the Medical Center, for its convenience, to work a shift of fewer than 10 hours (instead of one of her/his 10-hour shifts) will be paid her/his normal 10 hours pay for such alternate shift. (e) An eight-hour shift nurse who is requested by the Medical Center to work a 10-hour shift for its convenience will be eligible for overtime in accordance with Section 4.2, but an eight-hour shift nurse who works a 10-hour shift other than by Medical Center request (e.g., at her/his own request or as the result of a switch with another nurse) will not be eligible for overtime pay during such 10-hour shift. Section Clinical Development Program The Medical Center will provide full-time and scheduled part-time nurses an opportunity to practice in an area different from their current assignment, through a Clinical Development Program, subject to the following terms: In each calendar year, the Medical Center will offer Clinical Development program opportunities, each for at least a three-month period, in practice areas (and on shifts) determined by the Medical Center, provided that only one Clinical Development program opportunity will be made available (and in only one unit) for each such period. (a) In each calendar year, the Medical Center will offer at least two such opportunities. Clinical Development program opportunities will be posted for one week. (b) Each nurse must fulfill a one-year service commitment after completion of a Clinical Development program, which shall be at the same weekly-work-commitment level, unless otherwise approved by the Medical Center. If such nurse fails to so remain in the employ of the Medical Center (unless she/he is discharged or laid off or unless such failure is because of circumstances beyond her/his control), she/he shall reimburse the Medical Center in the amount of 40 Earned Time hours (or its equivalent) prorated on the basis of the of the one-year service commitment that remains unfulfilled. (c) To be eligible for a Clinical Development program opportunity, a nurse must have at least five years of seniority and must be employed in a position with a weekly work commitment of at least 24 hours per week. During the Clinical Development program, the nurse will have the same weekly work commitment, subject to the scheduling practices of the new department. (d) Eligible nurses who apply for a Clinical Development program opportunity will be selected by seniority, unless there exists a performance deficiency within the previous two years that is documented (e.g., in a performance appraisal or disciplinary action). The Medical Center will determine on the basis of operational -18-