Denying a hospital’s request to restrain its unionized nurses from refusing overtime assignments after the hospital had announced it would make layoffs, a federal court in Rhode Island concluded the hospital failed to demonstrate that it or its patients would suffer irreparable harm as a result of the nurses’ refusal to work overtime. New England Healthcare Employees Union, District 1199, SEIU v. Women & Infants Hospital, C.A. No. 15-55 S (D. R.I. Mar. 27, 2015).

After Women & Infants Hospital announced layoffs, the union representing its nurses and other employees notified the hospital that it would conduct informational picketing and that nurses would refuse to accept overtime assignments (the parties’ collective bargaining agreement and Rhode Island law prohibit the hospital from mandating overtime except in emergencies). The hospital asked the federal district court for a temporary restraining order requiring the nurses to accept overtime assignments pending arbitration of the parties’ dispute over the layoffs.

To establish the requested “Boys Market” injunction (named after a 1970 Supreme Court decision) in aid of arbitration would be appropriate, the hospital had to demonstrate that (1) the parties’ collective bargaining agreement contains mandatory arbitration procedures; (2) the work stoppage to be enjoined is over an arbitrable grievance; and (3) ordinary principles of equity warrant the injunctive relief, such as a showing of irreparable harm in the absence of injunctive relief. The court found the hospital established the first two conditions, but failed to show that the nurses’ refusal to accept overtime assignments would cause the hospital irreparable harm.

The hospital argued it would have to divert patients to other hospitals. It identified three ways in which it said diverting patients would cause irreparable harm: (1) reputational harm; (2) harm to patients; and (3) lost revenues. The court found the hospital’s evidence as to each type of alleged harm insufficient to warrant injunctive relief.

The court noted that the hospital had diverted patients in the past, including as a result of labor disputes, and that there was no evidence these past diversions caused any reputational harm. The court found the hospital’s evidence of potential harm to diverted patients was speculative and contradictory, in part because the hospital provided no evidence that past diversions had posed a health risk to the diverted patients. Further, the court could not gauge the amount of lost revenue the hospital might suffer because the hospital failed to provide monetary figures for the average reimbursements it received in the units that may be affected by patient diversion. Moreover, the court noted it was not clear the hospital would suffer any financial loss when patients were diverted to other hospitals within the same healthcare network as the hospital.

Significantly, the court also found the hospital’s claim that patient diversion would occur at all was speculative and prevented a finding of irreparable harm at this stage of the litigation because the hospital had alternatives to assigning overtime shifts, such as using per diem and temporary nurses. The court’s analysis in this case illustrates the importance of contingency planning when healthcare employers face potential work stoppages.