Unions are finding ways to break the chains of mandatory overtime.

Burlington, Wis., union leader Pam Mueller can't remember who came up with the idea of the ball and chain. It just seemed to express perfectly the feeling of someone who has been working hard for eight, 10 or 12 hours and now has to stay on the job regardless of urgent personal commitments--like children.

Mueller and her co-workers at Burlington Memorial Hospital needed good ideas because they had just gotten bad news at the bargaining table: Management indicated they would start using mandatory overtime to cope with staffing problems. That had never been done before although it was allowed under the expiring contract.

So members of the Wisconsin FNHP at Burlington Memorial Hospital got big rubber balls and chains, painted them black, connected them with velcro and set out on a series of public demonstrations asking their neighbors to support their fight against being chained to their jobs.

They gave out flyers that said, "How would you like to be the patient with a nurse forced to work 16 or more hours? How would you like to be the worker forced to choose between your family and your job?"

They also printed up signs and found 200 residents of the small city of Burlington to put them in their front yards.

The publicity campaign got management's attention. "It was a good way to hit them in the wallet without actually going on strike," said Mueller.

In the end, management accepted some of the toughest language against mandatory overtime in the nation.

Mandatory overtime is spreading across the country, but unionized health care workers are coming up with new and effective strategies to protect themselves.

The growing use of mandatory overtime is a result of cost-cutting moves in which managers try to staff their hospitals with as slim a safety margin as they can. At the same time, the growing nurse shortage makes it harder to hire temporary nurses on short notice. So when someone is sick or there are an extra few patients on the ward, managers find it easiest just to order someone to stay.

"When I started 10 years ago, you might get mandated every three or four years. Now, one nurse has had it twice in one weekend," said neonatal nurse Lois Diehm of the University of Connecticut Hospital in Farmington, Conn.

At Kaiser-Permanente's Sunnyside Hospital in Portland, Ore., mandatory overtime was "rampant and growing" a year ago, said OFNHP president Kathy Schmidt. Finally, "people got assertive," she said. They started wearing "NOMO" buttons and telling managers they would only work the extra time if formally ordered to do so.

Management agreed to reopen the contract and pay volunteers double time for working extra. They also negotiated raises of 4 percent to 8 percent, which made it possible to fill some chronically vacant positions. These two measures have drastically reduced the amount of mandatory overtime although the contract still allows for it.

The 8,000 state nurses of the New York State Public Employee Federation/AFT are handicapped in fighting mandatory overtime because state law forbids strikes and even binding arbitration. But they also have an advantage: their employers are elected. So PEF has been punching up its ability to reach the public with the workers" side of the story.

PEF nurse organizer Lenore Boris is also considering a lawsuit to enforce a state law that bans mandatory overtime "except in cases of fire, riot, flood, famine, pestilence or other cases of emergency endangering life or property." This list, she notes, does not include a supervisor realizing he or she didn't get around to finding a replacement for someone on vacation.

Lois Diehm of the University of Connecticut Hospital says mandatory overtime is self-defeating for management. "There's a nursing shortage, so they offer us $3,000 sign-on bonuses," she said, "but they don't look at retaining people. It's a Catch-22. When there's a lot of mandatory, people leave."