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Keven Moore: No such thing as ‘restroom rights’ for teachers, nurses; that could account for shortages

It’s common knowledge today that teachers and nurses are overworked, stressed, under appreciated, disrespected and disillusioned. Consequently many are leaving their profession at such a high rate—to the point where many states are dealing with teacher and nursing shortages. Meanwhile, the number of college students who choose to go into these professions is steadily dropping as well.
There are several factors and stressors that contribute to this discontent, but the number one common denominator grievance from both professions is the “Lack of Opportunity To Use The Restroom.“

As basic as that may sound to most of us who are not in either of these two professions, it’s a major problem for these professions and it leads to poor morale, but it also leads to long term health concerns later in life.

It’s hard to contest the suffering that a day without having much, if any, time to relieve oneself might cause — especially when multiplied with the other stressors associated with teaching and nursing. Now imagine how strenuous this would be if it was compounded with a pregnancy, Irritable Bowel Syndrome or just dealing with something you ate the night before.

According to a 2015 article in The Atlantic titled “Using the Restroom: A Privilege — If You’re a Teacher,” roughly one in two teachers reported having inadequate bathroom breaks, while about the same ratio said they’re unable to use the breaks they do get.

Teachers and nurses just can’t opt to leave their classroom, unit or hospital floor to go relieve themselves, because if they do they very well could lose their license if something was to go wrong while they were away. Nurses in fact can also be held liable and sued if something terrible was to occur.

Being married to a nurse for over 30 plus years, I know this problem to be true first hand— often times my wife’s 12 hours shift habitually stretches into a 14 hours shift (on her feet) due to inadequate staffing or increased acuity on the unit. Where most days she is lucky to just receive only one 15 minute lunch break and forfeiting her two 10-minute breaks afforded to her by the Department of Labor.

The fact is teachers and nurses make the choice to voluntarily delay necessary trips to the restroom while at the workplace. According to a January 2015 article in Allnurses.com, nurses list various reasons for resisting the urge to void during long work shifts. Some of the reasons include busy working environments, insufficient numbers of restrooms at the place of employment, the fear of falling behind in one’s tasks, inadequate staffing, and lack of time to take breaks.
In a school setting teachers have to call the front office or find another nearby teacher to watch their classroom, and if that teacher is in the middle of instructional time, many are instructed to wait because administrators don’t want to interrupt that precious and all important instructional time (for obvious reasons).

For teachers that work in detached portable classrooms this often times can be very difficult, especially if you are dealing with some other health issues. Some teachers will tell you that they only find time to use the restroom during lunch; and sometimes not even then because they may have lunch duty.

As a result, it’s not uncommon for teachers and nurses to become “functional retainers.” After years of purposefully ignoring the urge to void or relieve themselves at work, many are inadvertently training their bladders and bowels not to relax until they get home.

To reduce the discomfort many teachers and nurses end up compromising their health by avoiding eating breakfast and hydration properly throughout their shift—which is important to stay energized and focused to be able to perform at maximum levels.

Over the years many of these nurses and teacher start to develop severe health issues from urinary tract infections. It’s well-known in the medical community that urinary tract infections are a common side effect of limiting either bathroom usage or hydration (often both).

Constipation is common problem in both professions as well. By resisting the urge to void the last part of your intestines fills up with stool, they send a message to the brain that it’s time to go to the bathroom. If the stool out, the gut continues to draw fluid out of it for as long as it remains there. That makes the stool harder and dryer, which can make it more difficult to pass when you finally get some throne time.

Many teachers and nurses think that by not urinating all day or just only once a day at work that their body has simply adjusted and that it’s all good. But in fact by doing this they are developing long term effects that they will deal with later in life.

In fact urologists today have a name for it and it’s called ‘Infrequent Voiding Syndrome’ or ‘lazy bladder syndrome,’ and ‘nurses bladder.’ It is a characteristic grouping of signs, symptoms, findings, and features commonly observed in individuals who choose to delay urinating for extended periods of time. 
The cardinal sign of infrequent voiding syndrome is an enlarged urinary bladder with a smooth wall and a larger capacity for holding urine than usual. In fact, the bladder of a teacher or nurse afflicted with infrequent voiding syndrome is often so stretched out that it is capable of holding anywhere from 500 milliliters to more than 1000 milliliters of urine.  

Other signs and symptoms may include abdominal pain, pelvic pain, pelvic pressure, constipation, a slow urinary stream when voiding, a palpable mass in the pelvic area due to bladder distention, or occasional leakage of urine and sometimes incontinence. Chronic urinary tract infections and reduced renal function are two of the main long-term dangers associated with infrequent voiding syndrome, reducing one’s quality of life.

As a safety and risk management professional I have been asked what bathroom rights do employees have, and what does OSHA say about this?

Workers’ right to access restroom  refers to the rights of employees to take a break when they need to use the bathroom. The right to access a bathroom is a basic human need.  Unless both the employee and employer agree to compensate the employee on rest breaks an employer cannot take away the worker’s right to access a restroom while working. There is limited information on the rights workers have to access bathrooms among the world’s legal systems.

The law in the U.S. is not clear in  as to the amount of time a worker is entitled to use a restroom while working. Nor is there clarification on what constitutes a ‘reasonable’ amount of access to a restroom. Consequently, the lack of access to toilet facilities has become a health issue for many workers.

Issues around workplace allowance to use a restroom has given light on issues such as workers having to ask permission to use a toilet and some workers having their pay deducted for the mere human right of using a bathroom when they need to.

The Occupational Safety & Health Administration agency (OSHA) states that all employees must be provided with toilet facilities.   However, issues arise over when a worker can access a restroom. A memorandum on behalf of OSHA in 1998 stated that workers could only be restricted access to a bathroom if it was reasonable at the given time.  However, what is reasonable is still unclear today.
The court has held “While there is a clear public policy in favor of allowing employees access to workplace restrooms,” it does not support the proposition that employees may leave their tasks or stations at any time without responsibly making sure that production is not jeopardized.

In recognition of an employer’s legitimate interest in avoiding disruptions, there is also a clear public policy in favor of allowing “reasonable restrictions on employees access to the restrooms.” Thus it is clear the court made this decision with policy in mind.

The courts have been clear in their findings that an employee has an obligation to ensure they do not disregard their position as an employee and thus a reasonable restriction on the limitation a worker has to access a bathroom is to be allowed. And that by going to the bathroom a worker cannot be seen to be deserting their job.   However, this does raise issues over workers who have a large work load and that attending to the bathroom can be seen as abandoning one’s job.

Currently, when an employment dispute arises regarding bathroom use where an employee has been prevented or punished in terms of employment, they are referred to OSHA who decides on each individual case.

In addition, OSHA has ruled that where a worker has reasonably waited to visit a bathroom, or where an additional worker is not available, for replacement, in the worker’s absence, then the worker is entitled to use the restroom or else the employer will be in breach of their fiduciary duties to the employee. Furthermore, employees must be paid for any break which equates to less than 20 minutes which includes bathroom use.

The Americans with Disability Act can also be cited as a defense as there are also provisions for “reasonable accommodations” for those with some form of a disability as it relates to the need for more extended bathroom breaks.

The fact is there isn’t a straight-forward federal law protecting workers restroom rights, and a number of lawsuits have been filed against companies over the years. The fact is employees are at the mercy of their employers and the only law that I can personally cite to help guide employers is the Golden Rule, which was given by Jesus of Nazareth himself when he said… “Do to others what you want them to do to you.” Mathew 7:12.

Be Safe My Friends

Keven Moore works in risk management services and is an expert witness. He has a bachelor’s degree from the University of Kentucky, a master’s from Eastern Kentucky University and 25-plus years of experience in the safety and insurance profession. He lives in Lexington with his family and works out of both the Lexington and Northern Kentucky offices. Keven can be reached at kmoore@roeding.com.

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