Flat Rate Pay For Sleepovers Question

Nursing Students CNA/MA

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Specializes in DD, Mental Health, Geriatric.

Hey, all my fellow caregivers! Hope you are all having a good night! Anyway, the AFH I work at has an policy where the caregivers are paid an hourly wage from 8:00am until 9:00pm and if it's your turn to stay the night you get a flat rate of $25.00 per sleepover and from 9:00pm until 8:00am you are technically off duty. When I started working there last year there wasn't much to do after nine but answer the very rare call light.

But, now, due to circumstances beyond our control one particular resident has been hitting her call button, (it makes a loud auditory announcement which resident needs aide), for whoever is doing the sleepover to help her to the commode, which in itself isn't a problem it's what we're here for, but she has been needing to use the bedside commode every fifteen to twenty minutes from 10:30am until around 5 or 6 am. And we get up at 7:30am and start work at 8:00am.

She used to help herself but she has fallen several times over the last few weeks while attempting to get from her bed to her commode, so she is now a fall risk and we encourage her to buzz us if she needs to go during the night. During the times when I can go home the next morning the lack of sleep doesn't bother me, it's when I'm working my back to back weekend doubles with sleepovers from Friday pm til Monday am, that the lack of a rest period has me concerned for my, (and my coworkers who switch off the weekday sleepover doubles), about how well we will be able to take care of our residents the next day when/if we are on duty after having gotten almost no sleep the night before.

I guess my question(s) is/are this, (and it's really more of a gathering opinions, advice and information); 1. Does it seem fair to say a caregiver is not on duty during a certain time and yet they are working with residents most of the night after having been buzzed and to not pay them hourly during this but a flat rate no matter how often or not they are doing stuff for residents after 9:00pm?

2. At what point would you think it might be necessary to have a caregiver hired to work nights/graves and actually be paid hourly for working? Right now we have three caregivers who switch off/on but there is no night/graveyard shift, (that's what doing the sleepover is suppose to be for); there's Morning shift 8am to 2pm and Afternoon/Evening shift 2pm to 9pm.

Anyway, Thanks for reading this! Happy early Easter!

I would look into why she is having this change in bladder elimination. It sounds likes UTI. It is not normal to need the toilet that often.

Specializes in DD, Mental Health, Geriatric.
I would look into why she is having this change in bladder elimination. It sounds likes UTI. It is not normal to need the toilet that often.

I agree, but, the UA came back negative for a bladder infection. She did have bladder troubles before and is on Oxybutin gel rubbed on stomach before bed but that's suppose to slow down the need to pee or so I thought, but I wonder if one can build up an immunity to it? Anyway, we don't know what's going on with her since its not a bladder infection. Maybe Kidney. So right now when doing the sleepover, we now have to sleep in the spare room next door to her's instead of in the caregiver area so we can be closer to her in the night and we have been instructed to put a motion sensor next to her bed to alert whoever is staying the night that she is attempting to get out of bed and we need to be up and running and into her room if that happens due to her having fallen a few times going from bed to bedside commode. Hopefully our bosses will get it situated for everyone; client and caregiver.

I don't think that situation is safe.. If you're there the whole night waking up all night, how are you to be awake during the day to give care to all of the other people who live there? When I worked 24 hour live-in (home health) we needed at least 8 hours of sleep, and if we didn't get it, we had to let the agency know. :(

Specializes in DD, Mental Health, Geriatric.
I don't think that situation is safe.. If you're there the whole night waking up all night how are you to be awake during the day to give care to all of the other people who live there? When I worked 24 hour live-in (home health) we needed at least 8 hours of sleep, and if we didn't get it, we had to let the agency know. :([/quote']

Oh I agree 100% with you. I brought up the situation and my concerns for the safety and well being of the residents and caregivers and they said we may change to a half sleep/half up night schedule (9pm to 1am awake 1am to 7:30am sleeping or something like that) and so a portion of the night we will be awake and the other part asleep. We'd still get woken by bells during our sleep half but at least we'd be able to get at least six or seven hours of sleep hopefully. But, that was before we had to send her to the hospital and found out that one of her more recent falls had actually fractured her hip and that was the reason she wasn't able to toilet herself at night (due to the pain). I did say to the providers of the place that I bet she hurt her hip when she fell and her pain meds were masking the worst of the pain and when I went home over the week I looked up symptoms of someone who broke their hip and this clients was showing most of them. So I wasn't too surprised to hear about when I came in today. So, she is out of the facility being treated and I feel really bad that no one realized this sooner but the RN refused to come out to see her until last Monday and it was just a big mess, anyway, I'm glad she is finally being taken care of properly, and the overnight caregivers will be able to sleep during the night for awhile and provide good care for the rest of the household during daylight hours. I'm not sure what's going to happen in the future but hopefully its worked out so that everyone is safe and happy.

Specializes in DD, Mental Health, Geriatric.

Oh and they informed me that we will be compensated beyond the flat rate for having to work at night. So that question is taken care of, too.

It seems to me that this shift needs to be addressed for sure. At Any night you might have a bad night with a client and be up half or all night. How can this place even think that after having a sleepless night you can properly keep working the day shift. To me this should be a shift totally seperate from the day shift, where you actually work that shift and be able to sleep that day before. Is there things around the place that can be done during the shift when things are quite? After all 3rd shift care givers at a LTC has things they are doing when there is not a call light going on. Thy are not in another room sleeping. Seems like a weird setup to me, and can turn unsafe for residents and caregivers.

Specializes in DD, Mental Health, Geriatric.
It seems to me that this shift needs to be addressed for sure. At Any night you might have a bad night with a client and be up half or all night. How can this place even think that after having a sleepless night you can properly keep working the day shift. To me this should be a shift totally seperate from the day shift where you actually work that shift and be able to sleep that day before. Is there things around the place that can be done during the shift when things are quite? After all 3rd shift care givers at a LTC has things they are doing when there is not a call light going on. Thy are not in another room sleeping. Seems like a weird setup to me, and can turn unsafe for residents and caregivers.[/quote']

Oh, I agree with you. I've since moved on to another job where even though I work back to back doubles I am able to sleep the whole night through and my boss lives on site so she is always around if I need her. As for the other place, new owners took over, fired everyone and decided to move in with their family and live and work there by themselves. Which I think is extremely stupid, they should have other people to help out but they wanted to save money so it's their bed and I'm just glad not to be laying in it anymore. Also, I get confused about the different shifts because where I'm working now and at the other place we have morning shift which is from 7am to 2pm, then Evening/Bedtime which is 2pm to 8pm and whoever is doing the Eve/bed shift is also responsible for spending the night, which isn't paid hourly, but $25 a night. I know morning is first shift so would Eve/bed be second or third?

Yes, I'd say the 2pm to 8pm is like your second shift, and then your 3rd shift/overnight shift. Thi sset up is better I feel then the other because you double comes on the night part of your shifts, not work all night and then expect to work day shift. I see working second and then having to have the sleep over a lot better and safer of a set up

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