I work in a small rural hospital in Missouri, 100 beds. Our average census is anywhere between 30-50 pts. I and other staff have to take turns with on call and low census, when patient census is low. Sometimes this is a weekly ordeal. Our patient to nurse ratio is 4:1, and I truly love to work for this facility, although I still have bills to pay and PTO can only go so far.

What are other nurses doing or are facilities doing during the slow times to help their staff get by? Are there any special policy's other hospitals have that deal with this sort of thing?

I work in a bigger hospital,so while we do get EA (Excused absence-on call), it doesn't happen much. If we can't afford to take the EA, we can work on a different unit--usually as a tech vs RN though.

Since you work for such a small hospital I don't think there's too much you can do. The smallest hospital I've been at was approximately 300 beds so not very comparable. At my current facility low census goes to the person with the least amount of low census hours unless somebody has already requested low census. Unfortunately that meant I was getting low census since I had zero low census hours up until a couple of weeks ago.

I'm not sure there's too much hospitals can do to help you through this. They're trying to cut back as much as possible and finding more and more ways to cut back.

I work at an independent hospital. We have been called off to the point where many of have no PTO left to use. If I am called off now I don't get paid. When I need off in january for 5 days for my daughter's dance trip it will be unpaid. Fortunately, my husband is a pharmacist and he doesn't have call offs. As far as the hospital they aren't doing a darn thing.

Yes most of the other staff are running out of PTO also. I have picked up an extra shift every week for the last 7 weeks, and have never worked any that i signed up for. Always called off. But on the flip side i usually get to work my 3 12's.

I was just wondering what other hospitals do.

I mean my hosp is not going to retain good nurses because of this situation.

There has to be a compromise!

When I worked for a hospital, we still accumulated PTO when we were low census on call. But still that doesn't help pay the bills always. That is one of the reasons I don't work in a hospital. They closed units and you are screwed.

We have nurses who supplement their incomes by doing PRN at other facilities...just a thought?

Bet no member of management in a hospital has been called off and required to use PTO.

On my unit, there is usually always at least 1-2 people who want the LC or OC, so I have never had to take it unless i wanted to.

Of course, we rarely get it because the unit we float to is chronically short-staffed on nights so even if we are over grid we usually have to send someone to them.

I see this situation a lot at my current facility. Some take PTO, some take unpaid leave. I really don't know what others do, but I usually volunteer to pick up a shift later in the pay period if needed. Also, I budget accordingly so that I can absorb the impact of missing a shift. While it's not ideal, I have dealt with much worse.

This happens a lot at my hospital. We are a small, critical access hospital so it is either feast or famine. We maintain a 4:1 or 5:1 ratio, we have even been 3:1 so that no one had to take call. Generally speaking, someone always wants call so that helps. Other than that we all take turns. We are also not allowed any overtime at our hospital, it makes sense, they need to trim where they can and overtime is expensive. I've gotten a second PRN job at a close by hospital and I usually pick up 1-2 days there and usually even out to 4 shifts a week.

The person scheduled with the least amount of cancelled hours that month usually gets cancelled first, at our hospital.

I started signing up for extra shifts every week (4 hour princess shifts here and there) and get cancelled for, I wanna say, 9 out of 10 of them. They do count them as my monthly cancelled hours, so when they were looking to cancel somebody, I didn't get cancelled for my 12s.