Closed Staffing

  1. Our hospial is trialing a closed staffing model, and to be honest it's more than a little frightening. We are a 250 bed hospital with 5 ICU's. Is there anyone out there who currently has closed staffing? How does it work? What do you like and dislike about it? The thing I don't understand is how are we going to fill vacancies, sick calls, etc without mandatory on call or overtime and NO FLOAT POOL????. The plan is to call everyone who is not already working and ask them to come in. What kind of plan is that? People don't come in now and it's March. Who do they think will come in on a Saturday in the summer?? If anyone has a good system in place and can advise me on how you fill the vacancies created by sick calls, vacations, etc., I would love to hear from you.
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  2. 9 Comments

  3. by   Q.
    I currently work in a closed staffing model, and it seems to fit our needs.

    To cover ourselves, we have to sign up for on-call (about 20 hours of on-call in one month) - we also utilize agency nurses, we have what we call Unit Based Resource Team (which is what I am - which is basically per diem)

    We occasionally run into problems, and we do have frequent mandatory overtime, and we get phone calls at home alot, but the idea of not floating to other units is what our goal is. As OB nurses, we would have a hard time functioning in a medical ICU. Also, we would be unable to utilize any other in-house nurse who would float to us because they cannot do labor and delivery. There are pros and cons, but for now it seems to work for us.
  4. by   Suzerrn
    We call it "Self Containment" at our Hospital. Our ED will be the first department to implement it. Also, because we are an "at will" employee, if you don't like it....don't let the door hit you in the @*#!! I was lucky enough to transfer out of the department, prior to the start date of this containment issue. I will be leaving the end of the month. Thankfully, too. The rest of the nurses in ER have been told, that all transfers must be given to the Medical Dictator...I mean Director. Hidden meaning = no one will be allowed to transfer. I feel I got out, just as the ship was sinking. Mandatory Overtime, self-containment, and 5minutes of shoving a doughnut down your throat equals a lunch?? I think not!!
  5. by   Suzerrn
    I forgot to add that the dpartment I will be transfering to...Cath Lab, has not the problems that other unit departments are facing. There is no staff shortage, Nursing is 1:1, and I get a lunch everyday...OFF the floor! I'll have to suffer through a little added dose of "Testosterone in the air", but, I think I can handle it! Now, to get me through the next 28 days in the ER!!
  6. by   Tiara
    I worked on a closed unit once. We were responsible for all our own staffing. In short, this meant covering for each other, working over, etc. However, there were periods in this unit when the census was down and nurses were told to go home. Sometimes they had the option to float to another unit, but otherwise, you went home with no pay. Staffing your own unit can be a risky situation at best in my opinion.
  7. by   kaycee
    I work in a small community hospital and the ER where I work is the only area with a closed unit. We cover ourselves well with there are call offs and there is little or no mandatory OT. This way we don't get pulled to other units and they don't pull to us staff that has no ER experience. We are small and the staff gets along and are friends so it's easier to cover and really we don't have many call offs. It works for us but I can see why it may not work in a larger facility.
  8. by   KwizRN
    Originally posted by Tiara:
    I worked on a closed unit once. We were responsible for all our own staffing. In short, this meant covering for each other, working over, etc. However, there were periods in this unit when the census was down and nurses were told to go home. Sometimes they had the option to float to another unit, but otherwise, you went home with no pay. Staffing your own unit can be a risky situation at best in my opinion.
    I hope you don't mind if I throw some more questions at you. Were you required to sign up for on-call time (paid or unpaid?), and extra shifts? If so, was there a requirement that everyone had to work additional shifts, whether they wanted to or not? Did your hospital supplement closed staffing with agency nurses or a float pool? What did you do if you called everybody and nobody would come in????????? Thanks for any help you can give me

  9. by   plumrn
    Our hospital had closed staffing for several years and just recently changed their thinking.Many times we worked short and were told by supervisors they called everyone and there was no one willing to come in."You'll just have to do the best you can."After a while this became the standard response.We and our pts suffered because of this.We also lost a lot of staff after people realized things weren't going to change and we were all wore out.After losing a lot of good nurses policy has changed and now they are scrambling to try to make our facility look good to nurses again (raises,looser scheduling,and I must say a little more respect).The managers finally got angry enough when they themselves had to staff several shifts themselves when there was absolutely no one to come in.
  10. by   Q.
    Originally posted by KwizRN:
    I hope you don't mind if I throw some more questions at you. Were you required to sign up for on-call time (paid or unpaid?), and extra shifts? If so, was there a requirement that everyone had to work additional shifts, whether they wanted to or not? Did your hospital supplement closed staffing with agency nurses or a float pool? What did you do if you called everybody and nobody would come in????????? Thanks for any help you can give me

    We are required to take 20 hrs of call - we get paid $2.00/hour while on call - if you get called in, you get a call-in bonus of $40 and time and a half.
    If the census is down, you may get "put on call" where you don't have to come in but you get the $2.00/hr. Again, if you are called back, you get the call-in bonus and time and a half. We don't get cancelled that often so when it happens we welcome the extra day off.

    We aren't required to take any extra shifts at all. We utilize agency staff, and in-house pool staff. If we don't get enough help through the staffing office, then we 1. use the on-call person and/or 2. use mandatory overtime.
  11. by   Tiara
    When I worked the closed unit, there were quite a few nurses who were always glad to pick up an extra shift. We were occasionally floated someone else if no one on the staff could make it. The nurses on this unit looked out for one another.

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