How do they handle low census where you work?

  1. Tonight, we had too many nurses for the # of patients and I got to come home early. When we first arrived for our shift, the charge nurse said somebody might be going home and I volunteered for it because I wasn't feeling well to begin with. Another nurse said, "no, I want to go home because I didn't get any sleep." (Neither had I nor the charge nurse.) The charge nurse said she'd put off as long as she could before calling the supervisor to see if they wanted someone to leave. After we'd all seen our patients and things settled down, she came over to me and said that she'd talked to the supervisor and I could go home. She said the other nurse & I were the only two who had never gotten low census, but the other nurse is staff and I'm PRN, so technically, I should be the one to go home. I didn't hesitate to accept. I didn't mean to be selfish, but I really didn't feel well and wanted to go. I just hope the other nurse doesn't get upset with me.

    Where I used to work, it was always the PRN nurses who were sent home first (or called before they got there and told not to come in). If there were more than one PRN nurse or all staff, they'd keep a log and take turns on who's off first. Some of the staff nurses would get mad that they never could get off because there was always a PRN nurse. But if a PRN nurse doesn't work, they don't get paid. However, a staff nurse still gets their pay & benefits when they get called off. So, I can see where the hospital would want someone who's PRN to go home first. Does anyone see this differently?
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  2. 21 Comments

  3. by   GardenDove
    Where I work, the per diem nurses are the first required to go home if no one else wants low census. However, I believe the nurses with an FTE have first choice as to if they'd like to leave. In other words, the people with an FTE have more privilages all around, as prescribed by our union contract.

    Usually low census is handed out before the shift, and if there is a request for it, the first request submited to the nrsg supervisor gets it. They write it on their sheet on their clipboard and I'm not sure if they keep track elsewhere.
  4. by   Sunflowerinsc
    Where I work, the person who's shift would be overtime is the one sent home or called to stay home. Generally you have to stay "on call" if admissions come in and you are needed. Also have a choice to go to another unit if they need extra help or if someone has called off. If it is a sister unit ,can't refuse to go but can decline to work if it isn't a sister unit. If nobody is in overtime generally the prn person is called off unless someone "really, really" wants off. When we do have a time of low pt load we take turns being off and work it out between us. But most of time we are in "full house" mode and can have all (and more) hours we want.
  5. by   Soup Turtle
    Quote from SCRN1
    Tonight, we had too many nurses for the # of patients and I got to come home early. When we first arrived for our shift, the charge nurse said somebody might be going home and I volunteered for it because I wasn't feeling well to begin with. Another nurse said, "no, I want to go home because I didn't get any sleep." (Neither had I nor the charge nurse.) The charge nurse said she'd put off as long as she could before calling the supervisor to see if they wanted someone to leave. After we'd all seen our patients and things settled down, she came over to me and said that she'd talked to the supervisor and I could go home. She said the other nurse & I were the only two who had never gotten low census, but the other nurse is staff and I'm PRN, so technically, I should be the one to go home. I didn't hesitate to accept. I didn't mean to be selfish, but I really didn't feel well and wanted to go. I just hope the other nurse doesn't get upset with me.

    Where I used to work, it was always the PRN nurses who were sent home first (or called before they got there and told not to come in). If there were more than one PRN nurse or all staff, they'd keep a log and take turns on who's off first. Some of the staff nurses would get mad that they never could get off because there was always a PRN nurse. But if a PRN nurse doesn't work, they don't get paid. However, a staff nurse still gets their pay & benefits when they get called off. So, I can see where the hospital would want someone who's PRN to go home first. Does anyone see this differently?
    What is a PRN nurse?
  6. by   matchstickxx
    Where I work, bonus pay or people into OT go home first. After that, they ask for volunteers. If we have too many volunteers, the person with the least number of previous voluntary "low census" hours gets to go home. If there is a tie, the person with the most seniority gets to go.
    If no one volunteers, PRN go first. Next, we would look at who has the least mandated "low census" hours. If there is a tie, the person with the lowest seniority goes home.
  7. by   GardenDove
    I presume a PRN nurse is a per diem?
  8. by   MsLady06
    just cancel you...thats all to it
  9. by   ilostu12
    PRN is exactly what it means....as needed. All facilities have a staff of PRN nurses, if there is a call-off or there is a need for another nurse, the PRN nurse can pick up that time. They aren't part time or full time, I guess you can look at it as a facility with it's oun agency.
  10. by   purple_rose_3
    Where I work the people on a bonus shift (overtime) go home first and then the PRN.
  11. by   Roy Fokker
    Low census:

    1. Some folks get placed "on call" (like I am tonight)
    2. Some folks are told to stay home ("flex").

    On call and flex are ususally set by rotation - your turn comes up, you're flxed/on call. Sometimes, however, people can request to be flexed or placed on call out of turn -- this is at the discretion of the charge nurse(s).


    And yes - "Staff" nurses responsibilities are different from float pool/PRN nurses. E.g. If the conflict is between calling me in or calling in a float nurse, I'd get called first. if the conflict is between flexing a float nurse or me, I'd have to stay and float pool would be flexed.
    Last edit by Roy Fokker on Jan 16, '07
  12. by   TheCommuter
    I worked PRN at a psychiatric hospital as a medication nurse and, yes, I was typically the first to be sent home when the census dropped since I was not considered a permanent employee.
  13. by   SouthernLPN2RN
    The hospital I'm at sends the prn employee home or to float first, however, it does state in the policy that a FT nurse can go home instead if they request. It has been my experience that ft nurses never get asked if they'd like to go home or stay home, they just automatically downstaff the prn nurse.
  14. by   KulRN
    at my work, depending on the overall census of the hospital....if my unit's census is low, we either get sent home ( who ever is working extra shift is the first to go) or we get floated to a different unit.

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