Is flipping a coin a "fair" way to decide who stays when there is a call-in?

Sour Lemon · Dec 19, 2016

The fair thing would be for your DON to handle it ...either by covering the shift herself and getting some sort of registry staff in. It's not your problem that a nurse called in on the other unit, but it shouldn't be that unit's nurse's problem either.

llg, PhD, RN · Dec 19, 2016

Your facility should have a policy that covers such situations.

I would be on the phone to the people above me in the hierarchy and let them decide how they were going to solve their problem.

caliotter3 · Dec 19, 2016

A coin toss, really? I suppose you would be using her double heads coin?

Horseshoe, BSN, RN · Dec 19, 2016

The "fair" thing to do is get an agency nurse in. This is exactly the kind of thing that should be the DON's responsibility, given that she is, you know, the DIRECTOR OF NURSING.

SaltySarcasticSally, LPN, RN · Dec 19, 2016

I had something similar happen but the other nurse had already worked a double so obviously I had to stay. Our DON refuses to answer call offs or texts during the weekend, even if on call so no help there. My husband had to call off work since we have 3 small kids who can't be alone at night. I stayed but left a VM for my boss letting her know she needed to find coverage for my shift the next day because I wasn't coming in on 3 hours of sleep after a double. I actually resigned about a month ago, got a new PRN job. Was tired of a DON who wasn't being a DON.

blondy2061h, MSN, RN · Dec 19, 2016

So if someone on nightshift calls in you're expected to work a 36 hour shift?

My eyes are dilated, so sorry if this is littered with typos. I can't see

Here.I.Stand, BSN, RN · Dec 19, 2016

This is exactly why I inquire about their emergency staffing plan before taking jobs. :mad: It was neither your problem nor hers.

macawake, MSN · Dec 19, 2016

Anyways, around 10 pm, the nurse from the other unit comes over to me and says, "We have a problem. The night nurse for my unit has called in, and I've tried calling everyone on the list, including the DON. Only one person has picked up, and they can't do it. One of us has to stay." She then looks at me as if she expects me to volunteer to work her unit overnight, even though my unit is already covered for the night.
When I say that it is not possible for me to work, and that I've been mandated lately, she then goes, "Well, how do we make this fair? Should we do a coin toss or pick straws? I've been mandated recently as well."
I then go on to say that I work the next day, and she says she has to as well.
She then leaves to go back to her unit because our discussion is not getting anywhere--neither of us is budging.
I later phone over to her unit, and tell her that I've been sick lately, and cannot physically work an overnight shift. Her response was, "Well that doesn't make any sense. If you were sick, why didn't you call in?" I told her that I didn't call in because I felt I could probably make it through my shift and didn't want them to be short-staffed during that period, but that I could not, in any way, work any extra hours.
When I kept refusing to participate in a coin toss and insisted that I could not work overnight, she finally hung up the phone on me.
What are your thoughts?

My advice is that after telling the nurse on the other unit that you couldn't work the night shift is to; stick to your guns. You'd already explained your position, no need to initiate contact. Honestly, this is one of my pet peeves regarding nurses. Thinking that they have to please everyone, everytime. You didn't call because you'd had a change of heart and suddenly wanted to work the night shift on top of the shift you'd just worked. So why make the call at all?

To me, calling the other nurse to tell her that you'd been sick lately was an attempt to try to justify the rejection (of not wanting to pick up the extra shift) and perhaps trying to feel a bit better/less guilty about saying no. As far as I'm concerned you didn't owe her this explanation/justification and it only got you into a position where you felt you had to defend your position. It seems like this whole thing caused tension/conflict between the two of you, when it should have been up to management to solve staffing issues. The nurse in the other unit needed to ask her manager to solve this, not you.

I've worked with many nurses who I wish would practise saying no and learning how not to feel guilty about it. Employer.s take advantage of that guilt.

Employ.ers/mangement will never be motivated to improve staffing levels etc. for as long as nurses keep sacrificing their free time and health in order to cover unexpected/short notice vacancies in the schedule. The employer needs to have a plan B, for example agency nurses.

Just say no

oceanblue52 · Dec 19, 2016

Mandatory overtime policies are one of the worst things about working in healthcare. Tossing a coin is totally ridiculous. Not that this is your responsibility, but whoever does staffing should, at the very least, keep a log of who was last mandated, so that if it does come down to holding someone over, then at least it is more fair. A friend of mine also worked at a facility where staff got so many times they could refuse per quarter, and that was also logged. People shouldn't be forced to stay at all for safety reasons but at least policies like that attempt to make it more fair.

If you are ever in a situation where they force you to stay over, make sure it is clear that you will not be coming in for your next shift (unless you already have off). Standing firm on that creates a cascade of bring short staffed shift after shift which sometimes is enough to force the higher ups to bring agency help in.

Kooky Korky, BSN, RN · Dec 19, 2016

What if the DON's decision had been for one or the other of the 2 nurses who were present to stay?

What if they both refused?

What if they both left the building at the end of their current shift? Would the RN who had come in for Night shift had to have covered the whole house?

What if all nurses who are ever faced with such a mess, such disrespect for them and for the patients were to report these incidents to state and Fed lawmakers? Make it known to the public? Go on strike? Form unions?

This has been an issue since forever and will always be an issue as long as nurses don't stand up for themselves and the patients.

JadedCPN, BSN, RN · Dec 19, 2016

Not that this is your responsibility, but whoever does staffing should, at the very least, keep a log of who was last mandated, so that if it does come down to holding someone over, then at least it is more fair. A friend of mine also worked at a facility where staff got so many times they could refuse per quarter, and that was also logged. People shouldn't be forced to stay at all for safety reasons but at least policies like that attempt to make it more fair.

Working in large pediatric hospitals for over 10 years, I've been fortunate enough to note encounter mandatory staffing issues related to call offs. When I worked in the Midwest, there were times where a nurse would have to stay over an hour or so to cover for the oncoming shift who was going to be late due to a snow storm. This was handled by keeping a log of whose "turn" it was to stay and wait, and then rotating turns based on the last date. That is the same process that was used for mandatory floating as well.