Low census policy at your hospital?

Nurses General Nursing

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Hi-

I have a question that I am hoping to get answered here. I am a recent grad who is beginning to see the reality of working in a hospital, and the issues that I did not know existed when I was interviewing for work. One of the biggest that I can see at the moment is the issue of low census, and the policy at my hospital is as follows: I am scheduled for 36 hours per week ( 3, 12.5 hour shifts). At any time, if there is a low patient census, we are told (in rotation) to not come in, and will not be paid. However, we are expected to wait by the phone from 7 until 11, because they are able to call us back in any time during this four hour period. We are NOT paid for any of this time, and if called in, are only paid for the time we are clocked in once we get there, even though we were scheduled for and available to work for the entire shift. It also has happened once a person comes to work. You clock in, work an hour or so,and then are told to go home. However, you are also told that they might need you at 11, so you might have to come back. I saw a nurse actually do this two weeks ago. She was not paid for any of her time wasted on 2 trips to the hospital, waiting around, etc. Is this normal? Is this actually going on at other hospitals? PLEASE, tell me what your hospital's low census policy is. Are you paid for at least a minimum of say 4 hours? Do you have to wait around to be recalled? I am dying to know! This seems absolutely crazy to me. Thanks!

Specializes in med/surg.

At my hospital we can be called off 2 hours before our shift. They usually place us on call. per diems are called off first and then part-time with full-time getting the last calls. We also have a calendar in the house charge office where you can sign up for low census, if the census is then low for that day you will be the first one called, then the regular procedure is followed.

you can ask to come in anyway and they will usually call someone else off. we get 2.50 an hour on call pay and we are expected to be able to leave our house 10 minutes after the call. we can also use our vacation time to make up the hours. or you can opt not to use the vacation time and not get paid at all.

Specializes in ER OB NICU.

To cover staffing issues in a small rural hospital, it was not usually the RN s who got called off, as had to have so many of those there. BUT to aid in times of too many patients, we had to take turns being a "Star Person, which meant that if the census went up , you had to call in by one hour before time to start, and see if you were needed. Once you were called off, you were off. To be on call, like for OB call, we got very little like $1 hourly, and carried a beeper for the shirts we were scheduled on call for.

Specializes in Telemetry, Oncology, Progressive Care.
RNsRWe said:
You do? I must be jaded, LOL....I don't sit by the phone for work for any reason. If I'm off, I'm OFF. They need to decide if they want me in or not. If they want me in, I go in, I get paid my full rate. If they don't, and I'm asked to stay home, my time is my own!

Compared to my current situation, yes, I think it is fair. They would tell you up front but it wouldn't happen every time. The fact they are paying you to be on call and then giving you an time and a half when you come in even if you aren't over 40 hours yet for the week.

If our census is low, we can either be floated to another unit, cancelled, or put "on-hold".

Our "on-hold" policy is NOT required - they call and offer it and you can say yes or no. I don't know what happens if everyone says 'no' because so far, to my knowledge, someone always accepts it. While "on-hold", you're paid $5.50/hr and can be called in if needed. I work 7p-7a and the times I've been "on-hold" have always been 7p-11p when we have extra nurses leftover from the 3p-11p shift.

If you are cancelled, you're basically given the shift off and are not paid. You're not on-call so you're not expected to sit by the phone. Working overnight, I haven't noticed many cancellations for the 11p-730a part of the shift since we have less staff as it is.

The worst scenario, for me, is to come in and get floated from 7p-11p, then have to go back to my unit and start over with a new group of patients. It's pretty much impossible to get to report by 11p when you're still trying to chart out on another unit. That usually equals complete assessment and charting on a total of 11-13 patients for your shift. :angryfire

Specializes in ICU.

Our hospital got rid of 'call pay' ($4/hr) about 6 months ago. The new thing is 'flex scheduling'. The thing you should flex is your body habitus so you can assume the position. Basically the deal is this, if there is low census they will 'flex' someone back to 11, from 7. This time is not paid. Then around 10 or so they will make a decision to either cancel you or bring you in. I can tell you the next hospital I go to will not have this policy. Either cancel me or bring me in or put me on call.

Specializes in Med/Surg.

I'm actually surprised by all the anger regarding such policies...with the way the focus is all BUDGET now, hospitals have to be very careful with staffing!

My hospital has always had OWB (off with benefits) or on call time...we're just using it more and more now, than ever. We have a grid that dictates 'if you have 18 pts, you need x# RN's, x# CNA's, and so forth. So, often it would take one or two more patients to need another RN, that RN is on call. If it would take 5 more admissions, you'll give them off. We do four hour increments, but once you're home, you'll stay home as long as possible (ie today, I got called off my first four, since I was home, I got called off the rest of the shift). Call pay is 2.50 an hour, and time and a half if they call you in, minimum pay of 2 hours.

In fact, to cover costs even more, our administration has to take days off if overall census is low. That's a new thing.

I think what really bugs me is the whole "have to wait by the phone" thing. You'd be working that day anyway? I can use vacation time for call OR OWB time, that's my choice. It's just happening a LOT more in the last six months to a year. Good luck working in a hospital that DOESN'T practice this way!

Specializes in Maternal-Child/Ob-Gyne/NICU.

Here is the link for a policy from Harris County Psychiatric hopsital in Texas. At Least their policy is in writing unlike the place I work at but basically we follow the same and it seems to be working well and fair. We have to remember the hospital is also a business too. I know all too well the hardship of being cancelled my hours but its better than being laid off.

http://hcpc.uth.tmc.edu/procedures/volume1/chapter1/employee_expectations_and_qualifications-20.htm

That is a crappy low census policy! If we have low census, the hospital will call me and ask if I want to take the night off. However, we are not required to - it's purely optional. And once we're called off, we're off for good and have no obligation to wait by the phone and go in. I LOVE low census - it's like an unexpected present each and every time.

Specializes in Maternal-Child/Ob-Gyne/NICU.
uscstu4lfe said:
That is a crappy low census policy! If we have low census, the hospital will call me and ask if I want to take the night off. However, we are not required to - it's purely optional. And once we're called off, we're off for good and have no obligation to wait by the phone and go in. I LOVE low census - it's like an unexpected present each and every time.

I'm jealous! you are very lucky to have a choice!

we're not union. not sure what our "official" policy is, but our cenus has been low lately, too. I know all effort is made to cancel people who are ot or picking up extra shifts, then per diem, then regularly scheduled staff. I do know that there was an issue a few years back where float pool (who are scheduled staff, not per diem- I.e. I'm scheduled 32 hours/week) were being cancelled before anyone else, and on a very regular basis. because of this, the pendulum seems to have swung the other way, and it seems that floats rarely get cancelled now. I know the few times I have been cancelled it was always presented to me as a choice, and we are given the option to use earned time.

I believe it is state law here, but I know our policy is that if we are scheduled or called in to work, and arrive for work, we are paid a minimum of 2 hours. once we are cancelled, we have the shift off, and are not expected to wait by the phone. I doubt any of us would tolerate being put on call without pay, and I certainly would not tolerate coming in, being sent home, and called back in again!

Specializes in ER, L&D, ICU, LTC, HH.

Is this happening more and more lately? I just took a new job and they are doing this in Tennessee.

Thanks

Willow

I am working in a nursing home for almost 7 years now. The first 4 yrs of my life as a charge nurse, then got my RN and promoted to staff developer.As part of administration, if our facility is beyond our census( our cut off is 122 patients) if it is lower than that, we are force to go home 30 minutes early. So we are working only 7.5 hours in a day, and it's seems like we're working like this forever if our census is not getting better. i would like to ask somebody if you know any policy reagrding this issues.. Thank you..!

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