Suggestions???????

  1. i am a manager in an er for thos eof you who don't know me. here is a situation i am trying to deal with right now.
    in april we opened up four more beds, for a thru-care/fast track area. it required getting two more positions approved. the positions were approved.....but they were filled by people in the er already. these people were/are 3-11p, 9 days a pay period. the positions they filled were 1100-2330, 6 days a pay period. they seem to be still in the hriring process, to fill the positions these people worked (1500-2330). the problem is if i move them now, it short staffs the evening shift more than it already is at this time. i'm not so sure we could get enough agency to cover all the holes. yet, i am sure the people waiting for the move to 1100-2330 are getting anxious and maybe a little bit po'd.
    so the question is.......do i hold them.................or let them make the move and deal with it?
    one other note: the reason why holding them doesn't effect dayshift..............is because the prn's all suck up the dayshift hours. the majoraty of our prn's don't do evenings or nights.

    please give me your thoughts..............thanks
    Last edit by CEN35 on Jul 31, '01
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  2. 18 Comments

  3. by   RNed
    Can't speak to the ER staffing but would like to respond regarding staff thinking.

    I applied to a position within the same department. Similar situation. I waited and waited and was given the explaination that once my replacement was hired, I would move.

    I did move, I was offered another job and teminated my employment after giving two weeks notice as required.

    Had they moved me within an appropriate time frame they would not be looking for two nurses, just one.

    The old saying, "a bird in the hand is better than two in the bush" rang true. Take care of what you have. Currently you have two problems and can eliminate one.

    I say move them and deal with it. Good luck
  4. by   CEN35
    it's still a tough spot red...........will wait for some more replies.
  5. by   nurs4kids
    Rick,
    I'm with RNed..move 'em while you still have 'em. I have been through this promised move wait, and I've also seen others..more often than not, the staff gets tired of waiting and finds another job. Of course, talk with your staff..explain the problem to them..see how much they're willing to work with you on this.

    just my 2cents worth
  6. by   hoolahan
    Rick, can't you tell the prn's that you have no day spots available? They will have to work eves, or nights, or not get any time. It may seem cold, but I say take care of your FT/PT people first. PRN's are supposed to fill in the holes, not make holes for FT/PT staff to fill, right?
  7. by   Zee_RN
    I'm with keeping the staff you got as happy as you can. Move 'em where they want to be, if that's possible. Better to keep them where you can rather than lose them to another facility.
  8. by   P_RN
    I don't understand how the PRNs got first pick of day spots. Seems like staff relief should be for where the need is. The full time, loyal employees should be given the consideration.

    You have 2 loyal employees who bid on and were accepted into positions for fast track. I think that they deserve to be allowed to move and begin the new shifts.

    The ER staff should be able to call on them in an actual emergency, as someone already mentioned, the fast trackees can wait. As it is they're being seen much sooner than if they were just triaged and seen in order of acuity in the main ER.
  9. by   RNforLongTime
    Rick,

    I agree with the posters who said to move the RN's to the fast track positions. Move them before you lose them.

    Secondly, why are the prns getting the day shift slots and not your regular employees? The prn's should be working the off shifts where they are needed. That is why prn's get paid the big bucks--so they can work the holes in your schedule.

    Just my 2 cents!

    Thank GOD I am not a manager who has to do scheduling--what a headache! I don't envy you one bit.

    Have a nice day!

    Kelly
  10. by   CEN35
    why we added positions: the positions posted.........1100-2330 were not dedicated to fast track. the positions were added to cover all the assignments.
    we had 13 beds, with a 4 bed fast track prior to what we have now. the problem came as we got busier and busier with increased acutiy. the fast track patients go shoved aside, and next thing you know we had icu/ccu/tele/rnf patients admitted out of fast track.
    the answer: expanded by adding four more beds dedicated to fast track only. we then made the old fast track, regular er patients.
    so we went from 13 and 4, to 17 and 4. last year we saw about 40,000.........and the census keeps growing.
    curently: we rotate staff in and out of fast track...........basically it depends who wants what? we staffed prior to the new fast track area, 7 rn's and a medic. now because of the 4 additional beds, we need to increase it to 8 rn's and a medic. those two 1100-2330 shifts cover our fast track hours from 1100-2300. it doesn't mean that they are assigned to fast track.
    why i asked: because switching those two people now........would short me, 6 days a week from 3-11pm. we are already short d/t some people leaving for agency, etc already. we may not be able to keep it all open from 1500-2300, if i make the move for them now.

    i am not mad or upset, for any suggestions. it just seemed to get off track a bit, with the new positions....they are not dedicated to fast track.............it is in general over all to help cover all the assignments........if all the holes are filled.

    as far as the prn's? we have always had holes to fill............and with the prn's we have managed. the problem now is.......they take all the holes left on dayshift, after everybodys schedule is finished. the one valid point someone brought up..............is if i move these people now........it will use up many of the dayshift holes.......which either could force the prns to pick up evenings, or force them to leave period.

    keep up the suggestions........it's got me really thinking now
  11. by   RNforLongTime
    Rick,

    After reading what you just posted, my head is spinning.

    Yet another reason why I am not and will not ever be in a management position..Scheduling is a big PITA and you can never please everyone.

    Good luck!

    Kelly
  12. by   P_RN
    rick i have one more suggestion. our nm did it during the gulf war. each fte was made into 0.9 fte. that way every 9 nurses left 0.1 x 9= 0.9 nurse or one full time position.

    it was legal at our place. could you see if this would work there? our place considered 0.9 as a fte with no change in bennies or salary.
  13. by   MollyJ
    Well, to me your choices are:

    Don't move them to the new position until you've filled their positions.

    Move one of them at a time.

    Move them both now.

    Adv/disadv to 1
    Adv: stability to evenings
    disadv: employee dissatisfaction, you don't get your fast track rolling like you want to

    Adv/disadv to 2
    Adv: maintain some stability while getting your fast track started
    disadv: someone has to stay on evenings, someone will be unhappy

    Adv/disadv to 3
    Adv: they are happy and you get your fast track team rolling together now
    disadv: evenings unstability (what does the rest of the team on evenings look like? how big of an issue is this?)

    Whatever you do, keep your employees that have been promised the fast track informed of your problems (no new hires; need to maintain evening stability) and your goals. set a day by which they go to fast track "no matter what" and stick to it. Like, 4 to 8 weeks down the road--time to hire and orient. Let HR know your "no matter what" day so they take filling your position off the back burner. If you use plan 2, make sure the two folks who are scheduled to go up hear of it first. First person to accept the position goes up first. If it happened simulataneously, get their input but make the final decision on who goes up first _based on the needs of the unit_. (what overrides?: strength on evenings; strength in your fast track to hold the line at keeping it a fast track--as you and Wildtime alluded to).

    As I say to kids: This is a "no one right answer problem" there is only positives and negatives that will flow our of your decision either way. Which set of projected problems are you most willing to deal with?

    God bless middle managers.
  14. by   CEN35
    hhhmmmmmmmmmmm..........vnojin[auyr3ujjpkjfvn'akm[heph[onm[oz!!!!!!!!!!!!!! i will have to put a lot of thought into this one....and talk to a few people apparently. sighs......

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