Sick call policy - page 3

Hi everyone, I am a Nursing Director at a very small rural facility. Our professional staff is also limited, and we do not have a pool to draw from, so when we have sick call ins it really impacts... Read More

  1. by   kmchugh
    So, you managers who started this thread: Any responses? Are we being unreasonable to expect employers to come through with promised benefits without penalty? Or are you all too frightened to defend your ideas?

    Kevin McHugh
  2. by   KlareRN
    I am not frightened to defend myself...what I am is frustrated. Some nurses just continue to justify their poor behavior. Remember I never said ALL call-ins were avoidable. What we are talking about here are nurses who have abused more lenient attendance policies leaving no choice. Those who are abusing the sick benefit are the ones who are making it so difficult for everyone else. They are usually the ones who start defending their "right" to call in.

    For all of you who are saying that a make up policy is unfair and that sick time is a benefit that you are entitled to without penalty:

    How do you propose a facility cover your shift when you call in?
    Remember-
    1. We cannot "force" anyone to work over to cover
    2. Agency/pool may not be able to cover on such short notice
    3. Pulling from another unit will just make them short
    4. Your nurse manager works Mon-Fri and happens to also be sick on this particular Saturday morning
    5. We can call someone scheduled to work next Saturday and promise them the next weekend off if they will come in and cover- but we cannot require you to work next weekend when you are feeling better to cover their shift so they can cover yours today

    For all of you who tend to start slamming mgt for trying to control a bad situation....what is your answer???? Trust me- those of us in management are looking for it and if you can come up with it- you might enlighten all of us!!!
  3. by   SmilingBluEyes
    Klare-
    I saw a few good suggestions in some very thoughtful posts above, yet you did not really address them. I realize many of the posts, including mine, were RANTS and you probably did not want to hear what we were saying. But there were some very well-thought-out posts there from others; people who are probably mirroring what your staffers would say to you if you would LISTEN.

    I saw someone suggest paying a GOOD DIFFERENTIAL to cover those difficult shifts. I also saw someone suggest a Baylor Plan? I realize that would take some doing,but it might solve the issue? Or how about simply HIRING PEOPLE EXCLUSIVELY TO COVER THOSE SHIFTS? I work almost exclusively weekends,for a good reason. Also, How about reserving PUNITIVE actions for the REPEAT offender? (thereby preserving morale of the staff as a whole?).....

    Your attitude expressed in your initial post is what concerned me most. I realize you are in a difficult position, but did you really mean you do not CARE what reason a person calls in? Because that is a part of the problem if that attitude is clear to your staff. Like I said earlier, I call in legitimately. I would NEVER put my sick kids in the care of someone else...and I rarely call in sick for myself. If you cannot deal with people having lives outside the hospital and continue to punish them for using a PROMISED benefit LEGITIMATELY, expect worse staffing issues in the future. Yes, it is perceived as punitive, even though you say it is not aimed that way.

    The upshot is, you will likely be paying AGENCY nurses 2 or 3 times the amt. to cover what "regular" staffers should. I just think your "We do not care" attitude speaks volumes and will chase good people off to better pursuits, leaving you with the "troublemakers" you don't want. Good luck to you.
  4. by   ACNORN
    I have been reading all of these posts and I am so discouraged and depressed about the absolute divide between nurses who work in a management capacity and those who work in a clinical capacity. We are all nurses and should not see the other group as the enemy. I have to say that I have many staff nurses who are wonderful clinicians who rarely if ever call-in and feel like they let the team down when they absolutely must stay home. Then again there are others.........

    I guess since I'm on the management side of the fence (on most days), I can relate more to the feelings of utter frustration that the managers have when they go home on a Friday evening after working 10-12 hour days all week, you leave with staffing covered for the weekend and then a few hours later you get a bunch of last minute call-ins, you spend about an hour calling every nurse employed, leaving messages on answering machines in vain (you know you are being screened by caller ID), begging, pleading, making deals, offering an extra $100.00 bonus, you get no takers, the people who are already working don't want to stay over even a few hours (they're tired), so the manager (who is usually salaried) has to go in and work dog tired after having worked all week, and the manager is essentially working as a volunteer because we are salaried and don't get any extra money in our paycheck for working as staff. The manager resents the company and the employees who called in, but goes in anyway because if staffing is too short then patient care suffers and the nurses start resigning because the staffing is bad. When you get there the patients assigned to you are the highest acuity because the nurses are mad about staffing and are going to give you a dose of reality about how hard patient care is (as if we don't know). Then if a few nurses resign and it takes awhile to recruit new staff then the manager gets to work even more vacant shifts for free so that the remaining staff don't quit.

    Am I painting a picture here ?

    Now tell me who is being punished ?

    I really wish that we didn't have to use any "punitive" measures to cover staffing. We do require weekend make-ups for a weekend call-in, but it is on the nurse's usual shift and it is coordinated with the nurse. We also try to use a proactive approach by paying the employees an extra $100.00 for every quarter that they have perfect attendance. It doesn't stop the illegit call-ins, however. You should read the excuses on the call-in log (i.e. "I have to study", "my air conditioner broke", "I am out of town", and my personal favorite "I'm too tired"etc.). The staff EXPECT me to come in and work for free to cover call-ins whenever they happen regardless of whether I just left the place after 12 hours and they don't really care if I'm too tired. Is that a double standard or what !!

    If anything the staff nurses with good attendance and the manager are punished by having to work short too often.

    So tell me.....what is the answer? Other than the usual money schemes that do not work long term and we can't get approved anyway, our goal is to improve attendance. What should we do? Discharge half the patients on Fridays and let the call-ins happen?
  5. by   fergus51
    Originally posted by ACNORN

    If anything the staff nurses with good attendance and the manager are punished by having to work short too often.
    Man that is EXACTLY what I was trying to say. (And this is coming from a strictly staff nurse).
  6. by   KlareRN
    ACNORN-

    Thank you for telling it like it really is but be prepared...you are bound to get alot of flack for what you said. The truth is- staff nurses say "that is why you make the big bucks" not realizing that our hourly wage is usually about half of what they make because we do not get paid for anything over our salaried hours and in most facilities- nurse mgt does not get the "bonus" offered to floor staff to cover. Our "dose of reality" on the floor is done for free.

    Unfortunately most of these nurses that keep telling us to come up with an answer are the ones who can either screen the phone calls coming early Saturday from the facility or simply say "sorry- I just can't come in and help". Then they go on about their weekend off and do not give it another thought because "they are not scheduled to work".

    Also-SmilingBluEyes suggests paying a "good differential for those difficult shifts". What is a good differential? Isn't a $100.00 bonus a "good" differential when it is in addition to your overtime and shift diff that you are already getting? What do you all consider a "good" bonus to pick up a shift?
    Hiring staff to cover these shifts is impossible. At least in the northern half of Indiana- there are no nurses to hire period. We have one of our facilities that the DON is working at least 2 shifts every weekend as a staff nurse because there is NOBODY to work. Even the agencies are unable to staff alot of our buildings. The licensed staff is picking up as many shifts as they can but they are tired....and there is not much hope in thinking all the sudden it is going to rain nurses. Our company is offering a $5000.00 sign on bonus as well as tuition reimbursement and we pay very well...still no takers.
    It just doesn't look good....
    KlareRN
  7. by   OC_An Khe
    KlareRN,
    If there are truly no takers for the apparrently good compensation your facility is offerring then probably there are two things happening. First is that there truly aren't any RNs availble. If this is the case then your facility has to dowsize its patient population to fit the number of RN it does employ. If that doesn't work then it will probably go out of business as its location is uneconomical. Secondly it may have a reputation as not a good place to work, if that is the case no amount of money will entice RNs to work there. It needs to change its culture in order to attract RNs, if it doesn't the same thing will happen either downsize or go out of busines.
    Not all employers and health care facilities are going to survive this generation long shortage of RNs, the ones that do will be those that respect the RNs as professionals and provide good working conditions including a life ouside of work.
  8. by   nakitamoon
    As D.O.N . of an assisted living facility,,,,, staffing always problem (as in most LTC settings,,) after stuggling for over a year, to cover shifts with enough staff due to call ins,,,,,,, I just do the schedule and leave it up to each staff person to cover themselves,,,,, I am blessed with team players,,,,, took four years to find these ppl,,,,,, I treat them like gold,,,,, but,,,,, no one hesitates to cover for someone else and as soon as the staff member who called off is well and back at work they cover a shift for the person who worked for them,,,,,,, Realized it works much better when I placed it in thier hands,,,,,,, I don't get the call off,,,,, I just check schedule and someone has covered it,,,,, WHEW,,,,,,,,, soooooo much better for me and one less thing to worry about,,,,,,,,,,,, For example I have been short two 11-7 CNA'S for about three weeks now,,,,,, have interviewed and hired two to fill positions,,, but still going through orientation and background screening,,,,,, I have not had to ask one time for somone to cover the shifts,,,,,, everyone volunteered and I will be sure that they each get extra time off when I have full schedule,,,,,, and I also am sure to personally thank them for the work they do ,,,,,,,, praise the good stuff all the time,,,,,,, Let them know how blessed I am to have them,,,,,,, lol Works for my facility,,,,,,,,,,, Moon
  9. by   SmilingBluEyes
    NOW, NAKITA YOU ARE MY KIND OF MANAGER. Klare, you still fail to address other suggestions besides differential, or the fact you express a "We do not care what your reason" attitude. That is fine, but believe me when I do call in, i DO care that you CARE. I do care that you know I am legitimate and won't punish me for calling when I do. I say, go after the ones who say silly things like "I have to study" or other silly things. Do you think your staff don't pick up on that you don't CARE?

    I re-state what I said earlier. I would not work for management that expressed that attitude to me. I don't HAVE to, these days, thank God. I can CHOOSE MY SITUATION and I DO. I agree with you, Klare and the other managers here who say: It takes more than $$$ to keep the good staff. I am one of those "good" attendance people ( call in sick maybe 1 or 2 times a year), and don't feel "punished" to cover those who call in ill, when they make it worth my while and remember to THANK ME when I do. What do you do to REWARD your "good" people, anyhow? I still say reserve the punitive tactics for the trouble-makers.

    ATTITUDE MAKES THE DIFFERENCE. Nakita hit on it!! I would bend over BACKWARD for a manager who appreciates me in a geniune way. Thank you!
  10. by   kmchugh
    Klare

    I guess the bottom line is its a good thing there aren't more nurses like me who work for you. Otherwise, within five minutes of you publishing your "policy" for weekend call in's, you would have found yourself facing a SEVERE nursing shortage. Most of those nurses would have also given you a strong suggestion about what you could do with their letter of resignation, as well as a the original copy of your policy, which would have given you a SEVERE impaction. There are just too many jobs out there to put up with management with an "I don't care what your problems are" attitude. You better get familiar with that, lest one day you have to answer the question "what would I do if I opened a hospital and no nurses came?"

    You also wrote "Those who are abusing the sick benefit are the ones who are making it so difficult for everyone else. They are usually the ones who start defending their "right" to call in." Yeah, sure. Ain't it terrible when employees ask you to give them the benefits you promised? Next thing you know, they will actually expect you to give them off the number of days vacation you promised when you hired them. I never abused call in policy, and in fact, in the last year, I took exactly three sick days, all consecutive, and all at the absolute insistance of my own physician. But, sick days are a right, and people do get sick. Try to tell me you NEVER took a sick day for your mental health. For you to punish employees for taking the days you promised them when you hired them is the moral equivalent of running a sweat shop. If the shoe fits...

    Kevin McHugh
  11. by   SmilingBluEyes
    Sometimes, Kevin, they have to learn the HARD way. These places will lose all the "good" nurses and what is left will only multiply these problems they are having a hundredfold. There was a post previously in this thread that made reference to all institutions not surviving the ever-increasing shortage of nurses to staff them. I believe this post was right-on. Hospitals like this one won't survive ....no one will work where managment does not even "pretend" to care and cannot hide its comtempt for people who have lives outside their work.

    I for one, will continue to see only to work places where I am respected, trusted for my integrity, and allowed to use the benefits promised me when I signed on the dotted line, like any self-respecting employee will.
  12. by   Janis Noone
    I guess I cannot keep from tossing my own opinion out there too...
    When reading the horrors of nurses having to "make up" a weekend callin and especially the part about having to do any shift or place needed all I can think about is how we are designing our very own nursing shortage! How long would it take if I were the daughter, niece (or son or nephew), or friend of a person who lives under these "rules" to decide I really do not want to be a nurse? How long would it take me if I were subject to these rules to find something else?
    It seems like management who promote policies such as this have no real leadership skill and have their rules to hide behind. Why can't they deal effectively with the abusers? Why do they need policies to deal with a situation that is caused by a small few but punishes the rest?
    I also find it ironic that as nurses we can be so full of punishment and so easy to forget how to reward those who do well. I thought we were a caring profession.
    If a staff is treated badly and is not cared for I can also see why they would not care if the manager had to work all week (do they really believe what the manager does all week is work anyway?) and then has to come in to fill a staff spot. To make it even more obvious that they do not care for the manager they even give her the worst assignment...hello, I'd say the writing is on the wall.
    Maybe those in leadership positions need to plan better for contingencies such as illness, communicate better with their staff, and find a small bit of creativity to work out problems rather than resort to punishment of all. I personally would be mixing drinks in a local bar or waiting tables at a truckstop rather than work for those who treat their staff this poorly. Managers in nursing are going to have to remember that they are managing professionals and not greeters at the local WalMart. Poor management and lack of leadership may be the demise of nursing. It certainly would run me right out the door!
  13. by   PhantomRN
    well, the solution is simple....tell all the patients they must pack their little bags and go home at 5:00 on friday and they can't come back until monday at 8:00 am. does that work for everyone?

    why do we insist on fighting about this? we are all nurses and because we are all nurses we should be above this stupid petty stuff.

    i am going to get flack for this, but i believe there should be some type of policy in place for those who happen to only get sick on the weekends. those folks are being selfish and are not team players. they are the ones who think they are the only ones with kids and a life outside the hospital.

    for those folks who truly get sick on saturday: most of them are mature enough to understand that the rn who came in and worked for them gave up their saturday, which was time they could have had with their own kids and they should be allowed to get the next sat off, just as a matter of decency.

    remember that old addage if you scratch my back i will scratch yours. i think that is what we are forgeting. we are all under the inpression that if we call in mngt should cover the time we call out...guess what they do, but who do they cover it with......your fellow nurse.

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