IS THIS THE FUTURE OF OR NURSING?

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    Our hospital implemented a staffing system called Pro-Care. We are staffed according to the number of cases posted. We check our assignments the day before and come in 45 minutes before our case the next day and leave when the case is over. There is no such thing as a shift. If there are not enough cases to go around then you may be chosen to stay home and lose hours. Some weeks we get as little as 25 hours. Other weeks we are forced into staying late without overtime pay. My manager insists that "many" other hospitals and surgery centers are doing this. Is anyone else experiencing this new staffing "trend"?
  2. 7 Comments so far...

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    I live in the midwest and have a friend that works in O.R. Our OR used to have "core groups", nurses that did specialty of neuro, or ortho, or general, etc. Last year our hospital got rid of the core groups and has cross-trained everyone to be able to do every kind of surgery. I've heard that's working out ok, but many didn't like it. Some nurses used to get a lot of OT, because when their specialty surgery came up, they worked the case and they got the OT. They still do shifts, but it's 7a-3p and 10a-6p with no surgeries scheduled for later evening hours unless it's emergent, then the on-call nurse has to work it, unless someone that's there wants to finish out with it. There are times when someone has to go home early when there aren't too many cases scheduled, and they try to spread that around to make it as fair as possible.

    Your hours sounds unusual. It doesn't seem fair to not pay you overtime when you work it. Is no one in your facility getting overtime? Or are they scheduling your surgeries later in the day and making a lot of people come in late and stay late and yet keeping your hours just under the 40 hour mark so you still don't get the OT?

    That schedule isn't here, yet. I live in the eastern midwest.

    I always heard that OR nurses had the highest turnover of people being burned out or over worked. You would think that facilities would want to make OR nurses as happy as possible to help retain their knowledge.

    Good luck!!
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    Thanks for the reply! You were right on the money about us being kept right under 40 hrs. We do get paid OT for over 40, but my super is very adept at keeping that from happening. They are so meticulous about preventing OT that they keep hours to a minimum during the weeks that our weekend call comes up...just to make sure.
    This week they kept me off on Monday, I worked 2 hours on Tuesday, 14 hours on Wednesday, 15 hours yesterday, and 2 today...It is a nightmare that I hope doesn't catch on anywhere else. Thanks again for your reply!!
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    Doesn't it give ya a slow burn to read this? If your facitity is like ours, I bet your super gets a fat bonus for keeping overtime hours down!
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    Hi! I experienced this staffing pattern...then I found a new job!!!
    Originally posted by Rainczech:
    Our hospital implemented a staffing system called Pro-Care. We are staffed according to the number of cases posted. We check our assignments the day before and come in 45 minutes before our case the next day and leave when the case is over. There is no such thing as a shift. If there are not enough cases to go around then you may be chosen to stay home and lose hours. Some weeks we get as little as 25 hours. Other weeks we are forced into staying late without overtime pay. My manager insists that "many" other hospitals and surgery centers are doing this. Is anyone else experiencing this new staffing "trend"?
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    We have whats called MCO's(mandatory call offs) which we rotate and there are not very many days our Director makes us go home early. There are enough people who are willing to go home early so the rest of us can stay to finish our shifts. Now I work in the OR so the rest of the Hospital is a mystery to me, but I think they get MCO's more than we do. The Hospital is short on RN's so I think it doesn't apply that much anymore.
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    Yes, I have worked in hospitals like that, in Oregon, where we started each day at report by being told that we were lucky to have jobs, that there were nurses being laid off all over the country. The least senior people were always getting sent home early, even though supposedly they had been hired for 40 hour workweeks. (Read my letter I wrote in "burn out in the O.R".) to hear more sordid details.) Two solutions: form a union, and make sure that union works for you and earns the dues money you pay them. In California, no one is ever sent home early: CNA would call that "involuntary lay-offs" and absolutely not allow it. Also, you could quit and try registry or a travel assignment. When you do a travel assignment, your hours are guaranteed; most places, if they tell you, "the traveller," to go home early--don't argue--quietly do it--you will get to go home and kick back and still get paid, because your hours are guaranteed. Caution--before you take a travel assignment, go onto a travel nurse bulletin board or chat room site and solicit opinions from thiose people who have been where you might be thinking about going. They can fill you in on their experiences there; at a lot of places, the staff are intimidated by travellers, mostly, I believe, out of jealousy, because they knoew you have to be confident and highly skilled to work as a traveller. Oftentimes you get thrown in with the dooctors that the staff people can't stand to work with. But who cares? It's only temporary, some of the money is tax free, and hey!! you might even like the place enough to keep extending, or even go on staff there. Again, a caveat--some of those places offering huge bonuses, and are CONSTANTLY advertising in the journals such as AORN with big full page ads--there is a reason they need travellers or people to relocate. They are such miserable places to work, and they can't hold onto their own staff, because they treated them so badly.
    The place where I used to work is now offering a $6,000 bonus to any RN who will come work in the O.R. there--but no one in town will sign on, since the hospital has gotten such a bad reputation as to the way they treated their own staff (i.e., constantly sending us home early.) It is now a classic example of "what goes around, comes around--" they are forced to run the O.R. MOSTLY with travelers now, as they can't attract new staff. They have gone through several O.R. supervisors as well. Just remember--OR nursing is a highly skilled specialty, and they should be grateful they have us. If you are not treated like a professional in one OR, don't put up with it--because I guarantee there are places that will be thrilled to have a skilled OR nurse join their staff, even temporarily, as registry or as a traveller. Good luck, e-mail me if you want to and I will tell you where to stay away from in Oregon.
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    Oh, I forgot to mention another benefit of taking a travel assignment--NO CALL!!! I have not taken call since I was 35; I am now 46. I figure I did my years of middle of the night trauma call. Once you turn 30, it's no longer fun and challenging--just a real drain on your personal time. When you take a travel assignment, even if you have a car, it's none of their business. Since you are A TRAVELLER, you are not expected to even know how to get around town. Some facilities, too, still have the type of staff that guards their call ferociously (until they start getting burned out) and do not want the travellers to have it. Also, some hospitals are so desperate to take on a traveller to augment their staffing needs that you can pretty much call your own hours and days. When you take a travel assignment, do not let the company dictate to you what days and hours you must work-- YOU TELL THEM WHAT YOUR REQUIREMENTS ARE. If they won't deliver, I GUARANTEE there is another travel company that WILL They are fiercly competitive with each other. Let them know that you are on staff with SEVERAL companies, do not feel any particular loyalty to ANY ONE of them, and will sign with whoever best meets YOUR needs. THEN STICK TO IT. Travel companies all want you to believe that there is a "waiting list" of people anxious to jump right in and take the golden opportunity they claim they are giving you, but it's all nonsense. On my last travel assignment, I told them I would work MW only, no call, no overtime. I got it. If you do that , your housing allowance is reduced a bit, but who cares? You are free to go and work those days off with the local registry if you want to, or just enjoy having them off.


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