Agency nurses refusing to work on a certain unit

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When the LTC facility I work at needs agency nurses to fill staffing needs we utilize the services of one particular agency because this agency has been reliable, easy to work with and consistenly provides for our needs. Lately though there has been an issue with its' nurses refusing to work on a certain unit. This unit is busy but doable. The residents are more alert and for the most part know what they are suppose to receive for meds and treatments and when they are due. My feeling is that agency nurses shouldn't be able to dictate what floor they will be assigned to when they agree to work at a facility. Staff nurses can't do that so why should it be tolerated with agency nurses. There seems to be a 'telephone tree' among the agency nurses so they alert each other when they read the schedule and see that one of them is booked on this unit. They then call their recruiter and refuse to come to the facility unless they are moved. I've vented to the recruiter who feels his hands are tied because he can't make nurses go where they don't want to go. I say tell your nurses upfront what is expected and don't put up with the whining. If you don't want to go back to a facility then don't but if you agree to work at a facility then don't expect to work only on the floors you want to work on. What are your feelings about this? Need advice. Thanks.

Is it such a big deal to make your regular staff work on that particular unit then? The way you're describing it, it sounds like a good enough place to work. So, why would regular staff mind going there and letting agency go where they want? Maybe you could tell them you won't put up with any whining from them and they are free not to come into work at that facility if they don't like it, just like you suggested the agency recruiter say to the agency nurses.

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I can't improve on what anyone else has said. I hope you can get an honest account from some agency nurses on what that unit is like to work on and why they don't want to be there. I suppose it could be the difference in number of residents, but honestly, it doesn't seem that bad from what you described. I used to work agency too, and only once refused to go to an institution because the staff was HORRIBLE to me and I didn't feel I could give safe care. Now, I've also worked big hospitals as an agency and, of course, got floated to floors I knew NOTHING about. I'm a cardiac surgical nurse all the way, and they'd send me to floors like urology, etc. As little as I knew, I actually felt safe going and never refused because the staff on all the units were always helpful and I knew that if I had a question they'd answer it. Like you said yourself, the beauty of being agency, or per diem, for that matter, is the flexibility. I worked as a per diem nurse for a LTC facility a while back, and whenever they called me in I agreed as long as I didn't have to work one particular unit. (Long story on why, but it wasn't safe, believe me.) Anyway, if that's the unit they needed help on then they'd float a staff nurse off another unit and I'd go to that unit. I KNOW it doesn't seem fair, I'm a staff nurse now and I see it too, but if you need the help then you do what you have to do. The unit I work on now uses NO agency, they offer incentives for the staff to cover shifts. There's no madatory overtime and it always works out. And, if we use a float, we always give them a survey asking them about their experience on our unit. If anything bad comes up (which is rarely at this point), we know we need to work on that. We don't want people refusing to come to our unit. It's happened. We've had RNs and CNAs that were supposed to float to us and as soon as they walked in the building and saw they were floating, they said they were sick and had to go home. It's awful. Nurse on our unit have refused to float to another particular unit because it's so awful to work there...they'd rather be written up. Have a good heart to heart with the agency nurses, find out what's going on. Whew! I must have felt like typing! Sorry so long! :)

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On the other hand, if I worked agency I wouldn't expect to be able to pick the unit I work on or call off because I'm booked on a unit that I don't like or I feel is more work because of the number of residents on the unit but the acuity is basic LTC and the biggest part of the job is the med pass.

Not sure how long you have worked in LTC managment but in Nursing Homes it's ALL ABOUT THE MED PASS.

If agency has refused to work this unit YOU HAVE A PROBLEM WITH THAT UNIT!!!! If I'm agency and I have to give 400 pills THAT'S 400 potential med errors. Not being as familiar with the residents puts agency at a HUGE DISADVANTAGE.

I worked for an Eden facility that had 1 longer hall & they solved the problem by redistribution. The nurse on the nearest hall was assigned the first 3 rooms of our KILLER UNIT.

Either that or keep ONLY STAFF on this "black hole" unit.

btw When you say that residents on this bigger unit are more aware...it kind of implies that your staff likes working with the residents who aren't as "with it". If this is the case...ask yourself why.

Simple answer from the other posters... use regular staff ONLY on that unit.......OR as in the Eden facility..Redistribute the work load.

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Specializes in Gerontology, Med surg, Home Health.

I've had agency nurses arrive in my building only to tell me they 'don't do subacute' or don't do admissions. Hello...your agency booked you...you have a license. What do you mean you don't do admissions? I've worked with agency nurses who,frankly, were slugs...passed the meds and that was about it. I've worked with some who were wonderful..called me the next day to make sure they hadn't forgotten anything. I think sometimes the staff nurses are a bit jealous of the agency nurses because their salary is so much better (yes,no benefits) but, sometimes the agency nurses really are not carrying their weight.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
when the ltc facility i work at needs agency nurses to fill staffing needs we utilize the services of one particular agency because this agency has been reliable, easy to work with and consistenly provides for our needs. lately though there has been an issue with its' nurses refusing to work on a certain unit. this unit is busy but doable. the residents are more alert and for the most part know what they are suppose to receive for meds and treatments and when they are due. my feeling is that agency nurses shouldn't be able to dictate what floor they will be assigned to when they agree to work at a facility. staff nurses can't do that so why should it be tolerated with agency nurses. there seems to be a 'telephone tree' among the agency nurses so they alert each other when they read the schedule and see that one of them is booked on this unit. they then call their recruiter and refuse to come to the facility unless they are moved. i've vented to the recruiter who feels his hands are tied because he can't make nurses go where they don't want to go. i say tell your nurses upfront what is expected and don't put up with the whining. if you don't want to go back to a facility then don't but if you agree to work at a facility then don't expect to work only on the floors you want to work on. what are your feelings about this? need advice. thanks.

if more than one or two agency nurses are refusing to work on a particular floor, then there's a problem with that floor. rather than bash on the agency nurses, perhaps you should be asking them what the problem is, then working on fixing it.

it could be that the residents are unhappy about having a strange nurse and giving the agency nurses a hard time. perhaps the staff of that particular floor are unfriendly and unwelcoming to agency nurses or tend to dump on them. the workload may be uneven, the difficult patients may always be assigned to the agency nurses or it may just be too busy to be doable by someone who is unfamiliar with the routine. whatever the cause, it needs to be investigated and rectified.

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Specializes in Rehab, LTC, Peds, Hospice.

Alert and oriented patients can be difficult just because they often have routines that only regular staff would know and be prepared for. They also can occupy your time quite a bit with talking and can be more than a little hostile toward newcomers. 33 patients is on the heavier side, set backs and slowness because of not having a routine can make it very hard sometimes. Doable it may be on most days, but get too many of those bad days and you'll start having these problems with staff. I agree with the rest. If your nurses are mostly frustrated on this unit something needs to change.

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I just took a job on a "Busy but Doable" Unit. HA HA HA. It is only doable if you skip meds that some nurses consider too time consuming like med pass, eye gtts, nasal spray, colace, propass and neb tx. I was actually oriented to my unit by an agency nurse and I saw first hand that this is what she did in order to get out of there within an hour of shift end. Forget any of the "extra" stuff like reordering meds, etc. While my administrators say they understand my frustration all they can say is that they are working on making the job easier. Well, until the DON takes over that med pass for a day or so alone she will not "understand" how UNDOABLE it really is. I REFUSE to skip medication, I REFUSE to be rude to the residents or their families in order to be able to get out of there within 30 minutes of my shifts end. They will continue to pay me overtime if they intend to keep me without easing the load on that Unit. There is no ward clerk to answer the phone, make appointments, and schedule labs. Currently there is only one RN Charge in the entire facility so, needless to say, help with admissions, readmissions and incidents isn't even an option. I honestly don't know what the answer is....but I do know this, I have and I consider it a must have at this facility. If I were working agency, I would REFUSE assignments on this unit, too.

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Specializes in nursing home care.

We had several agencies refuse to come to a home I worked in because the care staff were too bossy!

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Specializes in Utilization Management.

A couple of thoughts:

  • One facility's aides refused to do their jobs and slept all night while I struggled with caring for residents as well as my med passes.
  • One facility had the nurse who'd been there forever. This nurse actually told me that she was out to "get" agency nurses. I suppose she felt threatened by us, but I didn't really have to care about the dysfunctional dynamic going on in that unit. I could choose not to go back there. I assumed that this particular longtime employee was actually running off potential staffers as well. So if you've had c/o bullying going on, you might want to listen and act on the problem.
  • One facility tried to give me patients that I had no expertise with. I called my recruiter and after setting him straight (he somehow thought he could cajole me into taking patients that were out of my area of expertise), I left the agency. That was not the facility's fault, that was completely the agency's fault.

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Specializes in ED, ICU, PSYCH, PP, CEN.

I was dumped on in one ER I went to as agency (given 7 acute care rooms) and the staff nurses there were actually teasing me about it saying "agency nurses never come back twice", and one of the ones teasing me was the charge nurse.

In spite of all that I actually enjoyed my 8 hours there and liked the staff because the teasing was light hearted.

I have avoided going back though because 7 rooms really is too much and I want to keep my license.

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Lately though there has been an issue with its' nurses refusing to work on a certain unit. This unit is busy but doable. The residents are more alert and for the most part know what they are suppose to receive for meds and treatments and when they are due. My feeling is that agency nurses shouldn't be able to dictate what floor they will be assigned to when they agree to work at a facility.

I have been dealing with this from the other side for about a month. I recently began picking up some hours at a nursing home via the agency with whom I have worked PRN hours on the side for about a year.

My first day at the nursing home, I learned there were 2 wings -- let's call them #1 and #2. They work 7-7's, and I was working the midnight shift on #1. 35 residents, pretty basic. Reminded me of correctional nursing, only more incontinent of b&b than continent, and all geriatric.

My second day there, I picked up a day shift. Instead of letting me learn ONE wing of residents, they flopped me over to the other wing, #2. There was so much packed in the day, literally meds, CBGs, dressings, resp tx's, or SOMETHING scheduled pretty much every hour. Tube feeding on several residents that were all on an opposite schedule and needed flushed 3 times during my shift. My personal view of the day? By 7:30pm, I was ready to pull my hair out, and when I left I felt like I should just tear up my nursing license in little pieces and throw it up in the air like confetti. On top of everything I was responsible for, I had CNAs who thought it was their job to hold down the chairs at the nurse's station and I ended up running in between my tasks and helping people up, putting them on/off bedpans, etc. I had an admission as well, and one person I had to send to the ER to have her G-tube reinserted because no one was able to get it in after she pulled it out.

After that horrendous experience, I made sure to tell the agency I worked for that I will NOT pick up hours there if they assign me to that wing. They have been accomodating, keeping me on the wing I'm comfortable on. I also don't feel I, as an agency nurse, should be assigned to that wing because the nurse assigned to that wing is considered charge nurse, and is supposed to take call off's (which they have a lot of), contact the DON and agencies to replace staff... something I think their own core staff ought to be responsible for.

As an agency nurse, I feel like I have the luxury of being more "picky" -- I have made requests and they've been honored. If the facility doesn't want to only assign me to the wing I'm comfortable with, they don't have to use me for the hours. I can pick up hours just as easily elsewhere. I think they choose me because I am hard-working, I don't call off ever, and I am close by. Many of their agency nurses that I've met have very abrasive personalities, are rude to the CNAs, and spend more time on break than on the unit. I am a team player and by all means, if I'm capable, I'll do it, and if I don't have anything else to do I am definitely not going to tell a CNA to go get a set of vitals while I sit on my butt.

Back to what you said, you described the wing as something like "busy but doable." What's doable to you may not be doable to someone else. As an agency nurse, you sometimes work at several facilities, and don't get to know the residents, and don't know the short cuts or ways to cut corners. You as a staff nurse have probably worked that wing enough that you have developed a routine and are able to "get it done," yet you complain that agency nurses don't want to work that wing, so you must end up working it more often? Sounds like maybe you don't want to work the wing either... so maybe it IS too much to ask for one person. I definitely felt like there was too much expected from me on the wing I refuse to work, and I don't go out of my way to jeopardize my nursing license.

Sounds like you might need to have a meeting and determine why no one wants to work that wing, and how it can be made MORE "doable" so you can find nurses to staff it.

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Specializes in Rehab, LTC, Peds, Hospice.

I think it is easy to blame the staff sometimes as 'whiny' or 'lazy' and don't get me wrong there are such nurses out there. However, when there are consistent complaints and problems, it needs to be investigated.

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