"Any Nurse Is Allowed to Step Up"

[SilverBells, BSN]

Short-staffing at my facility is nothing new, and I know other nurses can relate to the dilemma.  However, recently, we've had multiple staff members either become injured or quit, so many that we are now in "a staffing crisis."   There are many shifts to be picked up, and not enough floor or even agency nurses to fill them.  

We had a meeting last week about how we may need to rearrange staff assignments, including those of in management.  For one, they'll likely be pulling my co-manager back to the floor to fill some of these shifts.  This will leave me as overseeing all three of our facilities units, or 56 patients.  There is also talk of assigning a TMA only to our LTC unit and having the nurse manager (which will likely end up being me) responsible for not only managing their rehab unit(s) but also for administering all narcotics and insulins on the LTC unit and completing all nursing assessments for the unit.   I'm already working 60-70+ (even upwards of 80 sometimes) hours a week, and with this new rearrangement, I anticipate the hours will only become worse. 

Anyway, during this staff meeting, the Executive Director and Staffing Coordinator mentioned that "any nurse with a license is welcome to step up and fill in these shifts."  My co-manager has offered to fill in some and even be on-call sometimes on the weekend.  However, she will also be gone 2.5 days a week for school during the week.  Our Infection Control specialist has also volunteered to pick up a few shifts.   If I'm being honest, I haven't volunteered for anything extra at this point.  I feel as if I already have enough on my plate managing 56 patients Monday through Friday while also being nurse for one of those units.  For my own physical and mental health, I really cannot handle any more hours and need my weekends off. 

At the same time, I wonder if that comment was passively directed at me, because I haven't volunteered for anything extra.  I do worry about not being viewed as a team member and that not wanting to work extra shifts reflects poorly on me as a manager.  Any thoughts? Although I want to help out, I'm at the point I cannot do any more than I'm already asked to.  And yet, I want to be fair to my colleagues. 

[SilverBells, BSN]

I must also add that none of these extra hours or additional responsibilities would result in any additional pay.  Essentially, I'd be working for free.  

[JBMmom, MSN, NP]

You're in a tough position largely because to this point you haven't set boundaries that put you in a place to have a healthy work life balance. There are staffing crises everywhere in healthcare these days. While you are still entitled to your time off, there is definitely more of an expectation to pitch in and do extra.

You are putting in more time than is expected by your organization to complete the work of your regular job. You've mentioned many times that you put in hours far above and beyond what is expected, whether it's because the workload is more than you can reasonably manage or because you choose to spend extra time of your own. You may need to cut back on extra things in order to complete your regularly assigned work in a more reasonable amount of time so you can pick up a shift and pitch in. In all honesty, putting in the extra time to complete your job isn't helping anyone in your organization, including yourself. You don't get credit for the extra hours put in, and they don't help others in a tangible way.

It may seem unreasonable, but yes, everyone is expected to step up in many areas of healthcare these days. Best of luck finding a balance that works for you and sets you up in the best possible position to make a positive impact for your coworkers. 

[JKL33]

16 hours ago, SilverBells said:

At the same time, I wonder if that comment was passively directed at me, because I haven't volunteered for anything extra.

A fun option would be to start maintaining strict 8 hr days. Leave on the dot. Then you'll have 20 or 30+ additional hours each week in which you are free to "step up."  ?  Problem solved.

[SilverBells, BSN]

18 hours ago, JBMmom said:

You're in a tough position largely because to this point you haven't set boundaries that put you in a place to have a healthy work life balance. There are staffing crises everywhere in healthcare these days. While you are still entitled to your time off, there is definitely more of an expectation to pitch in and do extra.

You are putting in more time than is expected by your organization to complete the work of your regular job. You've mentioned many times that you put in hours far above and beyond what is expected, whether it's because the workload is more than you can reasonably manage or because you choose to spend extra time of your own. You may need to cut back on extra things in order to complete your regularly assigned work in a more reasonable amount of time so you can pick up a shift and pitch in. In all honesty, putting in the extra time to complete your job isn't helping anyone in your organization, including yourself. You don't get credit for the extra hours put in, and they don't help others in a tangible way.

It may seem unreasonable, but yes, everyone is expected to step up in many areas of healthcare these days. Best of luck finding a balance that works for you and sets you up in the best possible position to make a positive impact for your coworkers. 

Thank you for the thoughtful, well-written response.  I've started to think about how I can readjust the way I do things at work so I am able to help out if needed.  For example, it seems like most of the help is needed right away in the morning, so I might want to look at getting there earlier, with the goal of then leaving earlier. 

There's also a few things that I personally like doing that I might either minimize or put on hold because others don't find them valuable.   A lot of the time, I'm at work late documenting progess notes and updating the TARs.  I've been told that I write notes as if I'm writing a novel (in other words,  they're very long) and that some of the items I place in the TAR are unnecessary. Perhaps shortening up my progress notes and re-evaluating what I'm entering as orders will be necessary to allow me to leave at a decent time.  After all, I'm at work to be a nurse, not a secretary or author.  

Anyway, in addition to mentioning that anyone with a nursing license can step up, someone had commented something along the lines of, "We know your jobs are behind the desk, but we're needing all hands on deck until some of the regular nurses come back."  Maybe I'm overthinking things, but I do wonder if that comment was also directed at me.   It might have been directed at anyone who primarily performs office work, but I'm sure it won't go unnoticed if my co-manager is the only one adjusting her schedule. Nor is it fair or reasonable to expect her to.  Therefore, like you said, it's essential for me to find a balance that allows me to both help out and get my own job done.  I can be very stubborn and set in my ways of how I want to accomplish things, but now is the time for that to change. 

 

[hppygr8ful, ASN, RN, EMT-I]

19 hours ago, SilverBells said:

I must also add that none of these extra hours or additional responsibilities would result in any additional pay.  Essentially, I'd be working for free.  

IMHO it's time to walk! You are a Master's prepared RN. When you have time (ie... not working these crazy hour) to make looking for a job a Full Time occupation you will find something. 

Hppy

 

[SilverBells, BSN]

On 1/9/2022 at 2:11 PM, hppygr8ful said:

IMHO it's time to walk! You are a Master's prepared RN. When you have time (ie... not working these crazy hour) to make looking for a job a Full Time occupation you will find something. 

Hppy

I've thought about it.  I'd love a job that focuses more on writing or teaching, whether it be in a college or research setting.  I like the idea of being a nurse author.  I enjoyed completing my Master's thesis; my project entailed developing an educational competency for nurses working with cardiac patients.  I would love to create more projects like this, publish in nursing journals, or even write textbooks.  I don't think I'll ever find enjoyment in my current position, if I'm being honest.  It's a very thankless job and there is too much emphasis on activities and tasks I'm either not very good at, don't enjoy or both. 

[SilverBells, BSN]

However, in the meantime, I still need to figure out how to be fair to my colleagues while I figure out what to do next.  It isn't their fault that I'm likely in the wrong position, or even profession.  

[Daisy4RN]

10 hours ago, JKL33 said:

A fun option would be to start maintaining strict 8 hr days. Leave on the dot. Then you'll have 20 or 30+ additional hours each week in which you are free to "step up."  ?  Problem solved.

I am not sure if JKL was joking but this seems like a very good idea. Learn how to shorten those notes (esp since someone has already mentioned the bio) and other tasks so you can leave on time. This will indeed free up time for you to pick up those shifts AND be payed for your time! Once the Covid crisis is solved (ie they find appropriate staff or you just don’t want OT) you can bow out and continue with your regular position working appropriate hours only. 

[toomuchbaloney]

On 1/9/2022 at 9:05 AM, SilverBells said:

Thank you for the thoughtful, well-written response.  I've started to think about how I can readjust the way I do things at work so I am able to help out if needed.  For example, it seems like most of the help is needed right away in the morning, so I might want to look at getting there earlier, with the goal of then leaving earlier. 

There's also a few things that I personally like doing that I might either minimize or put on hold because others don't find them valuable.   A lot of the time, I'm at work late documenting progess notes and updating the TARs.  I've been told that I write notes as if I'm writing a novel (in other words,  they're very long) and that some of the items I place in the TAR are unnecessary. Perhaps shortening up my progress notes and re-evaluating what I'm entering as orders will be necessary to allow me to leave at a decent time.  After all, I'm at work to be a nurse, not a secretary or author.  

Anyway, in addition to mentioning that anyone with a nursing license can step up, someone had commented something along the lines of, "We know your jobs are behind the desk, but we're needing all hands on deck until some of the regular nurses come back."  Maybe I'm overthinking things, but I do wonder if that comment was also directed at me.   It might have been directed at anyone who primarily performs office work, but I'm sure it won't go unnoticed if my co-manager is the only one adjusting her schedule. Nor is it fair or reasonable to expect her to.  Therefore, like you said, it's essential for me to find a balance that allows me to both help out and get my own job done.  I can be very stubborn and set in my ways of how I want to accomplish things, but now is the time for that to change. 

 

I agree with you that the remarks are intended to inspire you, in a nice way, to stop spending so many hours on things not valued by your team members and then using those many hours as an excuse to not help out the team during unprecedented circumstances. 

How do you think you would feel if one of your coworkers spent so much time on her personal/professional areas of interest that she was unavailable to help when the team needed her most? Do you think that's how your coworkers might feel?

[Davey Do]

On 1/8/2022 at 2:36 PM, SilverBells said:

"any nurse with a license is welcome to step up and fill in these shifts." 

 

[kp2016]

On 1/10/2022 at 12:37 AM, SilverBells said:

However, in the meantime, I still need to figure out how to be fair to my colleagues while I figure out what to do next.  It isn't their fault that I'm likely in the wrong position, or even profession.  

I think the "fairest" thing you could possibly do for your colleagues is to refuse to participate in such a blatant abuse of nurses. For RNs, LPN's and aides who signed up to do X number of hours a week it is completely unacceptable that they are being bullied or forced into accepting significantly more hours. To suggested that salaried nurses even if they are managers will do them without additional pay is obscene! Can you imagine telling an electrician, plumber or pilot that they MUST work extra hours because "Insert Relevant Issue" has meant there is a huge surge of people needing their services. For bonus laughs suggest that they also do these extra hours without significant after hours/ on call bonus pay as they some how have a moral obligation to use their time and skill to assist other people.

I do not accept the notion that there is a huge shortage of nurses. There seems to be no shortage of Nurses willing to take Travel Assignments to units for 3 and 4 times the dollar pay that the local nurses are being paid on the same unit. There is however a shortage of Nurses who are willing to work in units with grossly unsafe work loads, ratios or poor compensation.

In my humble opinion the more Nurses that say NO - I will not be forced to work extra shifts, No- I will not do the work of multiple people the better off all nurses will be and the safer patients will be too! I feel like this is one of those times that the best thing you can do for yourself and your collages is lead by example by refusing to accept or participate in unfair or unsafe practices.