I have a job that is forever short staffed and scrambling to 'plug holes' in the nursing schedule. On a daily basis, either through a phone call, text, or email, someone is appealing for a volunteer to come in early (or on a day off), or to stay over. Yes, I understand that nursing is 24/7, 365, and that 'things happen'-i.e. unforseen circumstances. However, though I consider myself a dedicated employee, I am more into my work/life balance than making extra $$. Frankly, I would like to figure out a way to work less not more. I feel like by not agreeing to these requests, it casts us in the light of not being team players or willing to 'help out' and I honestly, I am growing a little weary of it all! Any suggestions appreciated
Specializes in Nurse Leader specializing in Labor & Delivery.
4 hours ago, humerusRN said:
I actually have a wonderful nurse manager that has done that. On a WEEKEND. But she is only one body, and her hands are tied from admin re: staffing. It's a never ending circle of UGH.
Yes, to the bolded! Luckily, I think most of my staff understand that.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
As we all learned in D.A.R.E in the late 80s, “Just day no”. After a decade of nursing I believe it is part of the job description of upper management/charge nurses/house supervisors to make employees feel like they are not being a team player if you say no. It has taken me a decade to not feel guilty about it.
I wish I understood more about how staffing works in our hospital, maybe it's the same everywhere. We probably have the best rapport with our manager and our people show up. That doesn't help us in the least, every morning I hear the night charge nurse say to another floor, 'what do you need from me?' That means that both nurses and CNAs are getting floated.
Then, some fancy woman shows up about once a quarter, asks us how often we have 5 patients? Uumm, never. Because your dud floors keep taking our nurses... And, if someone does call in, they will still give away a nurse and make day shift have 7 patients. Why are they allowed to do this? Is it because we don't stand up and say NO, I'm leaving, this is unsafe? Or what?
Why don't they ever have a reserve? Why don't they have 'on call?' Why is every single day of the week always a scramble? It does nothing to boost morale, it simply compounds the issue. If you show up, you get the shaft. Nursing is a steady income, but as a profession we sure are slow learners.
Why are they allowed to do this? Is it because we don't stand up and say NO, I'm leaving, this is unsafe? Or what?
Why don't they ever have a reserve? Why don't they have 'on call?' Why is every single day of the week always a scramble? It does nothing to boost morale, it simply compounds the issue. If you show up, you get the shaft. Nursing is a steady income, but as a profession we sure are slow learners.
They are allowed to do it because the morale of the staff and safety of the patients are secondary to the financial bottom line to the PTB. In short, they don't care. Same reason they don't have a reserve, or staff on call. And you are right, as long as nurses continue to accept unsafe assignments, someone will give one to you.
I've said it before: if the budget for a fully staffed facility is x, and the dollar value of absences in a given period are y, if the next period budget isn't x + y (to replace the absent staff), leadership is prioritizing keeping the budget low over the well being of your patients and the ethical treatment and retaining of valuable staff. Which leadership is free to do; where the dishonesty comes in is selling themselves and the facility as something else, typically a place that values patients and gives great care. You can't give great care if you have a demoralized staff and not enough of them.
And thank you from the bottom of my black heart to the NMs who continue to try to do their best for their staff, especially those who pull a shift once in a while. But when you continue to allow the PTBs to staff your units in an unsafe manner, you are supporting their values, which include profits over people, both patients and staff, including yourselves. And I can understand why you'd do it, just as I understand why staff make the choices they do. But neither supports change.
My NM in the ED would often come in and help out when we got overwhelmed. The union found out and told her that she couldn't do that per the contract.
Makes no sense to me.
If you allow managers to fill in when needed, you de-incentivize leadership from staffing appropriately. I've heard union members say it's because they care about the morale of their members, I think it's more likely from the union's perspective, allowing managers to work reduces the number of possible line staff union members and therefore their negotiating clout.
Could you do any of these if you were a new nurse or would it look bad?
When you say any of these, I'm assuming you are talking about ways to say no to extra hours. And it doesn't matter if you are new or not, saying no is inconvenient for management. It's up to each of us to decide how much that matters. But a new nurse is somewhat more vulnerable than one who has been with the facility for a while.
They are allowed to do it because the morale of the staff and safety of the patients are secondary to the financial bottom line to the PTB. In short, they don't care. Same reason they don't have a reserve, or staff on call. And you are right, as long as nurses continue to accept unsafe assignments, someone will give one to you.
I've said it before: if the budget for a fully staffed facility is x, and the dollar value of absences in a given period are y, if the next period budget isn't x + y (to replace the absent staff), leadership is prioritizing keeping the budget low over the well being of your patients and the ethical treatment and retaining of valuable staff. Which leadership is free to do; where the dishonesty comes in is selling themselves and the facility as something else, typically a place that values patients and gives great care. You can't give great care if you have a demoralized staff and not enough of them.
And thank you from the bottom of my black heart to the NMs who continue to try to do their best for their staff, especially those who pull a shift once in a while. But when you continue to allow the PTBs to staff your units in an unsafe manner, you are supporting their values, which include profits over people, both patients and staff, including yourselves. And I can understand why you'd do it, just as I understand why staff make the choices they do. But neither supports change.
Thanks Katillac. I've echoed this same sentiment over the years. So many hospitals' mission statements all more or less say the same thing-blah, blah, blah, ..."to provide excellent healthcare services in a compassionate and humane manner"...blah, blah, blah-just like a used car salesman! Those lofty statements sounds good to the public, but, unfortunately, they are just lip service. Why then are their actions, as in intentional bare bones staffing, in direct opposition to this lofty statement of "excellent healthcare service"-ha! If the unsuspecting public only knew! Shaking my head
When I still did the floor, I would throw a bone every once in awhile, but made it clear I didn't plan on doing it on a full-time basis.
Remember...you may need a favor from management. So offering to help in a pinch works in your favor, but all the time...that's an issue with poor management.
I've learned very few managers are willing to self-reflect on why people are leaving. People don't quit jobs, they quit managers.
That has been my approach and what I recommend to new nurses. It's not wise to be the person who is NEVER flexible with your schedule or willing to work a little extra occasionally. Demonstrate that you are a time player. But it is also not wise to be too flexible and always say "yes." That just invites people to take advantage of you and burns you out fast.
So I recommend that new staff look ahead at the schedule and see if there is a time they could be flexible and switch to help fill a hole ... or be willing to work a few hours extra. Then let the management know that you would be available to pick up some extra time that day (or weekend) if needed. Say something like, "I can't usually switch my schedule or work extra hours on short notice ... but I could pick up a bit this weekend if you need me." That way, you get credit for being a team player and earn some extra money -- on YOUR terms -- while simultaneously reiterating your usual position that you are unavailable for last-minute additions to your schedule.
That has been my approach and what I recommend to new nurses. It's not wise to be the person who is NEVER flexible with your schedule or willing to work a little extra occasionally. Demonstrate that you are a time player. But it is also not wise to be too flexible and always say "yes." That just invites people to take advantage of you and burns you out fast.
So I recommend that new staff look ahead at the schedule and see if there is a time they could be flexible and switch to help fill a hole ... or be willing to work a few hours extra. Then let the management know that you would be available to pick up some extra time that day (or weekend) if needed. Say something like, "I can't usually switch my schedule or work extra hours on short notice ... but I could pick up a bit this weekend if you need me." That way, you get credit for being a team player and earn some extra money -- on YOUR terms -- while simultaneously reiterating your usual position that you are unavailable for last-minute additions to your schedule.
thank you-good advice! I also agree that mutual reciprocity goes a long way and I do, on occasion, stay past my shift to help out. What I object to however, is the badgering, heavy sighing, and looks of disgust when I don't buckle under to these constant requests.
I like to tack an extra overtime shift or two in every month because I'm saving up for a house - but I like to tack that on up front at the beginning of the month by perusing the holes in the schedule and volunteering rather than getting called in at the last minute. I almost always say NO when I get a text asking me to come in to work that day. And I don't feel bad about it. I work to live, not vice-versa.
klone, MSN, RN
14,857 Posts
Yes, to the bolded! Luckily, I think most of my staff understand that.