Arriving early and not clocking in

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On the unit at the hospital where I work, it is the culure of my unit to come to work 15-30 mins before your shift to begin your pt research and prepare for the start of your day. If nurses decide to do this, however, they are NOT allowed to clock in until the actual time they are scheduled for bc otherwise, the hospital would have to pay overtime. So we have nurses working before their shifts, and then someone comes around and reminds people to go clock in when it's actually time. Some nurses feel strongly that everyone should be doing this, and then there are others that show up about 5 mins before their shift.

Is this the culture or expectation in any other facilities?

Specializes in acute care med/surg, LTC, orthopedics.
Ottowa, not sure if you work in Canada but here in the states if you leave your patients when they have not been "passed off" to another nurse to be responsible for you can bet an abandonment charge will stick to your hide. I have worked in many states and settings as a travel nurse and NO ONE plays that in any facility that I know of. You are leaving your patient without care. If you walk out and your relief is on the highway and that patient codes, who is responsible ? From 16 years in nursing I know that the nurse who walked off is on the hook. Maybe things are different where you work but any newbies reading this had better not think about trying anything like that or you'll have a serious problem.

Our transfer of accountability regulations are likely no different than yours, the stipulations of which are very vague. What happens if your pre-op patient is being portered down to the OR and codes in the elevator? Who is accountable for this patient, the pre-op nurse or the OR nurse assuming care? What if your partner goes for break but forgets to tell you (or tells you but you didn't hear) and her patient codes? Who's accountable?

The lines are very blurred. Any one patient can have 5 different nurses on any given shift, depending on the circumstances, is there a "I now accept this patient" oath to formalize who's accountable when and where? Of course not. Since my NM does not want outgoing nurses putting in for OT while waiting for oncoming nurses to get there, presumably the TL would "officially" be accountable should push come to shove.

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I always arrive 30 mins early to work to thoroughly read through my charts. I would say half of the nurses I work with do this. This is our decision to do this and we would never ask/expect to be paid for this. I would be very upset if coming in early to review pt charts were disallowed. I see that not allowing nurses to come in 30 mins early may be becoming a trend nation wide. I hope my hospital does not get on that band wagon.

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Conquerer, you are exactly right. In my state we also have an Abandonment rule. You could risk medical negligence/malpractice and risk losing your license or worse!

The purpose of taping report is so that during your "overlap" period when the new shift comes on, you only need to give quick updates. They can listen to the detailed report on tape. We only get 15 minutes of overlap, which is more like 5-10 minutes, because oncoming shifts always like to piddle around.

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Our transfer of accountability regulations are likely no different than yours, the stipulations of which are very vague. What happens if your pre-op patient is being portered down to the OR and codes in the elevator? Who is accountable for this patient, the pre-op nurse or the OR nurse assuming care? What if your partner goes for break but forgets to tell you (or tells you but you didn't hear) and her patient codes? Who's accountable?

The lines are very blurred. Any one patient can have 5 different nurses on any given shift, depending on the circumstances, is there a "I now accept this patient" oath to formalize who's accountable when and where? Of course not. Since my NM does not want outgoing nurses putting in for OT while waiting for oncoming nurses to get there, presumably the TL would "officially" be accountable should push come to shove.

If you are taking your patient to the OR then you are. If the OR nurse has the patient (meaning you have reported OFF to them) then they are. If you leave for a break and don't have a clearly designated nurse looking after your patients then it's still on you. In my experience the lines are not blurry at all and my patients don't have multiple nurses assigned to them in a given shift, just me. Our rule of thumb is that once you accept report those patients are your responsibility until you report off to another nurse. You can easily defend yourself if a pt codes in an elevator and POSSIBLY if they code while you are on a break. You will have your license swiftly revoked/suspended if you tell the BON that you just walked off the unit, got in your car, and drove away with no one responsible for your assignment because you didn't feel like waiting for your relief. And you should.:up:

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Specializes in neurology, cardiology, ED.

It used to be the culture where I work that nurses were expected to show up 15-30 minutes early, clock in, and then start getting report. Then it came to the attention of the union that even if you "clocked in" at 1840, the facility did not start paying you until 1900. There was a lawsuit, the facility was required to pay anyone who did this back-pay for all of their time (thousands of dollars for some people), and now you can't clock in until 1853. But some of the older nurses still show up early. Most do not. Why work if you aren't getting paid?

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To the poster who asked what kind of unit I work on where I only get 4 pts...it's a cardiac step down unit.

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Specializes in acute care med/surg, LTC, orthopedics.
If you are taking your patient to the OR then you are. If the OR nurse has the patient (meaning you have reported OFF to them) then they are. If you leave for a break and don't have a clearly designated nurse looking after your patients then it's still on you. In my experience the lines are not blurry at all and my patients don't have multiple nurses assigned to them in a given shift, just me. Our rule of thumb is that once you accept report those patients are your responsibility until you report off to another nurse. You can easily defend yourself if a pt codes in an elevator and POSSIBLY if they code while you are on a break. You will have your license swiftly revoked/suspended if you tell the BON that you just walked off the unit, got in your car, and drove away with no one responsible for your assignment because you didn't feel like waiting for your relief. And you should.:up:

I don't take my patient to the OR, the porter does. I don't report to anybody, they are expecting him. So patient winds up in the OR (with another nurse looking after him). Post-op he goes to PACU, (yet another nurse looking after him.) Then after couple of hours, he returns to me. 3 "responsible" nurses in that time frame alone. Damn straight the lines are blurry.

And as already mentioned... facilities that support written or taped report, aren't going to report anybody to the BON.

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Specializes in Med/surg, Quality & Risk.
I always arrive 30 mins early to work to thoroughly read through my charts. I would say half of the nurses I work with do this. This is our decision to do this and we would never ask/expect to be paid for this. I would be very upset if coming in early to review pt charts were disallowed. I see that not allowing nurses to come in 30 mins early may be becoming a trend nation wide. I hope my hospital does not get on that band wagon.

Well I wouldn't call it a "trend," it's the law that unless you are an exempt employee, you are paid by the hour for the hours you work. The only reason an employer would discourage someone coming in early and working off the clock is because they certainly don't want to make it appear as though they're endorsing an hourly employee working without pay. In an overtime lawsuit, it can amount to damages that are triple the amount of the unpaid work the employee is owed.

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I show up at work at least 15 minutes before my shift starts because that gives me an opportunity to meet the other nurses I'll be working with on that particular shift, to chit-chat with my colleagues because I know there will be no chance to even say hello once I've clocked in, to informally converse with the off going shift, and to familiarize myself with my patient assignment.

I'm awake anyway, so why not... !!!

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Specializes in Operating Room Nursing.

There's a bunch of us who always get to work early but we sit in the tea room which is upstairs from the OR department. We eat our breakfast, chat and go downstairs when it hits 0800. Someone on this thread said something about relaxing between traffic stress and work stress and I couldn't agree more. The coorindator knows we're always there and if there is an emergency etc they ring us and ask if we can start early. If we start earlier then we leave earlier as well so it's no problem.

But I think coming in and actually looking over assignments etc is madness because technically you're working and not being paid for it.

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I do agree that it is the law, not a trend. I guess I would say the trend is, that it seems to be enforced more nowadays. I am thankful to be a nurse at a facilty who is allowed to come in and prep for my shift as I see fit. I really hope that does not change for me.

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I don’t really care. Different people, different style. As long as they don’t bother me. I come in 7 to 5 mins early. I’m a new grad. LOL I’m not willing to give Away my free time. I have 12 hours to figure out stuff about my patients.

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