Breaks

[TMB RN]

I work at a Behavioral Health Hospital and rarely get a meal break while at work. Last night was a fine example. Eventhough I was busy with 5 orginal patients, a transfer from a different unit and three new admits I was told that it was my fault that I didn't get a break. I was told that I had poor time management skills and my lack of a break was essentially my own fault.

Last time I checked admit's take about an hour to complete sometimes more, transferred patients need to be oriented to the new unit as well and in the case last night the patient was not appropriate for my department and ultimately I had to get a doctors order to move her back. So, with that being said that is at least 4 hours of my evening. On top of that I completed 8 assessments, gave medications and since the hospital doesn't have a night house keeping staff I cleaned a room left filthy by the patient who was moved out. Yet, it's my fault that I didn't get a break or that I have poor time management skills? It seems to me that I worked my rear end off last night and my patients remained safe. Last I checked that was my job. In contrast isn't it your employees job to make sure their employees have appropriate breaks during their shift or get paid if they cannot take one? I hold up my end of this bargan nightly, my employer does not. I hope this isn't the norm throughout the country as I'm now in the market for a new position.

[evolvingrn, BSN, RN]

sorry we get paid if we don't get a full 30 minute uninterrupted break.

[joanna73, BSN, RN]

I have paid meal breaks because I can't leave the floor. However, that doesn't mean we can't take them....and yet I'm lucky to get 45 min out of the hour and a half we're entitled to.

[TMB RN]

Legally we should be getting breaks and/or getting paid for them. The supervisor I work with though tends to try and make you feel lousy if you take a break and if you don't trys her best to intimidate you to not request to be paid for it.

[nurse2033, MSN, RN]

Legally we should be getting breaks and/or getting paid for them. The supervisor I work with though tends to try and make you feel lousy if you take a break and if you don't trys her best to intimidate you to not request to be paid for it.

So what? Let her head turn around on its axis or speak in tongues if she wants. Insist on your break or pay for no break, this is not negotiable. Document her attempts to try and deny you your break (which is probably protected by law) and file a complaint for hostile work environment.

[Meriwhen, ASN, BSN, MSN, RN]

We are required to take breaks--if we work through them we get paid for them. Of course, the hospital would rather save the money and will stress the break.

Re dealing with difficult supervisors: when I'm the only nurse on the unit, I tell my supervisor in e-mail (cc-ed to the DON) that I can't take a break unless she either a. sends me a RN or LPN to replace me on the unit for the break or b. comes up to relieve me herself, because otherwise it's abandonment and I won't lose my license just because corporate wants to save a few dollars. I do this every single time. And somehow she always manages to find a way to get me the coverage to take the break (though a lot of the time she has to relieve me herself) or authorizes my pay for not taking a break :)

You need to stand firm...and CYA. Good luck dealing with them.

[sistasoul]

If I actually take a break off of the floor I leave work a half hour later. I never have time for a break and am also told that it is my fault. The only one who takes a break on my floor is a person close to retirement. I see people eating and charting daily- if you are lucky enough to sit down to chart in a shift. If the whole unit is doing this it is becuase there is too much to do in a day. I no longer work 12's because they routinely turn into 14-15 hours without a break. At least with the 8's it is usually only 10-11 hrs.

I dom think it is the norm unless you work as an office nurse where the office closes for an hour. Then again, maybe the nurses there have to finish up charting they don't have a chance to do. Who knows.

[joanna73, BSN, RN]

Same here. We get an hour and a half for break. I work 12s. I have never taken my full break because I'd rather leave on time.

[nola1202]

Welcome to the dark side. Since I have been a new grad some 25 years ago....gulp. Time management is the big rock thrown at the individual who does not get a break or lunch. Now most places have u punch out for 1/2 hours as the labor board can and does take this stuff seriously. My advice is, take your lunch, almost everything can wait for 1/2 hour. Seriously, it gives me time to regroup, decide what can be delegated, what I need to follow up on...and maybe have 10 min of peace from constant noise on the unit. I've worked exactly the kind of shift you describe. The next shift can assume some of the admission details. They will give you an ugly look and maybe a guilt trip, (not all, I have had many awesome co-workers who see this as a 24 hour operation.

The place I work now has 4-or 5 things the person who takes the admit must do.

(that way nothing falls through the cracks.) Initial short nsg note. (admit to, MD orders recieved/faxed to pharmacy, allergies, pt condition. etc...very short.)

Obtain MD orders, fax to pharmacy, Completion of any now orders (oxygen set-up, IV's etc.) Consents if family is there, can be delgated to LPN's. Initial assessment and these days if nothing else a very careful skin check, esp the feet and sacral/coccyx area (pressure sores pre-existing wil be paid for not aquired while at your facility) Dr.s order to treat same, on same day needed.

Dietary and lab orders for that day, Med's transcribed if you don't have E-mar systems in place. The rest can wait, Just make sure whatever orders you sign off happen. Anything you delegate, follow up on, it's your problem if it doesn't happen. Don't expect management to bend on the lunch/break thing...so, make sure to take care of yourself and your patients. I've always found it interesting that in general male nurses have less difficulty delagating and leaving things for the next shift...and they get their breaks and lunch. Rather than resent it, I decided to try to learn how and what is ok to leave, and what I should do while still taking care of myself. I do see a difference in my overall energy level and ability to think clearly when I take a little time for myself. Most of the time, I was afraid the other nurses and staff would think I was lazy or a bad nurse...what I found was some of the lazy ones were the ones who fussed the loudest, yet these were the same people who dumped on me with no problem!

I've decided the key factor in passing stuff on is to make sure it's clear what has been done and what needs to be done, don't be apologetic just state what needs to be done without an explanation as to why...a quick clean report, I did this and this is what still needs to be done. Hope this helps.

[noyesno, MSN, APRN, NP]

Same here. We get an hour and a half for break. I work 12s. I have never taken my full break because I'd rather leave on time.

I feel the same way. Leaving on time>getting full break. I hate that getting a full break means getting behind in work/charting.

:down: :down: :down: :down:

[AJPV]

In order to assist us in developing better time management skills, I propose that we petition our administrators to paint running track lane markers on the hallway floors and allow us to wear running gear. If everyone stays in their proper running lanes, hopefully we'll avoid disastrous collisions when going around corners. We also need a policy that allows us to throw supplies at our patients from the doorway rather than wasting time entering each room. Patients will receive pamphlets on admission explaining how they can do their own dressing changes and start their own caths.

[xtxrn, ASN, RN]

I have paid meal breaks because I can't leave the floor. However, that doesn't mean we can't take them....and yet I'm lucky to get 45 min out of the hour and a half we're entitled to.

Wow- 1 1/2 hours I couldn't leave the floor ( only RN) at one hospital I worked at (great place to work, though- I loved that place) and I'd get 30 minutes.

I've always accepted that nursing is just different from other jobs in many ways, and meal breaks are part of that. They have to pay you for 30 minutes (Labor Law) after 5 hours (I think)....any 15 minute breaks are a gift, and the employer is not obligated to pay you for those, or do anything to help you get them.

i hear ya about the housecleaning stuff.... one CNA job I had at nights, we were expected to BE the housekeepers, and vacuum the entire facility that wasn't patient rooms (those were linoleum). Cleaned windows, etc....I was an agency CNA at that time, and while it didn't interfere with patient care, it was a bit unusual :)