Call off guidelines

[MKS8806]

My unit is discussing possibly changing the ways that we currently do call offs. This is our current procedure:

1. Those that have signed up extra get called off first

2. Anyone that has requested a call off next

3. Then, PRN people get called off

4. Call off by hours - the RN(s) with the least number of hours gets called of next.

a. If there is a tie in hours, the RN that was called of longest ago is called off first

5. At the beginning of a new month, all RNs are started over at 0 and the RN called off longest ago, is the first to get called off.

There is some question as to why we are starting over each month. Some don't think its fair, because, regardless of the amount of call off hours they had the previous month, they start over at 0 each month, and, in turn, they may get called off more over a year than other employees. So should we make our call off guidelines stretch for more than a month?

Then there is question on how to handle new employees. Clearly the fairest method is the monthly method for them. Otherwise, they are going to get called off a lot in order to "catch up" on the hours everyone else has.

And preceptors...should they get called off? Could it be an incentive to be a preceptor if you don't have to get called off? I think this could be a good idea, however, if we changed to a longer term or even a yearly term, the preceptor would end up having to "make up" those hours they didn't have to take previously. So, it would be fairest, if we offer the incetive, to stick with the monthly terms.

I know there are pros and cons either way and no matter which way you go, someone is going to be upset. I understand that. I was just curious what other units in other hospitals do. Are there other ideas we could be considering.

Thanks!

[psu_213, BSN, RN]

First, I think you should get rid of rule #2..no requesting call offs. Based on previous experience this only causes problems and conflicts. Also, not sure what the "least number of hour" is all about--is this the least number of hours for which they have been called off? I would say to get rid of this all together and go to a list...start with who gone the longest without being called off, next time its the next person on the list...etc, etc. And the list does not get reset each month. Anyway, this is a thorny issue that definitely has to have a written policy...I've seen troubles if there is not one.

[klm49]

I work in Acute Dialysis. We regularly go through periods of feast or famine. We also have to decide who has to stay after hours to finish off the day. We try to keep it simple. The sequence we use was agreed to by everyone.

1. PRN staff are called off first

2. Anyone already into overtime is called off next

3. Hours worked versus days left to work that week...who is most likely to end up in OT by the end of the week

4. Part-time staff

5. Volunteers

6. Who was reduced last. They are the last to be reduced now.

Our unit clerk is able to pull the hours everyone has worked that week and uses the schedule to calculate how many hours each person has left to work before hitting overtime. That way the person with the least number of hours/day left to work that week is called off first.

The beginning of the week is always more difficult as most of us don't have many hours in yet.

It isn't a perfect system but it is the best we have worked out and one everyone as agreed is the best compromise for this week at least.

[cwa82]

On our floor, if you are overtime/signed up to work extra, you get sent home first. After that, they go by the list. Staff can put their name down if they are interested in being called off - it goes by "turns". There is a list of call-off dates for each employee - whoever was on call longest ago from that list gets sent home. We don't reset each month - its just an ongoing list. It seems to work well for us. Its a fair system, and there are always names on that list, so people rarely get put on-call if they don't want it.

[smartin13]

The way our hospital (union) works is

1. Those in overtime (which is an issue as it is ambiguous in our contract)

2. The most senior nurse gets the offer of being called off down the line

3. Once you are down to the least senior nurse there is no longer an option and you are called off

There hasn't been anyone called off yet this year, our census has been very high. Usually the more senior nurses love to take the time off so that those of us who are newer don't even get a call.

[TransplantRN3]

Our policy is pretty easy and has worked really well for us. PRN and overtime staff are always called off first. Then we go by our "list." Basically, each staff's name is listed and the date they were last on call is next to their name. We call off the person who's last call off date is the furthest back. However, if that person is called and does not want to be called off, we would offer it to the offer staff according to dates as well. If all other staff don't want to be called off either, then the original person with the oldest call off date has to be called off. It works well, and the charge nurse is responsible for writing the call off date in our record list after a staff member is called off. May sound a little confusing, but we don't have many problems with this system.

[MrChicagoRN, RN]

The starting over evey month sounds real unfair. So I could be called off on the 30th, and then again in the same week on the 1st because the slate was wiped clean? Why not just keep it on a rolling basis? If you have 5 staff and one needs to be cancelled, and none are overtime, you just check the dates that each was last cancelled & cancel the one who's gone the longest without being hit.

Our method, based on cost and for providing safe patient coverage:

1. Cancel our SSO (think internal agency staff).

2. Cancel OT shifts

3. Cancel unit based per-diem.

4. Cancel those names on the request board. They may go unpaid, or use PTO

5. Cancel according to the mandatory call off rotation list. Depending on when the need is, & when you happen to be scheduled, you may go a week, or may go 2 months.

Cancellations also must take into consideration the skill mix. We don't want 1 senior nurse working with 5 or 6 novice level nurses covering the floor.

There's also no "making up, or catching up." We focus on who was last called off, not some aggregate total. When it's your turn, it's your turn.

Cancellations are usually done in 4 hour blocks to ensure staffing if census rises or someone calls in.

New nurses are assigned primary preceptors. We seek consistency and want each new task to build on the last, so we try not to float or cancel preceptors unless the new employee is near the end of his/her rotation.

Orientees are not cancelled. We rotate our primary preceptors with each new employee, so any safety from being called off is short lived, and shared.

[Rose_Queen, BSN, MSN, RN]

We start with people who request a low census day, and most of the time there's no shortage of those folks. After that, we go alphabetically. I work OR, and generally we know almost exactly what we'll be doing the next day, so people are told the day before whether they come in or not. We do take into consideration those who are on call for the night- they get skipped that day and low census the next time it's needed. The reason we went with alphabetically was because some people were saying how they've been working at the hospital for x number of years but were new to the OR, so this took away hard feelings from some of the people who worked in the OR for 15+ years but would get preempted by someone working in the OR for a few months who had been a PCA/CNA for 20+ years in the same hospital.

[I<3H2O, BSN, RN]

We place our staff on "standby" for the 12 hour shift.

1st SB is OT

2nd is Float Pool

3rd is the person/ppl who want to take a SB day for low census

4th we have a list, calling off those who were called off the longest time ago.

Funny, I was just coming here to ask something similar to this. Will create a new post.

[evolvingrn, BSN, RN]

We do not start over every month....also preceptors usually get to go even with the person with the lowest hours so they don't have to make up tons of hours .

[meandragonbrett]

1-Agency/Travel/Anybody picking up from an outside department

2-Anybody in overtime

3-PRN

4-Weekenders working an extra shift

5-Part Time

6-Full Time

7-Weekender on regular scheduled day

We rotate the call offs based on the list above but generally never use the list unless there is agency, traveler, PRN, or another unit nurse working. We generally have a few certain people who "fight" over who gets to stay at home or go home. It's never an issue on who HAS to go home as there are usually 1-2 people who are always willing to stay at home or go home. We are also NOT forced to use our vacation time when staff is sent home/kept at home for low census.

[Mandychelle79, ASN, RN]

Our nurses

1. Volunteers

2. Picking up extra hours and PRN. If its between these two it is turn based.

3. Turn Based. A record is kept of when your last down staff was.