Can the DON make you stay for OT if the next shift doesn't show or is called off?

[TonyaM73]

I work in a long term care facility as the evening supervisor. I just took this position a couple of months ago, but have noticed that we have A LOT of call offs. The DON told me on Tuesday that if the 11-7 nurse calls off then it is the responsiblity of the 3-11 nurse to stay until relief is found. She told me that the 3-11 shift needs to stay at least 4 hours and then the unit manager can take the other 4 hours of the shift. Okay.....so what if no one can stay? They have other jobs, have to get home and sleep to take care of their little ones, or have a ride waiting for them outside. Last night I had a nurse call off AFTER she was suppost to be there. Called around to try to get someone and asked everyone in the building if they could do a double or at least another 4 hours, but no one could stay. I called the unit manager at that point, who poor thing had just gone to bed an hour earlier, and she came in. Obviously the nurse that called off will get in trouble for not following procedure, but where does that leave everyone else? Can the DON MAKE someone work 1/2 a shift of OT or is it the unit manager's responsablilty to fill the shift? My husband leaves at 5am in the morning, so if I ever have to stay the full shift, he will not be able to go to work on time himself, since we have 3 kids at home that he couldn't just leave. By the way this has happend twice this week. I don't know if this is a trend or if it's just a bad week, but I am concerned.

[mindlor]

That has nothing to do with patient abandonment.

Have you ever been represented by a union.

After 12 hours the average human is exhausted. Add in extreme frustration and anxiety that the nurse being required to stay is feeling and boom, there is a patient safety issue waiting to happen.

If there are nurses chronically calling out, that is a management issue.

In a union, it is recognized that situation happen where a nurse will need to work beyond their shift. A union contract makes sure that this goes down in a fair and consistent way.

Unions also help to minimize the extremely cavalier attitudes that many managers exhibit.

If their is a crying child at school, wondering where mom or dad is whilst all the other kids have been picked up....that could be considered abandonment as well......NO?

[TonyaM73, ASN, RN]

I would never leave the patients. If there was no one, I would stay. That is not the issue by any stretch, but what I am saying is can the DON make someone stay if the manager lives only a few minutes away? No one wants to come in with a situation like that, no one wants to stay when they have other obligations especially when you meet your own work obligations and this is then thrust upon you.

[SuesquatchRN, BSN, RN]

Have you ever been represented by a union.

After 12 hours the average human is exhausted. Add in extreme frustration and anxiety that the nurse being required to stay is feeling and boom, there is a patient safety issue waiting to happen.

If there are nurses chronically calling out, that is a management issue.

In a union, it is recognized that situation happen where a nurse will need to work beyond their shift. A union contract makes sure that this goes down in a fair and consistent way.

Unions also help to minimize the extremely cavalier attitudes that many managers exhibit.

If their is a crying child at school, wondering where mom or dad is whilst all the other kids have been picked up....that could be considered abandonment as well......NO?

I have been represented by a union. That has nothing to do with the requirements of my license or the content of my character. Even then I could not walk out on my unit with no one to hand-off to. If you work with people who lack the character to come in for their shifts and stay when irresponsible jerks call off no union is going to fix it. When we have a blizzard it doesn't matter whether we are union or not. I show up with an overnight bag and work a triple with 4 hours of sleep in between.

And your crying kid is not my problem. Any working parent needs bullet-proof backup plans in place, union or no.

[caliotter3]

Knowing that this nurse is unreliable, hopefully moving her to night shift was done to provide her the means to hang herself and she will soon be shown the door. But chances of this happening are slim. They just wanted to put her somewhere where her slip ups are not obvious to TPTB.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

This is one of the (many) reasons I no longer work LTC. It seems as though there is low staffing, and ANYONE is hired, and excessive call offs are tolerated just to keep the body/license. Having to stay over unless it is an extreme emergency doesn't work for me. I have young kids and tag team with my spouse. I have no local family to help out. My kids are 4 and 2 and can't be left home alone, obviously. There is no daycare for past 6pm until 7am for a 70 mile radius, and then it goes to 7pm. So seriously, what should I do? Leave my kids alone in the morning when it isn't possible for someone to supervise them? It is one thing if I know a major snow storm is coming and I can sort of "plan" on staying. (begging others to work for me and I will work their weekend or Christmas in return, etc.) It is totally different when it happens at least weekly to have to stay over b/c so and so called off AGAIN. for you know, 1/2 inch of snow, the sniffles, it happens to be a weekend, a full-moon, etc. Thankfully, this isn't allowed in PA anymore unless there is a true emergency. (not a regular "sick" call off or similar, but more like severe inclement weather. agency is supposed to be called now.)

[CoffeeRTC, BSN, RN]

This is happening alot with the CNAs and sometimes us nurses. Thankfully, our DON has helped up out and actually worked the floor or made deals with other nurses to come in or given some days off.

[rn/writer, RN]

With the abundance of nurses who can't find jobs, seems like it's time for management to cut this undependable nurse loose and hire someone who would be happy to come in.

It also strikes me as unwise to not have any PRN staff as backup. Surely it's more cost effective to keep one or two people as PRN nurses than to have to train new people when the current staff throws in the towel and says "Enough, already!"

[Emergency RN]

it is simply amazing to me how little nurses know about what "abandonment" is, and how willing don's are, to use nursing guilt against their own nurses in order to make them work harder.

fact: state bons have repeatedly stated that "abandonment" is not a charge to be used as a management staffing tool. in such cases, the onus is clearly on the institution, not the individual rn, for providing enough qualified care. in other words, at the end of your shift, you give your report to your don or nursing supervisor, and you go home. if there are no nurses there, it is the institution that is criminally liable, not the individual nurse going off duty.

for anyone who doubts this, please go to your state bon web site and read up on what constitutes abandonment.

or else, nursing ignorance will continue to be a tool for unscrupulous managers to work their nurses raw. about unions? lol... that's an easy one; they know what the law is and hold the institution to it. that is, they can't be hornswoggled like most individual nurses

abandonment and unprofessional conduct

the decision to charge a nurse with abandonment will depend on an examination of all of the circumstances surrounding a particular situation as assessed by state education department staff in consultation with a member of the state board for nursing. key questions considered include:

• did the nurse accept the patient assignment, which established a nurse-patient relationship?
  
• did the nurse provide reasonable notice when severing the nurse-patient relationship?
  
• could reasonable arrangements have been made for continuation of nursing care by others when proper notification was given?
  

an investigation by the department of abandonment charges would consider whether managerial or supervisory personnel made adequate provisions for competent staffing to ensure necessary patient care in routine situations. the department and the nurse may obtain a copy of the nurse's written notice of patient assignment refusal in the event of such an investigation. in most cases, the following situations are not examples of unprofessional conduct nor automatic violations of the regents rule:

• refusing to accept responsibility for a patient assignment(s) when the nurse has given reasonable notice to the proper agent that the nurse lacks competence to carry out the assignment.
  
• refusing the assignment of a double shift or additional hours beyond the posted work schedule when proper notification has been given.
  

source: nys nursing:practice alerts lpn practice issues:abandonment

support your nursing unions!

[SuesquatchRN, BSN, RN]

Dude. I AM the supervisor. And while the practice alert is nice, nowhere does it say you can walk out without someone to cover.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

But WHY should it fall on the off going nurse to find coverage or have to stay? She/he did their 8 or 12 hours already. They aren't the ones that called off. WHY should they be the one punished for doing what they were supposed to do? Sure they will get paid, but money really doesn't cover certain hardships. Again, like elderly parent care, child care, sometimes pet care, etc. Many people have obligations outside of their 40ish hours a week to work. There really should be a PLAN in place for WHEN, not IF something like this happens. Like PRN staff, agency, etc. Requiring people to stay when their shift is DONE is just going to create more burn out and PLANNED call offs if they know if it their turn to be mandated on a certain day when you KNOW the oncoming nurse is famous for call off's.

[Emergency RN]

Dude. I AM the supervisor. And while the practice alert is nice, nowhere does it say you can walk out without someone to cover.

The legal requirement is to tell the nursing supervisor that the nurse is at the end of their shift and that there are patients that will need coverage; you, as the supervisor, are now responsible for that patient (or to provide the needed coverage). This is what is meant by "providing notification" insofar as state BONs are concerned.

But WHY should it fall on the off going nurse to find coverage or have to stay? She/he did their 8 or 12 hours already. They aren't the ones that called off. WHY should they be the one punished for doing what they were supposed to do? Sure they will get paid, but money really doesn't cover certain hardships. Again, like elderly parent care, child care, sometimes pet care, etc. Many people have obligations outside of their 40ish hours a week to work. There really should be a PLAN in place for WHEN, not IF something like this happens. Like PRN staff, agency, etc. Requiring people to stay when their shift is DONE is just going to create more burn out and PLANNED call offs if they know if it their turn to be mandated on a certain day when you KNOW the oncoming nurse is famous for call off's.

Legally, such an argument is pointless. Your obligations outside of the institution don't matter, nor are the perceived sick call patterns of another employee. The only thing that matters to a state BON is what labor law is, and whether there was violation of professional conduct. In certain states (like NY) it is actually illegal to have an RN work longer than 16 hours continuously. Further, that RN must then have at least 10 hour rest before being returned to duty. In essence, that would mandate the next day off. Again, unions know the law and hold the employer to it. Employers have traditionally taken advantage of employee ignorance to openly flout labor laws while they fear monger employees into docile submission. They throw out words like "abandonment" and "license revocation" to cow nurses who don't know any better into doing what they want.

[SuesquatchRN, BSN, RN]

The legal requirement is to tell the nursing supervisor that the nurse is at the end of their shift and that there are patients that will need coverage; you, as the supervisor, are now responsible for that patient (or to provide the needed coverage). This is what is meant by "providing notification" insofar as state BONs are concerned.

So someone DOES get mandated. I would love to see a nurse actually walk out and defend it to the BON.