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.

[Emergency RN]

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

Frankly, it would be the institution who would notify the BON that a nurse "abandoned" their patient. I would love to see the institution bring up such a charge because the next question the BON would ask is "what was the staffing?"

But I think you're missing my point. What I'm saying here is, that state BON's have acknowledged that it is ultimately the institutional employer's responsibility to provide a safe level of care, consistent with, and in line with all legal requirements, including the labor laws of whatever state they're in. By notifying you that they are at the end of their shift and that there remained patients who needed care; the individual nurse, in effect, provided notification to his or her employer. You, as the supervisor, are simply acting as agent, or representative of the institutional employer.

Ultimately, it is the institution's legal obligation to provide for the continuity of care, and that means hiring enough staff to provide for operational contingencies like sick calls, inclement weather, unexpected emergencies, etc, along with routine and ordinary staffing.

[SuesquatchRN, BSN, RN]

I understand your point. I also know that most places WOULD report the nurse for abandonment and the NYS BON has worded the alert in a deliberately vague way, making it quite clear that everything is on a case-by-case basis. I don't want to be the one to find out if my alleged "protection" has any worth.

[canoehead, BSN, RN]

I have asked the Maine BON that specific question and they said that so long as you notify your supervisor that you cannot stay, the responsibility to staff the unit falls back on them. When asked how long the notification period should be they said 2 hours. So once you get the call in, and notify your supervisor, they have 2 hours to figure it out, then you go home. Remember this would protect your nursing license, but the facility can still fire you for not following it's policies, and they can still register a complaint with the BON that would be investigated and dismissed. So lots of stress, and it might be easier to stay the extra shift and quit later.

[CapeCodMermaid, RN]

The last place I worked had a union. We also had mandated overtime in the contract. If someone didn't show up, one of the nurses had to stay. It was done on a rotating basis and only happened a few times in the year and a half I was there. I HAVE reported a nurse to the BON for abandonment. She left the building after throwing her cell phone number at the aides. No excuse for leaving a floor full of elderly people.

[juliaann]

While working as a CNA, I was required to stay until my relief showed and report had been given. Rather than citing "abandonment" my nurse manager would write us up for unprofessionalism and lack of teamwork for not "going the extra mile for our patients." Forunately, we had an awesome staffing office working hard all the time to make sure our replacements arrived on time. Fortunately for me, I'm pretty chill about stuff like that.

I'm going to echo what someone said earlier - if it looks like we're in for bad weather, I pack a bag and plan to stay. We're not allowed to work more than 20 hours in a 24 hour period, but I've done back to back 20s several times. I've also come in a day early when I know the weather is about to get bad, and just chill out at the hospital until my shift begins, so I know I won't have any trouble getting there. I bring a book, watch TV, or sleep in the overnight staff rooms (we shut down our inpatient rehab unit and converted it to 20 staff sleep rooms for people staying over or coming in early. It's a locked-down unit, and decently comfortable for wasting a day).

[kcochrane]

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.

Actually the new NYS law covers all nurses and it prohibits being required or mandated to work beyond your regular schedule hours. So if you are scheduled for 8, that is all you legally have to do. It is up to the institution to provide a plan for covering their facility without mandating staff. It is ok if nurses volunteer to stay. The only exception is in the case of a real emergency.

But I do agree with you...employers love to throw around the abandoment threat. But this law also states

The law affirms that RNs or LPNs who refuse to work beyond their regularly scheduled work hours cannot be charged with patient abandonment or neglect on that basis alone. This codifies a position statement adopted several years ago by the New York State Board for Nursing.

http://www.nysna.org/practice/mot/intro.htm

I believe MN also a similar law. So I'm with you for everyone to check thier local labor laws. :)

[elprup, BSN, RN]

CA Board of Reg Nurses states:

ABANDONMENT OF PATIENTS

Inquiries have been received by the Board of Registered Nursing (BRN) regarding which actions by a

nurse constitute patient abandonment and thus may lead to discipline against a nurse's license.

For patient abandonment to occur, the nurse must:

a) Have first accepted the patient assignment, thus establishing a nurse-patient relationship, and

then

b) Severed that nurse-patient relationship without giving reasonable notice to the appropriate

person (e.g., supervisor, patient) so that arrangements can be made for continuation of nursing

care by others.

A nurse-patient relationship begins when responsibility for nursing care of a patient is accepted by the

nurse. Failure to notify the employing agency that the nurse will not appear to work an assigned shift is not

considered patient abandonment by the BRN, nor is refusal to accept an assignment considered patient

abandonment. Once the nurse has accepted responsibility for nursing care of a patient, severing of the

nurse-patient relationship without reasonable notice may lead to discipline of a nurse's license.

RNs must exercise critical judgement regarding their individual ability to provide safe patient care when

declining or accepting requests to work overtime. A fatigued and/or sleep deprived RN may have a

diminished ability to provide safe, effective patient care. Refusal to work additional hours or shifts would

not be considered patient abandonment by the BRN.

The RN who follows the above BRN advisory statement will not be considered to have

abandoned the patient for purposes of Board disciplinary action. However, it should be noted

that the BRN has no jurisdiction over employment and contract issues."

http://www.rn.ca.gov/pdfs/regulations/npr-b-01.pdf

[Emergency RN]

I have asked the Maine BON that specific question and they said that so long as you notify your supervisor that you cannot stay, the responsibility to staff the unit falls back on them. When asked how long the notification period should be they said 2 hours. So once you get the call in, and notify your supervisor, they have 2 hours to figure it out, then you go home. Remember this would protect your nursing license, but the facility can still fire you for not following it's policies, and they can still register a complaint with the BON that would be investigated and dismissed. So lots of stress, and it might be easier to stay the extra shift and quit later.

Forgive me, but register a complaint with the BON? For what? The institution already knows what the law is, and what the BON's stance is. So would they really go through the motion of making a complaint that they know wouldn't stick, at the expense of calling attention to their own suboptimal staffing practices? LOL...

Unscrupulous nursing managers have long used this "unloaded pistol" to try to frighten nurses into doing extra for the institution. I've known some nurse managers who have actually quit rather than resort to these sorts of unethical tricks simply because to do so would become a smear on their own sense of personal integrity. The bottom line is though, there are always going to be some supervisors would not hesitate in saying a bald face lie, in order to get you to do what they want.

But I understand what you mean by your "...still fire you for not following policies." Despite this however, the institution walks a fine legal line, because their policies would still have to withstand legal muster vis a vis state (variations depending on the locality) and federal labor laws.

Again, having the aegis of a union would ensure that any individual employee is provided with the knowledge of what those laws are and their employment rights protected. That is why unscrupulous employers (not to mention unscrupulous nursing supervisors) hate unions.

[TonyaM73, ASN, RN]

Thank you all for your input. I didn't think it was legal for me to require a nurse to stay over, even though the DON said that I had to tell them this. I guess I am the monkey in the middle if this happends again. I just wish we could get some stable/reliable staff. Even if this was not illegal, I didn't plan on threatening my evening nurses. (Bad juju for staff relations, not to mention rude) Does anyone know how to look up the BON for FL? I have gone to their site and have not found anything regarding the actual nurse practice act there.

[rn/writer, RN]

Here's a link:

http://www.doh.state.fl.us/mqa/nursing/info_practiceAct.pdf

Good luck with your situation. I'm glad you aren't just passing the intimidation on to your staff.

[TonyaM73, ASN, RN]

Thank you. I couldn't imagine using that tactic myself. Most of the evening nurses at my facility work very hard, love their patients, and are reliable. I have really learned a lot from them and try to help out in any way that I can. I think that it is just plain rude to use this type of threat to people who come in on time, work their shift, don't call off unless it is a true emergency and want to go home at the end of their shift. I understand the managers not wanting to come back in after they worked all day, but they are the ones with the hiring/firing capabilities and have a say in the scheduling. The rest of us do not have any hand in this at all. The only thing that I have going for me in my position, is that if someone is late or calls off without the 2 hr notice on my shift, I have the ablility to write them up. Thank you to everyone for responding. I just needed to get my facts straight and VENT!

[CapeCodMermaid, RN]

Having a union insures having difficulty firing incompetent nurses. And since it's so easy for you all to trash management, why don't you speak to the fact that many of the so call professional nurses think nothing of calling out at the last minute? We spend hours making sure all the slots are filled for proper staffing. If someone calls out we immediately start to try to fill the shift. But if that person calls out 15 minutes before their shift, if is almost impossible to get someone to come in on such short notice.