cancellations

Brownms46 · Feb 28, 2004

Does anyone have any ideas on how an AGENCY can decrease the number of cancellations? So far my only ideas are to charge to hospital or nursing home
less and that may not be feasible. I know some angencies do better than others because when I worked for SNI I was never cancelled.
Thanks for any input, Bess

I think they should charge hospitals a fee for cancellations, just like every other industry does. Especially when hospital request a nurse, and then cancel them several hours later, right before the shift! And they should have to pay the whole 8 hrs, if they cancel 4hrs before the shift. They can either op to have the person work as extra or pay them!

suzanne4, RN · Feb 29, 2004

Most agencies, at least all that I have ever worked for, have cancellation contracts with the hospital. But it works both ways. If the hospital cancels within two hours of the start of the shift, they have to pay the agency. BUT if the nurse cancels within the two hours or doesn't show, and the agency can't get an immediate replacement, then they have to pay the hospital for the shift. So depending on the cancellation rate of the nurses that they employ, some may no longer have a contract like them because they were having to pay out too much money. You may never call in, but all it takes are a couple to spoil it for everyone else.

Brownms46 · Feb 29, 2004

Most agencies, at least all that I have ever worked for, have cancellation contracts with the hospital. But it works both ways. If the hospital cancels within two hours of the start of the shift, they have to pay the agency. BUT if the nurse cancels within the two hours or doesn't show, and the agency can't get an immediate replacement, then they have to pay the hospital for the shift. So depending on the cancellation rate of the nurses that they employ, some may no longer have a contract like them because they were having to pay out too much money. You may never call in, but all it takes are a couple to spoil it for everyone else.

The hospital only pays the agency IF they don't call and cancel the shift within 2hrs of the start of the shift! In the 80's, the hospital had to cancel FOUR hours before the start of the shift, which gave the agency time to re-book the nurse!

Now some agencies have allow hospitals to wait ONE to ONE HALF hours before the shift starts to cancel!! Therefore making it almost impossible for the nurse to find another shift! Hospitals will request nurses, even though they KNOW they probably won't need them, because there is no cost to them to do so!

So the way I see it, the hospitals have ABUSED the system!! I have been on travel contracts, and heard supervisors or HN/NM tell charge nurses to wait until a few mins before the cancelation deadline to call and cancel a nurse! That is the reason I did travel contracts, but now I see that hospitals admin/PTB could less about their staff, and even less about the nurses they cry for help too, and then screw!

Hopefully soon I won't be dependent on either!

suzanne4, RN · Feb 29, 2004

I am not sure where you are living, but my last contract which just finished up one year ago still had the four hour cancellation. Also getting cancelled also has to do with how flexible the nurse is, and the number of different types of units that the nurse can work. And is staffing centralized through one single staffing office or is each unit responsible for their own staffing?

If I was still in the US on a full-time basis, I would definitely only consider working agency. Even though I had to pay for my benefits just knowing that I was in control was the most imporant thing to me. If I wanted a week off for vacation, I didn't think that I had to request it 6 months or even a year in advance. But I am no longer in the US, so I will have to live through the shoes of everyone else. But always remember, it is whatever that works for you is important, and you should always put yourself first and your health. Not the health of your hospital administrators or managers who have 24 hour responsibility but don't want to be called after 8 pm at night. It is THEIR responsibility.

Brownms46 · Feb 29, 2004

I am not sure where you are living, but my last contract which just finished up one year ago still had the four hour cancellation. Also getting cancelled also has to do with how flexible the nurse is, and the number of different types of units that the nurse can work. And is staffing centralized through one single staffing office or is each unit responsible for their own staffing?
If I was still in the US on a full-time basis, I would definitely only consider working agency. Even though I had to pay for my benefits just knowing that I was in control was the most imporant thing to me. If I wanted a week off for vacation, I didn't think that I had to request it 6 months or even a year in advance. But I am no longer in the US, so I will have to live through the shoes of everyone else. But always remember, it is whatever that works for you is important, and you should always put yourself first and your health. Not the health of your hospital administrators or managers who have 24 hour responsibility but don't want to be called after 8 pm at night. It is THEIR responsibility.

I have worked agency/per diem since 1981, and been a traveler since 1992. I have worked for at least 8 different agencies if not more, as I worked several agency while doing per diem, as did/do many other agency nurses. But my flexibility is limited, even though I have worked almost every area of nursing. I tend to stay away from med-surg, and definitely stay clear of LTC/AL SNF, and I don't float!

I have been across this country several times, and back. I have watched the agency nursing business go down hill, in my opinion. And the four hour notice of cancelation, has been lost in many areas! In the past, there weren't as many agencies around. Now there are like gas stations, one on every corner. So their market share is thin to say the least! Therefore they have made concessions to the hospitals, which have cost nurses their ability to feel in control of their work life! Even though they work agency!

Right here on this board, many agency nurses are, and have found it difficult to work enough shifts to make a living. Yes in the past there have been slack times, but I never saw the amount of cancelations, that I seen recently. Hospitals will allow nurse sto work short, rather than pay for an agency nurse. Or even hire enough nurses to adequately staff a unit!

I had a recruiter tell me about a hospital, that had ads for nurses for over a year. But they refused to use agency/travelers. When he asked weren't they short, they said YES, but not nothing they couldn't deal with. Yeah nothing they couldn't deal with, because they have MOT, or martyrs who feel they just have to deal with having 10 to 12 pts. with only one CNA, or even NO CNAs!

And as long as there are those who will put up with working under such conditions, being used and abused, then toss aside for the next crop that comes along....wide-eyed and naive! Not even agency nurses have any real control.

Many times I have read on here, and other sites, about how to change things. But nothing is going to change, until nurses stand up and say ENOUGH, IS ENOUGH!

I believe nurses need to change the way they think about how nursing is done. It is time for a revolution in the field of nursing, as for too long nurses have allowed their altruistic nature to be their downfall. It is this nature that allowed TPTB to profit off, degrade, belittle, and subjugate them.

I also believe the only way to have true freedom over your life, is to work for yourself....not for an agency.

suzanne4, RN · Feb 29, 2004

My last five years of working in the US, were with an agency one that I owned and still do. If you work for yourself, you are still set up as an agency. By IRS rulings you need to be set up either as a corporation or LLP. Your contracts with the hospital are the same, as those of a larger agency. What you get in the contract depends on what services that you can offer and how well that you can negotiate with the hospital administration. You are required to meet the same insurance requirements that the large agencies have to meet, etc. I personally think that this is the only way for nurses to go.

Good luck to all of you that choose to be your own boss. :balloons:

athomas91 · Feb 29, 2004

in my experience, i found that the lower paying agency's were cancelled last.....when i worked for very good paying agencies...i was the first one off the list....being able to secure contracts also helps.

BadBird, BSN, RN · Feb 29, 2004

My agency has been cancelling a lot lately to the point where I took a part time job and will probably sign with a different agency. I think to ensure less cancellations the agency should meet with the staffing of the hospitals and only schedule their nurses when needed, not just hope for the best. Don't bother schedueling me if you know there is no need, just tell me that there are no needs that day. If the hospitals agree to accept a certain amount of nurses for a particular day/shift and they cancell then they should have to pay a fine.

Brownms46 · Feb 29, 2004

suzanne4,

Thank you for the knowledge you have passed on, for those who wish to continue working in the sweat halls of all too many hospitals. But for me, working in a hospital is not the path I chose to gain my financial freedom.

Although I have had many great experiences while working in hospitals, too much about them turns me off, and no longer provide the stimulus I need to feel not only challenged, but inspired also. I no longer wish to be at the whim of the newest customer service ploy, work at a maniacal pace, or deal with egomaniacal MD's, which too many hospitals continue to refuse to rein in!

As long as hospitals give only lip service to better working conditions, better pay, benefits, and refuse to allow nurses a meaningful voice in how they work, they will continue in my mind to be the last place I want to be.

But I agree with you on encouraging all who seek to be their own boss, to do so quickly, before TBTP sucks the very life out of them. It is high time that nurses not only look outside the box, but throw the box away!

Brownms46 · Feb 29, 2004

My agency has been cancelling a lot lately to the point where I took a part time job and will probably sign with a different agency. I think to ensure less cancellations the agency should meet with the staffing of the hospitals and only schedule their nurses when needed, not just hope for the best. Don't bother schedueling me if you know there is no need, just tell me that there are no needs that day. If the hospitals agree to accept a certain amount of nurses for a particular day/shift and they cancell then they should have to pay a fine.

Totally agree, but maybe you should set up your own contract with the hospital.