Does scheduling affect absenteeism?

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I have been a nurse about 15 years. I worked in another industry before nursing.  I had jobs where if you called in sick, there was only 1-2 other people to pick up the slack and they still had to do their own shifts.  No option to bring in a substitute on short notice.  So you knew your own health and wellbeing affected your coworkers. You took responsibility to be as accountable as possible to meet the demands of the schedule. And it was obvious that not everyone can have the same day off, holiday or otherwise. This shapes how I see calling off and showing up. 

There seems to be a different expectations from other nurses.  I was speaking to a novice nurse who was upset she had not received the exact schedule she had signed up for one scheduling period.  She was planning a camping trip and had requested to work early one week and later the next week.  She had failed to indicate in her schedule request that she would be out of town on the days in between.  I showed her how to address it in the future and suggested she email our NM about the current schedule. She was frustrated and disappointed that her requested schedule might not be guaranteed now or ever? She was not the only novice nurse caught off guard by the notion that the unit needed a certain number of nurses on every shift and so she might not get the exact schedule she wanted. 

Why are they so caught off guard by how not-flexible hospital nursing schedules sometimes can be? They will print out the schedule they requested and never check to see what the actual posted schedule turns out to be.  So they are getting called... why aren't you at work? "I don't work today?!?" 

There is truly the expectation that they get to work whatever they want? And if they get scheduled on a day they thought they were going to have off... if they bothered to look at the final posted schedule... they just call off.  

It seems like every new nurse wants to work in the hospital as it pays better than most other nursing jobs. But they want clinic hours with weekends and holidays and birthdays off? They are surprised that they don't get every holiday, mom's birthday, or whatever off? Nurses who have been at this hospital for a long time expect a seniority credit for requests for time off.  I have not been at this hospital long, so I have no seniority. Plus I change jobs and switch units, and seniority is by unit.  The novice nurses have voiced that it should be more 'fair' and it should not matter if they are new. (We do have a union.)

I have been wondering if management took more time to explain staffing needs, if that would help? Why don't some nurses see how calling off without an adequate pool of per diem and float nurses hurts their coworkers? It is a rural area that has trouble attracting nurses.

All of these nurses who call off have had to work short staffed other shifts, and all of them notify the union every time it happens. Yet it doesn't occur to them that when they call off because they did not get the exact schedule they wanted, that they are contributing to being short staffed?  They just blame the hospital - but they don't pick up on short notice when called to work either. 

They don't need to have my mindset, but how can they be made to see how their actions are detrimental to the cohesion of the unit? I wonder if they knew there was a minimum of 5 nurses signed up for each shift would make them look at scheduling differently? Is there something they are seeing that makes them feel no obligation to their coworkers and patients? 

How can I better understand their expectations for work?

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Well, a good work ethic is important and my call ins are at the rate of less than 1 every 4 years. But I'm going to challenge some of your thoughts.

On 3/19/2021 at 2:59 PM, SunDazed said:

 I was speaking to a novice nurse who was upset she had not received the exact schedule she had signed up for one scheduling period.

It seems like communicating expectations would be the simple place to start here--something like making sure they understand that if there's a situation where they really need or want the day(s) off it will have to be approved through the vacation mechanism, not just the self-scheduling mechanism. I could see how that might not be completely clear or how they might not understand that if they schedule themselves  off 3 days in a row they might get 0, 1, 2, or 3 of those days off, and they might get day 2 off and not the rest. Or however it works at your place.

On 3/19/2021 at 2:59 PM, SunDazed said:

Why don't some nurses see how calling off without an adequate pool of per diem and float nurses hurts their coworkers? It is a rural area that has trouble attracting nurses.

Absolutely none of that is their problem in any way, shape or form. I don't mean to be hard on you but your train of thought is not appropriate. You write as if these nurses are in charge of the budget and deciding staffing mechanisms and having a say in how money/profits will be spent. In fact, it's more than likely that staff nurses in any given place aren't even in charge of what color clothes they wear to work. So...I think you kind of need a reality check. ? Yes, they are responsible to show up according to the schedule. That's the piece that needs some work. But as far as whether or not the hospital has seen fit to have back-up plans to cover their own business needs when employees call in sick, that's solely their problem. Trust me, they can make plans to cover their needs if they want to badly enough.

On 3/19/2021 at 2:59 PM, SunDazed said:

Yet it doesn't occur to them that when they call off because they did not get the exact schedule they wanted, that they are contributing to being short staffed? 

I'll give you that. Seems rather uninsightful of them.

On 3/19/2021 at 2:59 PM, SunDazed said:

They just blame the hospital - but they don't pick up on short notice when called to work either. 

Well, they only have this obligation if it is part of their employment agreement/union contract. Outside of that it's another issue that is on the hospital. Again, there are ways they can work toward having more stable staffing if they want to. Generally speaking they usually prove that they just don't want to very badly.

On 3/19/2021 at 2:59 PM, SunDazed said:

I wonder if they knew there was a minimum of 5 nurses signed up for each shift would make them look at scheduling differently?

Seems like that might be helpful.

On 3/19/2021 at 2:59 PM, SunDazed said:

Is there something they are seeing that makes them feel no obligation to their coworkers and patients? 

It might be interesting to just ask them. Important to keep in mind that there have probably always been nurses who did this kind of stuff.

Also important to realize that it's sometimes kind of nuanced. For example, I'm all for work ethic and being responsible and showing up when people are expecting you unless there's some very good reason you can't. But then there are places where management screws around and tries all kinds of shenanigans to not grant vacations. And treatment of staff nurses isn't very stellar in any hospital. Like it or not, these things add up. Lastly, I have watched some of the shifts in relationships between hospitals and nurses in real time and my opinion is that hospitals were the first to declare how little they cared. I find their shenanigans especially over the last 10 years pretty much beyond the pale. They have no problem letting nurses know exactly how unimportant they are as individuals. Well...I'm not trying to be an apologist but what goes around will come around.

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Specializes in Critical Care.
On 3/19/2021 at 11:59 AM, SunDazed said:

I wonder if they knew there was a minimum of 5 nurses signed up for each shift would make them look at scheduling differently?

One of the best things I ever did many many years ago was request to be present when the schedule was made for a 4 week period for a CVICU that staffs at least 21 nurses per shift.  It gave me such a greater appreciation for what one of our ANM's goes through with each and every schedule and each and every request.  We are a union hospital as well.

Maybe you can request to see how your schedule is done and how decisions are made (if you are not already familiar)?  It could be a great way to give you confidence when chatting in passing with your co-workers (stealthy teaching moments, LOL!).

I agree how JKL33 describes the staffing issues.  That is 100% on the hospital.  Seems like maybe your union needs to address this with more umphf!

 

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2 minutes ago, CABGpatch_RN said:

Maybe you can request to see how your schedule is done and how decisions are made (if you are not already familiar)?  It could be a great way to give you confidence when chatting in passing with your co-workers (stealthy teaching moments, LOL!).

Or actually it might be nice for some of the newer staff to be invited to observe the scheduling process. It might be a great experience as long as it isn't done with a punitive/blame tone. It would just help them better understand how things work, which could be for their own benefit too.

Great idea!

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Thanks for the thoughtful replies JKL33 and CABGpatch_RN.  I was seeking to better understand another point of view; and maybe I am a little closer.  

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