Feeling Forced to Stay Late?

[Kooky Korky]

I was re-reading a shift from last May about calling off for lack of sleep and was just amazed by how many posters feel obligated to work late when their relief nurse calls off.

I have never felt this way and have pretty much done it only when mandated a couple or 3 times per year.

I don't believe it's my duty to do staffing and I pretty much have worked OT or come in extra only when I want to.

The purpose of saying this is to just observe that so many of you seem to feel it's your responsibility to cover call-off's, but it is really the facility's fault to have adequate staff - unless it's a natural disaster or huge accident with lots of casualties and sick patients that couldn't really be foreseen or totally planned for. But routine daily staffing? It's just not the staff nurse's problem.

[lemur00, BSN, RN]

I always found this odd. None of the facilities I've ever worked in has made staff stay. You can choose to stay for a while for ot, but if you're working 12s you can only stay for 4 hours anyway because it's against the law to work more than 16 at a time here. And most people will only extend if it's their last shift in a row.

The incoming nurses are expected to cover the patients, never the nurse from the last shift. When you're short staffed on a shift, people take a bigger patient load or educators and charge help on the floor. We do extra things to help them, but when our shift is done, we go home without a second thought.

[Kooky Korky, BSN, RN]

I always found this odd. None of the facilities I've ever worked in has made staff stay. You can choose to stay for a while for ot, but if you're working 12s you can only stay for 4 hours anyway because it's against the law to work more than 16 at a time here. And most people will only extend if it's their last shift in a row.

The incoming nurses are expected to cover the patients, never the nurse from the last shift. When you're short staffed on a shift, people take a bigger patient load or educators and charge help on the floor. We do extra things to help them, but when our shift is done, we go home without a second thought.

While that might help 7-3 shift, the educators and other specialty nurses (wound care, MDS Coordinators, Admissions Nurse, Unit Managers ADON, DON) are not usually there at 1900 or 2300 to relieve 3-11 or 7a - 7p shift, nor are they usually there at 0700 to relieve 11-7 or 7p - 7a.

Someone stated above that once the managers have to start working the floor, Admin will start hiring. I have seen where an ADON was expected to cover call-off's. They had her to home around 11 a.m. so she could come back and work 3-11, then come back at 0700. Then had her come back to work 11-7 after working a Day shift. After 4 times of doing this ridiculous one woman coverage stunt, guess what - she quit!

[Kooky Korky, BSN, RN]

If you haven't taken report, you're not responsible for the patients. The nurse who didn't come in hasn't taken report.

There are a lot of reasons that a nurse might not show up for work: overslept, forgot, copied the schedule down wrong, resigned but wasn't taken off the schedule, called in sick but the supervisor who took the call forgot to notify the floor, got into an accident on the way to work, was arrested on the way to work or died unexpectedly at home, on the way to work or in the employee bathroom before signing in to work. I've had the police do welfare checks on the nurse who was supposed to relieve me but didn't, and I've worked a 20 hour shift, but I have never left the patients in my care without handing them off to someone who was physically present.

Just curious - what happened on the welfare checks?

[LetLoveNReasonUnite]

There's a saying that goes... "You give an inch, they take a mile"... if nurses continue to keep doing this, management and administration will not feel the strong need to staff their hospitals better. I think after a 12 hour shift, you should not have to put in a minute more.

[lemur00, BSN, RN]

While that might help 7-3 shift, the educators and other specialty nurses (wound care, MDS Coordinators, Admissions Nurse, Unit Managers ADON, DON) are not usually there at 1900 or 2300 to relieve 3-11 or 7a - 7p shift, nor are they usually there at 0700 to relieve 11-7 or 7p - 7a.

On nights we rearrange the teams or work a team alone (we have rn/lpn teams in most facilities and units), or there will be float coverage (not necessarily someone on the unit though). We also have evening and weekend managers who can approve calling in people from other units, close beds, or sometimes they will help if the situation warrants it. Still we're not expected to remain after the shift is done. Rural is a little different due to having less staff, but usually the oncoming nurses are expected to figure out how to cover all patients if relief isn't found.

Eta: additionally our union just won a fight to enshrine in the contract language that gives charge the right to call out overtime in the absence of a nurse manager. This is because the regions are creating planned shortages and not calling out shifts, hoping that people won't notice or something. They don't really want to give people that much OT.

[mrsboots87]

What about suing a nurse that is supposed to report (and, therefore, care for the patient), but did not come due to whatever reason?

That doesn't even make sense if you take the time to think about it. How can a nurse that has not stepped in the building and not taken assignment for the day be sued and held responsible for another nurse deciding to leave?

If you are too sick to come to work and call out, and the previous nurse decides to leave without reporting off. Can the family of a patient who dies sue you for being sick? Ya. I didn't think so.

[mrsboots87]

The report's not for some unknown nurse - it's for your supervisor. Your supervisor would be accepting responsibility for the patients' care. Yes, it's inconvenient for them because they would actually have to do things like get out of the office/back hall/whatever and do actual patient care, which they may not have done in years, but if something happened to the patient after you left, it would be on your supervisor's nursing license because you gave your supervisor report before you left. Not your responsibility. Once you've reported off to another nurse - in this case, your supervisor - you're in the clear.

And if that hat supervisor has already taken report for another unit, what then? If the supervisor refuses report and refuses the assignment, what then? In my LTC our supervisor do a lot. I don't k ow where you work that they sit around, but our supervisors do most admits, as well as help across all 4 units in the building. If a nurse calls off and coverage can't be found, they do take over a patient assignment. On occasion, more then one nurse will call off. Should a single nurse be responsible for 64 residents on 2 separate floors in the building?

And again, the nurse practice act is what matters on if you have to report to a nurse on the unit or can just write report and leave. In my state we can't just write report to a supervisor and hope they get it. I honestly am scared for the patients of nurses who find it ok to leave them because the clock says 7:30 and they can't wait.

[mrsboots87]

So at my jobs we were expected to stay although could only work a maximum of 16 hours in a row if I recall correctly. As others have noted their idea, philosophy or work place might have different arrangements but that was my experience. IMO nursing isn't always a clock in and clock out type gig.

FWIW regarding the "be nice in doing so" thing. I'd consider increasing your discomfort threshold especially on an open online forum. Who gives a rip if some stranger in cyber space gets snarky? Especially when there are almost always good, supportive answers as well. Life isn't all "nice" so being prepared to either ignore or address the not so nice is a worthwhile skill. :)

This is actually a labor law issue. Im not sure if it's federal level or state specific. But where I am, an employee of any facility cannot work a shift over 16 hours in a rolling 24 hour period. This means it is the employers responsibility to find you coverage before 16 hours or you could technically sue them or whatever people do when employers don't follow labor laws. If you are in a state that requires physical report to be given, you stay over the 16 hours, then take it up with the labor board. But st the same time, a fatigued nurse is an unsafe nurse, so any facility willing to keep their nurses over shifts on a regular basis is not somewhere I would ever work. Occasional mandarin is what it is. If it was weekly I would walk.

[Jules A, MSN]

There's a saying that goes... "You give an inch, they take a mile"... if nurses continue to keep doing this, management and administration will not feel the strong need to staff their hospitals better.

I hear this and agree however the way I interpreted the OP was not as a constant management problem where they are attempting to under staff but a last minute your relief called out type scenario which are totally different things, imo. I'm all for not being a martyr and accepting unsafe, disrespectful working situations but do feel I owe my coworkers and patients the common courtesy of helping out on occasion, when I can, for the unforeseen.

[Ruby Vee, BSN]

There's a saying that goes... "You give an inch, they take a mile"... if nurses continue to keep doing this, management and administration will not feel the strong need to staff their hospitals better. I think after a 12 hour shift, you should not have to put in a minute more.

So it's better to leave vulnerable patients alone while you merrily clock out? That is abandonment and will get you (justifiably) terminated from your job and possibly an investigation by a licensing board and sanctions on your license.

If a unit is so chronically understaffed that this is happening constantly, the smart and ethical thing is give notice and quit. But if it's a temporary thing because two night nurses have the flu (or on maternity leave) or a carful of carpooling nurses skidded off the freeway on the way to work, give the inch. Or even a danged mile. Leaving your patients safe is a part of your ethical responsibility.

[Kooky Korky, BSN, RN]

And if that hat supervisor has already taken report for another unit, what then? If the supervisor refuses report and refuses the assignment, what then? In my LTC our supervisor do a lot. I don't k ow where you work that they sit around, but our supervisors do most admits, as well as help across all 4 units in the building. If a nurse calls off and coverage can't be found, they do take over a patient assignment. On occasion, more then one nurse will call off. Should a single nurse be responsible for 64 residents on 2 separate floors in the building?

And again, the nurse practice act is what matters on if you have to report to a nurse on the unit or can just write report and leave. In my state we can't just write report to a supervisor and hope they get it. I honestly am scared for the patients of nurses who find it ok to leave them because the clock says 7:30 and they can't wait.

There likely are precious few nurses who would actually leave, myself included, short of a true case of simply have to leave - like a warrant for your arrest will be issued if you fail to appear in court. Or your babysitter simply cannot stay over with your kids and they are too young to be left alone.

The point of this thread is that I found it shocking how many nurses seem to feel they would be wrong to not stay if their relief failed to arrive. It's a new generation viewpoint I guess - believing that they have to stay on duty no matter how often their relief doesn't come in, no matter how sick they themselves might be, no matter what happens to their own children or other folk they care for, no matter how costly child care will be if they arrive late to get their children. I just think it is Admin's duty to staff. It is wrong, IMO, to expect a nurse to stay over every time their relief doesn't show up or is late.

If you do write Report, you have to hand it to the Sup, you don't just hope he or she gets it. That was made clear long ago in this thread.

I fear for the patients of nurses who are routinely exhausted and/or routinely forced to take more patients than they can reasonably care for properly.

[Kooky Korky, BSN, RN]

So it's better to leave vulnerable patients alone while you merrily clock out? That is abandonment and will get you (justifiably) terminated from your job and possibly an investigation by a licensing board and sanctions on your license.

If a unit is so chronically understaffed that this is happening constantly, the smart and ethical thing is give notice and quit. But if it's a temporary thing because two night nurses have the flu (or on maternity leave) or a carful of carpooling nurses skidded off the freeway on the way to work, give the inch. Or even a danged mile. Leaving your patients safe is a part of your ethical responsibility.

MERRILY would not be the way one would clock out in this situation, Ruby.

Maternity leave, even flu are foreseeable absences and should be covered by Float Pool, PRN Pool, or agency.

Let's hope to God that no one skids off the freeway.

And part of the ethical and probably legal duty of a facility's owners and Administrators/Managers is to staff properly the great majority of the time.