Forced to work longer than scheduled hours....

[PrincessO]

I am a new RN at a long term care facility. I was called in after midnight on Friday to come in to work that Saturday morning to work for a few hours because they were short staffed. Even though it was my weekend off and I wasn't feeling well, I agreed to help them out and work half a shift. When I got to work that morning I told the supervisor that I would only be working for half a shift she asked, "who would be relieving you?" Of course I did not have the answer to that question as I am not a supervisor or staffing coordinator (I assumed they would try to find someone or the supervisor would take over as usual). However, when my shift was over and I tried to give report to the supervisor she refused to take the key. I called the staffing coordinator and DON and they both told me to hand the key over to the supervisor, but she refused to take the key because they were also short staffed for the next shift, which means she would be covering that shift also. She eventually took the key from me after the DON found someone that could stay over for the next shift. As you could imagine this was a very uncomfortable situation as the supervisor was very ****** off at me (I thought I was helping by coming in for a few hours so she wouldn't have to cover the whole shift). Has anyone ever had this happened where the nurse supervisor refused to take the keys? I would assume that it is their responsibility to find someone or take over the keys, not mines. Have anyone ever had this happened? What is the policy at your facility regarding this?

There is only one policy and procedure manual at our facility that is kept locked in the DON's office, which means it is nearly impossible to ever read it, as she locks it in her office when she goes home.

[chevyv, BSN, RN]

I've learned to not answer my phone when work calls. I've also been told that if I would answer and they mandate me to come in, to let them know that I'm not refusing to come in but I've had a couple of drinks and do not feel that I would be safe to drive or carry a pt load. Never had to use that one, but I've been mandated before and then learned that staffing never called anyone to see if they would come in. Ticked me off.

[chevyv, BSN, RN]

I would also add to joanna73, to get it in writing before you punch in. Once you punch in, it may be considered pt abandonment.

[joanna73, BSN, RN]

Possibly. Although I'm not sure how they could classify leaving pt abandonment when they asked for certain hours that are agreed upon. Then again, many places are slippery and underhanded, so to be safe, get it in writing.

[chevyv, BSN, RN]

In Wisconsin once you clock in you are accepting an assignment. The facility counters that after you accepted to come, in the person who was supposed to come in to relieve you wouldn't or couldn't, leaving the facility short staffed. If you can't report off to someone, it's pt abandonment and is reportable to state. That's how they mandate me.

[jadelpn, LPN, EMT-B]

Thank you JZ_RN for replying.

I thought maybe I was missing something because I am a new RN. The other supervisors have always taken responsibility for the floor if we are short staffed(which we always are), but in this particular case the supervisor refused because she knew she would also be short staffed from 3-11. She works 7-3 and 3-11 on weekends because she no longer wants to work during the weekday. Whether I stayed or left she would still be there 7-11, but usually at the desk. I thought by me coming in it would save her from at least not working the floor during the heavy morning med pass. Her beef should have been with the company and not with me. I am a new RN with no supervisory authority or pay so could not understand why she thought it would be my responsibility to deal with staffing issues. As you have stated, my "obligations are not any"more" than the supervisor". The coordinator and the DON called to tell her she had to take the keys, but she still refused until they found someone to stay over from 3-11. I have learned a valuable lesson....never to accept a partial shift. Had I just walked off and left the keys I'd be in trouble for abandoning my shift as I had nothing in writing saying that I was only supposed to work half a shift. This was a very uncomfortable situation and I could not understand how they allow this type of stuff to go on there. I am going to call the DON to make an appointment to speak with her about this in person as I feel like I was tricked. Do you have any advice? Should I type a statement or write an incident report?

I hope that the meeting will also include the staffing person. Even if the staffing person needs to call in to the meeting if she is off site. The agreement you made was with the staffing person, not the DON. I would ask to see the handbook that the DON has under lock and key. I would also be specific in that you agreed to come in on your day off for 4 hours to help out, not to take the entire shift, and the staffing person agreed to that. Otherwise, not sure what can be done at this point, and the supervisor was already spoken to by DON and management. So that is between them. Also between the staffing person and management. Now that you have the knowledge that you are more than likely going to be forced to stay longer than anticipated, unless you want the overtime and want to do that, I would not accept. The supervisor is responsible for the activities of the floor under her watch. She should negotiate for more staff should there be a short staffing issue. The staffing person should not negotiate with RN's partial shifts if that is not going to work, and she needs to be held accountable for that decision--but to the supervisor and DON. The handbook should determine what is the acceptable amount of hours in a 24 hour period someone can work. Should also have language about overtime, mandatory overtime, and if a nurse can work a partial shift or not. Ask for a copy. You should have one on hand. Sounds like you were caught up in a managment power struggle. I would be clear with the DON that you do not appreciate being put in that position when you were willing to come in for med pass to help out in good faith, to have a supervisor not allow you to be clocked out within the agreed time frame. And to think outside the box for a minute, it would be just as much money to hire part time med nurses for the off shifts than it is to pay you overtime. But in order for that to work, they need to change their practices of force stay overs, unless that is part of the handbook it is mandatory in your facility.

[forbidden2know]

Possible solution to this problem.

I'm thinking of becoming a CNA and after reading and researching these post, I was wondering if there is such a thing as applying

at several different places, to be used for fill-in's only. If this is a common problem at hospitals and nursing homes, other-words, look at it as kind of same as a substitute teacher, only not a teacher but a CNA that fills in when no one is available to work that shift.

Is there anything like that, that already exist ?

[forbidden2know]

I'M new, so please explain, what is the name of this "handbook" and why would it be kept under lock and key?

[PrincessO, MSN, RN, NP]

You were helping them out. Staffing is the facility's problem, not yours. In future, should you accept a partial shift, before you have report, say, "I've agreed to such and such time. I need to leave by...Thanks." So everyone is clear that you aren't staying. The end.

That was my full intention. I made sure all the nurses that were there on time knew that I was only staying for 4 hours, but the supervisor came in late as usual so by the time she had come in I had already accepted the keys and started my shift.

[PrincessO, MSN, RN, NP]

I would also add to joanna73, to get it in writing before you punch in. Once you punch in, it may be considered pt abandonment.

Possibly. Although I'm not sure how they could classify leaving pt abandonment when they asked for certain hours that are agreed upon. Then again, many places are slip

pery and underhanded, so to be safe, get it in writing.

These are very good ideas. I will definately get it in writing next time because who know what they would have tried. They are very sneaky and seem to always have staffing issues.

[PrincessO, MSN, RN, NP]

Possible solution to this problem.

I'm thinking of becoming a CNA and after reading and researching these post, I was wondering if there is such a thing as applying

at several different places, to be used for fill-in's only. If this is a common problem at hospitals and nursing homes, other-words, look at it as kind of same as a substitute teacher, only not a teacher but a CNA that fills in when no one is available to work that shift.

Is there anything like that, that already exist ?

Yes, there are agency CNA's that travel to different facillities and units that are short for that day(I used to do this) and there are per diem CNA's that are staffed by the facility to fill in when there is a need.

[PrincessO, MSN, RN, NP]

I'M new, so please explain, what is the name of this "handbook" and why would it be kept under lock and key?

It is the Policy and Procedure Manual. I am not sure why my facility keeps it locked up. Most facilities usually have it readily available at each nursing station. It should be readily available as you may need to reference it for certain procedures. For instance, some facilities may say to hold the GT feeding and call the doctor if you get more than 250 residual back, while others may say to hold it if you get more than 200 back. I wanted to reference it in the situation I was in regarding the staffing issue, but could not because it is locked in the DON's office, which defeats the whole purpose of it!

[bluewillow7]

As a new RN in a long term facility..worked nite shift. After one month came in and was told I would be responsible for two floors as they are short staffed. First floor had only two aides to care for patients, bed changes, etc and second floor had three aide, one of which was working with back injuries. Total of 59 patients... I had six seriously ill patients, two on thermoblankets for high fevers, two who were off the wall mentally, and had orders of .25mg of thorazine..which would not affect a flea, much less this three hundrend pound man who was manic and combative, and others were labeled "guarded".and "guarded" were more sick than all of the others....had meds for both floors..staff screaming they need more help..went to supervisor and she told me to go out onto the floor and help them..when I said it was impossible as I could not leave the the critical patients, and have meds, etc..she at first said she would try to get help. One hour later, staff asked me to call her again...when I did go to her office, found her sleeping. I said I see you are not busy, and understand by law, I can ask you to come upstairs and help.. as it was obvious she never called anyone..when she said to me..."are you refusing to help your staff " I answered, I have overload of work and and its impossible,.she answered "this sounds like insubordination..I remarked..you just used the wrong word with me...I reacted by taking the keys off my neck and put them around hers and said, now I have officially passed the responsibility of it all onto you where it belongs, and went home..also reminded her I did not abandon my patients..as she was now officially in charge and took the keys..I found better jobs and never even gave them as a reference..it was not worth my sanity...