How do they handle low census where you work? - page 2
Tonight, we had too many nurses for the # of patients and I got to come home early. When we first arrived for our shift, the charge nurse said somebody might be going home and I volunteered for it... Read More
Jan 16, '07Occupation: Registed Nurse Specialty: LDRP ; Joined: Oct '04; Posts: 1,679; Likes: 350Well, we just never know when an admission is coming,and, one could come up at any time and just might not be able to wait for someone to come in from home (labor and delivery) so if we have more nurses than needed, one or two stay without patients and just help out for a while. if it gets to be that we have way more nurses than patients or it gets to be like, 5 in the morning, someone goes. we ususally ask who all wants to go and draw the name out of a hat.
Jan 16, '07Occupation: RN Specialty: Open Heart/ Trauma/ Sx Stepdown/ Tele ; Joined: Jun '01; Posts: 137; Likes: 11on the extremely rare occasion of low census...first ot then we go by seniority.
Jan 17, '07Joined: Sep '05; Posts: 7,767; Likes: 1,230They ask the PRN people if they want off first. If they don't then they ask around. Often times, someone will request to leave or to be off completely. The first person in line will get it regardless if they are PRN or staff.
Jan 17, '07Occupation: Nurse of course! Specialty: NICU, PICU, educator ; From: US ; Joined: Feb '04; Posts: 1,838; Likes: 1,115When we have low census:
1. OT and ET for the day is canceled.
2. If needed we float to nurseries, the PRN is first to float.
3. If no floats or we still have extras after floating then we go by last date canceled(we keep a log). We call about 1.5-2 hours before the start of the shift. Our PRN's are always last to be canceled as they are required to work their hours based on their contract.
4. Only if no regular staff want to be canceled and the PRN isn't floated, then do we cancel the PRN.
5. If there is no PRN or we still have no volunteers to stay home, then we mandatory cancel by dates (we have a log on that too).
Jan 17, '07Occupation: Operating Room Nurse Specialty: 5 yrs OR, ASU Pre-Op 2 yr. ER ; From: US ; Joined: Jun '03; Posts: 17,036; Likes: 1,008Everyone takes their turn to go home. If someone doesn't want to lose any hours, then they might find someone to trade with.
Jan 17, '07Occupation: RN Specialty: 34 year(s) of experience in L & D; Postpartum ; From: US ; Joined: Nov '99; Posts: 9,721; Likes: 11,860Where I work, low census is handed out first by low-censusing any nurse who would be OT or working an extra shift. Low-census at our hospital can either be a call-off or on-call, but that decision is not management's. It is stated in our contract that if put on low-census, the nurse has the option of taking call or not. We have fought for years to keep this in our contract for the nurses who work in more than one facility. If on low-census at our place, they can opt for call-off and might be able to replace that lost work with another facility.
After OT people are called, then it's per diems, unless anyone else has requested it. First on the list, first called, depending on staffing needs. The full time nurses have a cap of 8 hours per pay period that they can be put on low-census as a job security issue.
Management has yet to learn that when calling the low-censused RN, they should say, "do you want to be on-call or would you prefer call-off?" I try to remind them of that, but some RN's don't know they have that option, so management bullies them into being on-call, when they don't really have the power to require them to do it. Their argument is "well, we won't have anybody to cover L & D?" Well, then you should have considered the possibility that I want the day off BEFORE you make staffing decisions. Most of the charge nurses have a feeling who will and who won't take call, and will try to feel you out before having to make the decision firm, but there are some who just don't get it, and probably never will.
Jan 17, '07Occupation: RN/MOM Specialty: cardiology-now CTICU ; Joined: Mar '06; Posts: 148; Likes: 13if we have low census we float. and float and float. they have tried to make unit nurses float to the floors before. there is always another unit that needs staff. they regularly call in staff to work extra or "time change" (re-arrange their schedule)so we can float staff to another unit. seriously. in the rare case that no float is required, we have a list of who had time off last.
i'm not aware of a policy regarding full time or prn going home first. if there are hard feelings one way to avoid it is to post the floating/low census policy so everyone is aware and apply it to everyone (yeah right) lol.
Jan 19, '07Occupation: Psychiatric Nurse Specialty: Psych, Extended Care, Med/Surg ; Joined: Jan '07; Posts: 93; Likes: 3We always have the same amount of staffing at our hospital which requires at least one RN (charge), one RN or LPN (meds), and 2 others which are RN, LPN, CNA which will equal 4 staff. If there are extra and it has been quite then we can opt. to put in a lottery as long as the above requirements are met.
Jan 19, '07Occupation: Med/Surg RN Specialty: 14 year(s) of experience in Med/Surg, Perinatal, Float ; Joined: May '06; Posts: 105; Likes: 1In anticipation of possible call-offs for low census, we can write next to our name on the staffing sheet for that day "1st Req" for call-off. If you have that next to your name, they pretty much honor that and call you off (or put you on-call) if the acuity and census calls for it, even if per diem were scheduled. However, when you request it, you can't add the hours to your call-off time which is accrued every schedule. You could still be next to be called off next time, which could be the next day, and with longer periods of low census, that can be a pretty big chunk out of your pay check! You can use PTO hours to cover for that time, but who wants to use it all on call-off time and not vacation time?
If no one requests call-off, then the perdiem stays home first or the charge nurse goes by total call-off hours accrued, and the one with the least stays home.