Staffing issues; call-ins

Nurses General Nursing

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I have recently taken on the role as staffing development coordinator in a skilled nursing facility. I absolutely love my job. However, we continue to have staffing issues with call ins. We have implemented a "3 strikes you're out" rule. However, this still doesn't seem to "phase" anyone. While we are a busy and fast paced facility, I still feel that we are definitely an awesome facility.

Does anyone have any suggestions on ways to encourage our staff not to call in? We give bonuses, make sure we continue to let them know they are appreciated, etc. Apparently we just haven't found exactly what works well for our group-if anything will work.

What works for you? I would LOVE to hear your ideas!!!

I will also add...I am not talking about people that legitimately call in when they are sick but those that call in because "I have to study" or "My grandma died for the 7th time" (No joke this was really a call in), "I locked my keys in my car" (never mind that they lived within walking distance to the facility)

Follow through with the rule and actually fire someone. That will set an example and actually scare them into not calling in for bogus reasons. If they don't comply, then keep firing until you find staff that can be responsible and work their jobs. There are tons of nurses out there looking for jobs and willing to work.

If what you say is true, it sounds like you've managed to attract a very low caliber of employee. The solution would be to attract better employees by offering better working conditions, better pay, etc. There is no magical way to make losers behave with integrity.

I also believe the "three strikes" policy will anger good employees and leave you in even worse shape than you already are. I know how I would react to it.

I realize you may not have control over these things ...the classic "responsibility with no power" is a no-win situation, unfortunately.

Specializes in Med/Surg, Academics.

You can't fix it if you don't know what is broken. Have you asked the staff?

When the units I've worked on in the past started getting rashes of call outs every shift, it was a symptom of a greater problem. We were extremely understaffed, and despite numerous pleas to management and upper management and even having the physicians go to bat for the nurses, nothing got any better. People got burned out and started calling out all the time. That doesn't make it right, but it's what happened. Twice, in 2 very different hospitals with 2 very different patient populations. Understaffing, low morale, and lack of responsiveness from management all came before the call outs started coming. Then came the mass exodus of nurses.

If it's just employees with poor work ethic, then yes, follow through with your rules and start firing or giving warnings or whatever the policy states. I encourage you to make sure that it isn't something else, though, first.

Specializes in CMSRN, hospice.

Also, I would look at your vacation and personal/holiday time policies. I know several people who have called in because, after literal months of their requests for time off being rejected, they need a day off! (I'm not endorsing this as the best way to handle the problem, but I kinda see where they're coming from.) Make sure everyone is getting adequate time for their personal lives whenever possible.

Specializes in Cath/EP lab, CCU, Cardiac stepdown.

Well if there hasn't been any repercussions for violating the policy then of course no one is gonna be phased. If you're not following up, what's the point of having that policy. You need to follow up with documented verbal warning. Then a written letter warning. And finally the axe. If there's no punishment, who's gonna listen, not to mention the employees who are following the rules are basically treated unfairly then.

Does the facility have self-scheduling? If they do, how far in advance is the schedule posted? Prevention is better than cure.

What is employee morale like from the staff point of view?

Does the facility have the ability to handle call-outs? In hospitals, we are lucky enough to have a large pool of scheduled flex-team nurses to handle any staff shortages. What does your facility do? Are there any per diem nurses who can work part days to cover a nurse who just needs to leave early.

I work with a few per diem nurses who can pick up part of the shift giving a bit of flexibility for full time staff and this prevents call outs.

Specializes in Med/Surg, Tele, Dialysis, Hospice.

There were times in the past with previous jobs where I did call in when I wasn't sick on occasion. I'm not proud of that and it has not happened for at least 3-4 years, but I can tell you why I did it, when I am normally a very conscientious employee who values my co-workers and tries not to call in because I know it will inconvenience them.

I did it because the thought of going in to work that day/night was so unbearable that I just couldn't make myself do it. If you see this happening across the board, even with employees who are normally honest and conscientious, then you have a problem with your staffing or something else that is making the idea of coming to work unbearable, even for people who feel guilty about it, like me, and would never normally do it.

If it is because your employees have no conscience and don't think twice about lying, not because the job is unbearable but because they just don't feel like working and have something fun to do instead, then you have a character problem with your employees, as a PP pointed out, and you probably need to clean house across the board.

I'm not sure if firing people would work. If they truly hate their jobs, they would probably just quit after two strikes or sooner to avoid having a dismissal on their employment record and move on to another facility. I don't know about where you live, but where I live, pretty much every SNF is desperate for employees and can't keep staff, so it's fairly easy to move on to another facility.

To faze is to disturb, bother, or embarrass, but a phase is a stage or step. It could faze your family if your princess phase lasts well into your college years.

If you are making empty threats, of course no one is going to be fazed.

I will also add...I am not talking about people that legitimately call in when they are sick but those that call in because "I have to study" or "My grandma died for the 7th time" (No joke this was really a call in), "I locked my keys in my car" (never mind that they lived within walking distance to the facility)

This right here is the problem. You are picking and choosing who has a legitimate call in. You can't fire one persons for calling in three times for things you don't feel are legitimate and let someone else keep their job for calling in a third time. It doesn't work that way.

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