Heavy Assignments and Overtime

ponymom · Dec 19, 2016

I never 'politically' justified my OT. When I got flack about it, I told them "Look, this is how long it's taking. It is what it is"

SaltySarcasticSally, LPN, RN · Dec 19, 2016

I say same as above poster. When asked about time management skills I sweetly suggest that they follow me during a shift and tell me where to improve -- never happens and they leave it alone for awhile.

Here.I.Stand, BSN, RN · Dec 19, 2016

Should I cut back on patient care, charting, or lunch? Well skipped lunches ARE OT, so maybe not #3.

Not very political, but hey.

Been there,done that, ASN, RN · Dec 19, 2016

Justifying your overtime is not the issue.

Why are you taking a heavier load in the first place?

macawake, MSN · Dec 19, 2016

Should I cut back on patient care, charting, or lunch? Well skipped lunches ARE OT, so maybe not #3.
Not very political, but hey.

:laugh: :roflmao:

You're a woman after my own heart :up:

OP, with a heavier assignment charting will take longer. This isn't rocket science and management are well aware. They are just trying to make you run even faster :mad: Perhaps they should start worrying about the high turnover rather than hounding the few experienced nurses they have left :facepalm:

freework · Dec 19, 2016

Justifying your overtime is not the issue.
Why are you taking a heavier load in the first place?

How would I approach this?

AceOfHearts<3 · Dec 20, 2016

How would I approach this?

We use a workload tool on my unit for every patient. It takes about a minute to fill out and takes into consideration: drips, # of times you have to pass meds, Braden score and continence, # of invasive lines (not IVs or oxygen), if the patient is in isolation, assist level, tele vs non-mon, communication impairments, complex psychosocial needs, # times call bell has rung in X amt of hours, pre/post procedure, possible d/c, mental status of patient (A&O vs confused/impulsive vs unresponsive), and unstable vitals or labs that need to be closely monitored. Might have missed something, but you get the point. I've had patients with workloads as low as 3-6 (super easy A&O independent pt) and as high as 25-35. We use the workload tool to help balance the patient assignments as best we can. Sometimes due to the layout of my unit we might have a nurse with a workload that's 10-20 points lighter or heavier than others, but that's the exception and our charge nurses really do their best to keep it as even as possible.

Most of the time when the next shift completes the workload it hasn't really changed much from the prior- maybe up or down a couple points. Sometimes though the numbers can really change. I had a patient who went up over 10 points during my shift because of family issues, a drip being started, invasive line being added, and the assist level increasing.

freework · Dec 20, 2016

Quote

We use a workload tool on my unit for every patient. It takes about a minute to fill out and takes into consideration: drips # of times you have to pass meds, Braden score and continence, # of invasive lines (not IVs or oxygen), if the patient is in isolation, assist level, tele vs non-mon, communication impairments, complex psychosocial needs, # times call bell has rung in X amt of hours, pre/post procedure, possible d/c, mental status of patient (A&O vs confused/impulsive vs unresponsive), and unstable vitals or labs that need to be closely monitored. Might have missed something, but you get the point. I've had patients with workloads as low as 3-6 (super easy A&O independent pt) and as high as 25-35. We use the workload tool to help balance the patient assignments as best we can. Sometimes due to the layout of my unit we might have a nurse with a workload that's 10-20 points lighter or heavier than others, but that's the exception and our charge nurses really do their best to keep it as even as possible.

Not trying to be combative here.

We have a similar scale. With a score of 10 being highest. I am spending more time and managing rooms that are a 5/10 than 8/10 sometimes and vice versa. I'm not sure what's happening here. Also, I don't know how to articulate this, but not all 7/10s are created equal. Some people on my unit will switch or refuse switching a 7/10 for another. If they both scored a 7, why would a switch me made or declined?

Do I arrive earlier to review my patients/assignments? I rather claim that as overtime, though.

crazin01 · Dec 20, 2016

Who makes the assignment for the next shift? Everywhere I've worked has the charge nurse making the assignment for the oncoming shift. the number system mentioned by PP sounds similar to what I've seen, and seems to be a good way to ensure as equal an assignment as possible.

Especially with you being higher up on the seniority scale, I imagine they (nurse manager, other charge nurses on off-going shift, etc) know you're possibly the most experienced on your shift and therefore you are the one who can most easily handle more. I've seen that before. And while it's nice to pay you a compliment it does nothing to change the problem.

I also think the assignment makers/other shift charge nurse haven't been told about unequal assignments and therefore think that if you're done it this way for awhile, why change?