How does your facility handle low census?

We take turns taking "availability" call if the census drops below staffing guidelines. We get paid one hour for every 8 we are on availability.

Most of the time, the decision to cut staff is made every 4 hours, (1100, 1500, 1900, etc.) but it can happen at any time of day.

You have to be within an hour call back time if off, an can use vacation time to make up your time lost.

How are other facilities handling low census?

What's low census? We never have low census.

If we start off the shift full (census 30) and lose 4 patients, someone's going home on availability. They run a tight ship around here.

My facility handles it with pay cuts, since the low census is becoming a chronic condition.

My facility uses the on call system also, we get paid so much per hour for each hour on call. Our census flucuates alot this time of year, especially this close to the holiday.

[Tweety, BSN, RN]

We get canceled during low census. Usually there's no shortage of takers, however, if there is then "per diem" are first canceled. I love being canceled becuase I have plenty of PTO to take. We rarely get put on call, perhaps they do in critical care areas, but not med-surg. The irritating thing is if you work 12 hours, you're only canceled for the first 8 (or the first four if you work 7p to 7A) and they try to keep you at home but expect you to come in otherwise.

If someone refuses to go home then they're floated to another unit. It can be risky because the unit one is floated to might be undesirable for that nurse, but them's the choices. One can always float to the ER, we will always take an extra body in case the doo-doo hits the fan. Other units will accept a float only if they need the help.

We have to take turns being called off. Fortunately they don't just call off the perdiem staff first, but offer it to the full-timers. Often they are willing and would love a day off. If I got cancelled with every low census day just cause I were perdiem, I would not be working there anymore. I am glad they share the wealth. It motivates me to be more flexible for them, in turn and cover others when they need me. It's win-win!

We take turns taking "availability" call if the census drops below staffing guidelines. We get paid one hour for every 8 we are on availability.

Most of the time, the decision to cut staff is made every 4 hours, (1100, 1500, 1900, etc.) but it can happen at any time of day.

You have to be within an hour call back time if off, an can use vacation time to make up your time lost.

How are other facilities handling low census?

Ours is about the same, the census is checked every four hours, if we are out side the matrix then we check last call off dates for the staff one or comming on and the the employee say that was called off three weeks ago verses one week ago will be called first to either be on call or be called off. We can refuse call off but then you go back to the end of the line to be called off again. Holidays are by senority.

[RNHawaii34]

if we start off the shift full (census 30) and lose 4 patients, someone's going home on availability. they run a tight ship around here.

in my former workplace, one of the bigger hospital here in honolulu area, they used to float the people with lower seniority to the other floor ( which everyone hates to do it, but i didn't mind). the most irritating part is, when i want to request to be off work on low census days i couldn't get it because the one's with the higher seniority always gets the day off because they are more senior! and sometimes they will tell you to take off when you don't want to take off therefore you ended up using your vacation hours! now i am working at ltc facility, we never have low census days:rotfl:

[MomNRN, BSN, RN]

If someone refuses to go home then they're floated to another unit. It can be risky because the unit one is floated to might be undesirable for that nurse, but them's the choices. One can always float to the ER, we will always take an extra body in case the doo-doo hits the fan. Other units will accept a float only if they need the help.

Tazzi -

When other dept RN's float to ED, are they allowed to function as a nurse or as a tech? We often have floaters, but only those who have gone through the ED orientation are allowed to take patients. Just wondering how other hospitals do this.

[Zippedodah]

We can be floated to the nursery if they need us. If no floats are needed then we are cancelled voluntarily...we keep a log of dates people were cancelled and go by dates. If we get thru the whole list and no wants it (a big rarity) then we cancel or PRNs (they are last to be cancelled usually...they are contracted to work X amount of hours and they need to fulfill that requirement). If no PRNs then we mandatory cancel in 4 hour blocks. We can be mandatory cancelled up to 16 hours per pay period. I've never seen that happen as we are happy to take any cancellation we can get. On the peds floors they combine if there is no viral outbreaks and then combine staff and cancel/float as we do.

The PRN nurses are called off first since they don't get paid if they don't work. If no PRN nurses are scheduled that shift, they rotate the other nurses. They can use their PTO if they still want to get paid.

At the hospital I used to work, if you got called off, you were off that entire shift and not on call in case they started filling back up. Where I work now, I haven't exactly been told we are on call if called off (because I haven't been called off yet) but I have heard of someone who was called off. So, she & her husband decided to go out-to-eat. As soon as their food arrived, she got a call telling her to come on in.

[snowfreeze, BSN, RN]

I work on a busy unit, if the census is down we take fewer patients each and most of the time this unit gets numerous admissions so it evens out by the end of the shift, daylight is 4 patients and evenings and nights is 5. If the census drops considerably during a shift we are offered PTO if anyone wants to go home. If you take this option you may also have to stay if the census goes up before the end of the shift. If no one wants to go home they call someone off from the oncoming shift, this rarely happens. Anyone on overtime hours of course goes home first. I am usually quite flexible and find the facility is flexible also when I need a schedule change at the last minute.

I once worked at a facility that closed a few years after I quit, we had to take time off without pay there as we had all used up our vacation time.

We take turns taking "availability" call if the census drops below staffing guidelines. We get paid one hour for every 8 we are on availability.

Most of the time, the decision to cut staff is made every 4 hours, (1100, 1500, 1900, etc.) but it can happen at any time of day.

You have to be within an hour call back time if off, an can use vacation time to make up your time lost.

How are other facilities handling low census?

well lets see - short staffing us - bringing more heavy residents in that we cant care for adequately - once in a while if they think state might have an issue ( ie threat by family to call) they have the bosses - DON etc work a few hours to help. sad but they refuse to call agancy. so basically they dont handle it just leave us to fend for ourselves

[mom2michael, MSN, RN, NP]

Usually you get floated to another floor. You can sometimes offer to stay on the floor as a tech if the techs are short handed. If you are simply not needed in the facility, then you are called off and paid 1/2 your normal pay for your time off - you can make up any difference w/PTO if necessary. If they call you back in, it's 1 1/2 times you pay from the moment they call you back in, not when you clock in. You are expected to be back in the facility w/in 1 hour of when they call you back. It can be voluntary but if there are not takers for the call off(s), then the it goes by the date of the last call off.

For those of us that live far away----we never get called off because of the 1 hour rule.

[AuntieRN]

I am not exactly sure how the whole thing works where I am as I just started in my RN role and have yet to be called off in this capacity..but...I know as a tech...I was put on call one night...got $1/hr to be on call and then got called in 1 1/2 hrs after start of shift and got pd straight time. Now from what I hear from the other nurses....we can either get floated to another floor if they need help, get put on call if there is a chance our floor may need help, can be put as a nurse tech somewheres as they are always short...or just take 12 hours PTO time. They try to call staff who are in OT first to see if they want off, if not then they hit the flex staff. But once called off...(different then being put on call) they can not call you and make you come in. Our head nurse and nurse manager are awesome though about helping us out if we need help or run into trouble.

Yea I was wondering about this also. If a floor gets overstaffed and an oncoming staff member gets called asking if they want to take a holiday. What does this really mean? Does one still get paid?