How does your facility handle 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.

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.

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:

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.

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.