So, this last weekend, one of the night nurses called in sick. We have three units in our facility, and this nurse was supposed to work the two units that I do not work at. The nurse who works at my unit was already there.
Anyways, around 10 pm, the nurse from the other unit comes over to me and says, "We have a problem. The night nurse for my unit has called in, and I've tried calling everyone on the list, including the DON. Only one person has picked up, and they can't do it. One of us has to stay." She then looks at me as if she expects me to volunteer to work her unit overnight, even though my unit is already covered for the night.
When I say that it is not possible for me to work, and that I've been mandated lately, she then goes, "Well, how do we make this fair? Should we do a coin toss or pick straws? I've been mandated recently as well."
I then go on to say that I work the next day, and she says she has to as well.
She then leaves to go back to her unit because our discussion is not getting anywhere--neither of us is budging.
I later phone over to her unit, and tell her that I've been sick lately, and cannot physically work an overnight shift. Her response was, "Well that doesn't make any sense. If you were sick, why didn't you call in?" I told her that I didn't call in because I felt I could probably make it through my shift and didn't want them to be short-staffed during that period, but that I could not, in any way, work any extra hours.
When I kept refusing to participate in a coin toss and insisted that I could not work overnight, she finally hung up the phone on me.
What are your thoughts? Would a coin toss be "fair" to determine who stays?
My thought was...it was HER unit that needed to be covered, not mine. I already had someone to take over for me, so it really wasn't my problem. If it had been the other way around, I certainly wouldn't have gone over to her and basically, indirectly, expect her to volunteer to work over on my unit when I'm already the one covering over there.
How is there not a clear mandatory policy in place? It should never come down to two nurses flipping a coin who see who has to stay. Sadly, as much as I hate mandatory OT in a smaller facility with already limited staffing it is sometimes necessary. After all, somebody has to be there.
Our policy sounds complicated but it is really pretty simple. If a hole on the schedule needs to be filled first the casual nurses are called, then the part time staff and finally full time staff. OT pay is always offered to staff that will cover the shift, frequently a bonus is offered as well if the situation is desperate enough. If nobody agrees to cover the shift and a nurse needs to be mandated it goes first by the date of the last mandate for that nurse, so the one with the oldest mandate is the one that has to stay. We keep a list of mandates right with the schedule so it is easy to see who's turn it is. If it turns out that two [or more] nurses have the same previous mandate date then it goes by seniority with the least senior nurse the one that has to stay.
The only time a nurse is usually exempt is if they are already doubling back, but it has happened before where there was just nobody else and that nurse had to take the mandate to fill the immediate need and was taken off the following shift. Which of course creates another hole so the cycle starts all over again.
edited to add: another part of the policy I forgot to mention is if a nurse is mandated it is their choice where they work. So if the mandated nurse would rather stay on the wing she [or he] knows they can bump the other nurse to the unit with the hole. This is not always done though as depending on the personality of the other nurse already scheduled it can cause some tension making an already crappy situation of being stuck at work even worse.
Specializes in Nurse Leader specializing in Labor & Delivery.
Mandatory overtime policies are one of the worst things about working in healthcare..
Oregon just passed a law forbidding mandatory OT. A nurse cannot be compelled to work past her shift more than 2 (?) hours, I believe, AND there must be a mandatory 10 hours of rest between the end of shift and beginning of next. The purpose is to prevent exactly the scenario as described in the OP.
They're putting the onus of finding adequate staffing on the employer and removing it from the floor nurse, which is exactly how it should be.
If mandation is a possibility then you should know which of you worked a mandated shift more recently than the other. If one of you is already on a double then obviously the one doing the double is the most recent mandation. Only if both of you were currently doing a double would it be a point of discussion.
A phone call to the DON to tell her that one of you doing a double meant that she wouldn't be there the next day would be appropriate. Meaning that she could either get herself there to fill in that night, or someone else to fill in that night so you could both be at work the next day, or she should plan on covering the day shift the next day for whichever of you got stuck there that night.
Her habit of not answering texts or calls when she's off work means that you should have the number of the person next in line up the food chain, her boss. That would be the call to make immediately after the DON refused to answer. Either she'd become more available after getting an unhappy call from her boss or she might find herself replaced by someone who answers the phone!
I think what you two should have done: she covers the unit while you track down and drag your DON in to work out the shift coverage, meantime facility is paying OT twice waiting on DON to do her job.
What never should have happened is for you two to splinter off against each other, that's where you lose power and work divided versus united. Very short sighted.
The "fair" thing to do is get an agency nurse in. This is exactly the kind of thing that should be the DON's responsibility, given that she is, you know, the DIRECTOR OF NURSING.
Exactly. Except our DON doesn't seem to take care of that responsibility. We are put in this position because she refuses to answer her phone at night.
My advice is that after telling the nurse on the other unit that you couldn't work the night shift is to; sticktoyourguns. You'd already explained your position, no need to initiate contact. Honestly, this is one of my pet peeves regarding nurses. Thinking that they have to please everyone, everytime. You didn't call because you'd had a change of heart and suddenly wanted to work the night shift on top of the shift you'd just worked. So why make the call at all?
To me, calling the other nurse to tell her that you'd been sick lately was an attempt to try to justify the rejection (of not wanting to pick up the extra shift) and perhaps trying to feel a bit better/less guilty about saying no. As far as I'm concerned you didn't owe her this explanation/justification and it only got you into a position where you felt you had to defend your position. It seems like this whole thing caused tension/conflict between the two of you, when it should have been up to management to solve staffing issues. The nurse in the other unit needed to ask her manager to solve this, not you.
I've worked with many nurses who I wish would practise saying no and learning how not to feel guilty about it. Employer.s take advantage of that guilt.
Employ.ers/mangement will never be motivated to improve staffing levels etc. for as long as nurses keep sacrificing their free time and health in order to cover unexpected/short notice vacancies in the schedule. The employer needs to have a plan B, for example agency nurses.
Just say no
Well, I guess the reason for making my phone call was because it didn't seem clear to her that I was not going to stay after she returned to her unit. I got the impression that she was hoping that, given some time, I would volunteer to stay and I wanted to make sure she knew that I was not.
I agree that it should have been management to figure out the staffing issue. Only problem? None of the supervisors, managers or DON answered the phone. So, we had to "figure" it out on our own.
I do feel bad that she had to work a 16 hour shift, but again, I was in no position to be working an overnight myself. I don't feel guilty about leaving, but do feel bad as the way it was handled. I'm sure to her, I came across as unwilling to compromise (and, in this case, I was). I know that I was ruder than I usually am, but it seemed like that was the only way I was going to ensure that I got home so I could rest and recover from my illness.
It was honestly a no-win situation for anyone. She had to work 16 hours, but in order for that not to have happened, I would have had to work while sick.
The fair thing would be for your DON to handle it ...either by covering the shift herself and getting some sort of registry staff in. It's not your problem that a nurse called in on the other unit, but it shouldn't be that unit's nurse's problem either.
I agree, but the DON was magically unavailable during the time this was happening.
Next time call the police and have them go to her house... we've done that in situations where patient safety is at risk. (Mostly when drs don't answer)
RegularNurse
232 Posts
Is this a joke?
There should be a policy for something like this. It amazes me how weakly managed places are...