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.
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.
That's a very equitable and practical solution. Since OP's night nurse had arrived, that meant that she could more easily devote time to chasing down the DON than the nurse who was still carrying her full patient load on the other unit. It's a way to show good will towards the other nurse without letting management off the hook. The responsibility to fix this, belongs to them.
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.
I agree 100%. Divide and conquer is an amazingly effective strategy for management to avoid being held accountable for something that is their responsibility (staffing). If they can have the nurses squabbling among themselves, feeling guilty and applying pressure on each other instead of on management, then management can sit back, relax and continue to not do their job. Nurses should in my opinion stop being such enablers.
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.
@OP I understand the point you're making but what I'm trying to illustrate is that there was an element of "trying to get along" and trying to justify your decision. Think about it. You told the other nurse that itwas not possible for you to work the extra shift. That's notatallambiguous. You gave her a very clear answer. The fact that you got the impression that she was hoping that you'd change your mind (and that's likely an accurate impression as she didn't want to work the night shift any more than you did), doesn't mean that you hadn't already stated your position. You had. You're not responsible for what she hoped might happen.
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.
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.
I realize that right there and then, seeing as you guys were unable to reach your DON, that you were in a tough spot. What you need to do (you and all your coworkers) is to ensure that this situation is never repeated. This sort of thing should never happen more than once. Unless your DON was unconscious in an ambulance in transport to the nearest ER (or otherwise legitimately indisposed), it's her darn job to pick up the phone. Your DON has a boss. If the DON won't do her job, the problem needs to be brought up the food chain. If you guys accept this behavior from her, rest assured itwill happen again.
And you guys will be flipping coins for all eternity, with burnout and job dissatisfaction/resentment increasing exponentially.
I know that going to battle against your employer can be a daunting prospect, but standing united as one and demanding a reasonable work environment is really the only way to bring about change.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
First, the DON is responsible for 24/7 staffing. Not answering the phone is not doing her job. Unless she's delegated that staffing responsibility to someone else, she's obligated to deal with staffing issues.
Second, there should have been a fair way to determine who is mandated to stay in place before this issue ever came up. A log of who has been most recently mandated, a policy of the least senior person being mandated, or a policy of coin tosses to decide these things -- it should have been known and understood in advance of this situation.
Why in the world did you phone over to her unit after refusing to stay? Unless you'd had a sudden change of heart, there was no reason to make that call. You just interrupted whatever she was doing to try to resolve her situation.
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.
But when the DON refuses to answer calls or if your staffing coordinator isn't there to make a bunch of calls that you really don't have time to make (on weekends, 3-11, 11-7, holidays), what are you supposed to do?
And if you are mandated for the 2 hours and relief still hasn't arrived, then what? Leave your floor to the wind? Laws are needed to force facilities to have responsive and available DON's, staffing coordinator available 24/7, and adequate staffing guaranteed - otherwise there should be not only huge fines but perhaps shut down these facilities. And force them to pay at least 10 times the OT rate to nurses who are forced to be mandated more than once or twice per year in the most dire of emergency situations.
No more of using forced OT to cover basic staffing routinely!
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)
I love this! How come I never thought to do it??? I've had so many instances of doctors not answering calls. It was so insane to not be able to reach a doctor. They're raking in the bucks with two fists, living high on the hog, and not answering their calls, not making Rounds sometimes for days so you could discuss some necessary issues. You try reaching their offices during Mon-Fri Day hours and get put on hold forever.
That is fantastic to send the Police to make sure they're alright!
Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.
When I worked in facilities that were short staffed: you had to stay if there was no coverage because not staying = pt abandonment. Thankfully, I was rarely mandated to stay, and when I did it was usually just 4 extra hours (therefore a 12 hr shift). Ideally one nurse would agree to stay 4 hrs and another come 4 hrs early.
macawake, MSN
2,141 Posts
That's a very equitable and practical solution. Since OP's night nurse had arrived, that meant that she could more easily devote time to chasing down the DON than the nurse who was still carrying her full patient load on the other unit. It's a way to show good will towards the other nurse without letting management off the hook. The responsibility to fix this, belongs to them.
I agree 100%. Divide and conquer is an amazingly effective strategy for management to avoid being held accountable for something that is their responsibility (staffing). If they can have the nurses squabbling among themselves, feeling guilty and applying pressure on each other instead of on management, then management can sit back, relax and continue to not do their job. Nurses should in my opinion stop being such enablers.
@OP I understand the point you're making but what I'm trying to illustrate is that there was an element of "trying to get along" and trying to justify your decision. Think about it. You told the other nurse that it was not possible for you to work the extra shift. That's not at all ambiguous. You gave her a very clear answer. The fact that you got the impression that she was hoping that you'd change your mind (and that's likely an accurate impression as she didn't want to work the night shift any more than you did), doesn't mean that you hadn't already stated your position. You had. You're not responsible for what she hoped might happen.
I realize that right there and then, seeing as you guys were unable to reach your DON, that you were in a tough spot. What you need to do (you and all your coworkers) is to ensure that this situation is never repeated. This sort of thing should never happen more than once. Unless your DON was unconscious in an ambulance in transport to the nearest ER (or otherwise legitimately indisposed), it's her darn job to pick up the phone. Your DON has a boss. If the DON won't do her job, the problem needs to be brought up the food chain. If you guys accept this behavior from her, rest assured it will happen again.
And you guys will be flipping coins for all eternity, with burnout and job dissatisfaction/resentment increasing exponentially.
I know that going to battle against your employer can be a daunting prospect, but standing united as one and demanding a reasonable work environment is really the only way to bring about change.
Best wishes!