Is it the nurse obligation to stay ovetime when you can't find to replace?

April, RN, BSN, RN · Apr 2, 2009

If this is a regular occurrence, I would not be working there anymore. It's not safe for the patients or the nurses.

Atheos · Apr 2, 2009

I'm surprised they can't find people drooling for overtime.

I've yet to have to mandate anyone here. As soon as 'Overtime' comes out of my mouth nurses are tramplign each other fighting for it. Especially since the recession started hitting.

Medic09, BSN, RN, EMT-P · Apr 2, 2009

Ari, it sounds like they are abusing you. The abandonment issue (which does exist) is easily solved by the Charge (or Supervisor, or whomever) assigning the patient to themselves while they get you out the door. I can understand them begging you to stay; but mandating should be saved for disasters and other extreme situations.

Now, it becomes a moral question for yourself. I started in the military and EMS/SAR, so I have a particular bias to 'dedication to the mission'. Caring for patients often involves discomfort and even risk to us; so it is part of the job definition. Staying over because an EMS call came in just before shift end is fairly common. Of course, it is also expected that the oncoming crew tries to get there and provide relief. My attitude is also influenced by the fact that I live only 1 mile from my hospital job.

In the hospital I stay over if I see there is really good reason. I DO NOT stay over on the schedule; I'm too tired after 12 hours overnight. But if the day shift comes up really short and the patient is really sick, I may stay long enough to ensure continuity of care and a smooth transition. Handing over a really sick patient awaiting transfer to ICU to a supervisor who can't give them full attention just isn't good. The longest I've stayed over is about 1 1/2 hours. I've only stayed over like that twice in the past year. More commonly I'll stay over 20 or 30 minutes, but even that is fairly rare.

Part of it comes down to a loyalty to issue, to the institution and the public. If you feel that the workplace is taking advantage of you, you have less reason to display such loyalty. In fact, you may have to protect yourself by protesting and refusing to stay unnecessarily.

Are you guys a union shop? The union rep should have something to say about this also; and it is probably covered in the contract.

It'sMe, RN, BBA, MBA · Apr 2, 2009

I am surprised that no one has directed the OP to look at the nursing policies related to staffing. I use to run the staffing department for a 5000 RN hospital system and we had very specific policies for "mandating." Mandating is not taken lightly because of the emotional distress as described in these posts. If you mandated at the small 23 hour department for just one 11-7 shift it was felt all over the system, even the 700 bed hospital 40 miles away. Nurses talk to each other and the worse the news the faster it traveled. Even the rehab hospital would react and they weren't under our control. I would get a call at 10:30 pm asking if they could mandate and I would tell them no, you find a nurse to go to that unit and work. I would offer them triple pay, bonus pay, travel pay and time off in exchange to get one shift covered. I would offer the nurse having to stay for the extra couple of hours all kinds of bonus pay (you had to be careful about paying for hours not worked, there are laws against it). In the end we got the shift covered. Of course the next day the nurse managers and the SVPs of nursing would be all over me because I spent $$$ to fill the position. My response was always the same, "will you come in and work the shift next time?" They always said no but that I had better not do that again. Gee, I never got fired. Imagine that. Go check the policies. Mandating is a horrible thing to do and can destroy morale faster than anything. Any facility that is using mandating as a staffing solution is poorly managed and dooomed to failure.

And Stanley, you are right on. I have several friends in nursing managment positions that are telling me that there single largest issue now is that their staff are "PO'D" because there is no overtime. One facility cracked down on end of shift overtime and you would have thought there had been lay offs! All of the nurses were yelling because those little 15 minute blocks of OT had become routine. Some of the staff was racking up 6-8 hours of OT just by hold over time and it was adding up. With an OT rate of $45 they were getting a couple of hundred more in their paychecks. Some of them complained that it would make a significant difference in their families income. The hospital was wise enough to assure the nurses that OT would be available if they needed the work as the hospital would reduce hours for Per Diem and eliminate agency nurses as long as the nurses would fill the shifts.

It is truly an exciting time to be in nursing!

Atheos · Apr 2, 2009

And Stanley, you are right on. I have several friends in nursing managment positions that are telling me that there single largest issue now is that their staff are "PO'D" because there is no overtime. One facility cracked down on end of shift overtime and you would have thought there had been lay offs! All of the nurses were yelling because those little 15 minute blocks of OT had become routine. Some of the staff was racking up 6-8 hours of OT just by hold over time and it was adding up. With an OT rate of $45 they were getting a couple of hundred more in their paychecks. Some of them complained that it would make a significant difference in their families income. The hospital was wise enough to assure the nurses that OT would be available if they needed the work as the hospital would reduce hours for Per Diem and eliminate agency nurses as long as the nurses would fill the shifts.

Oh definitely! The level of hatred I've received since we 'ended' the insane amount of overtime we did have has been crazy.

Now, every time someone gets overtime and someone else doesn't there in there either yelling at me or telling me about how they need money to pay for such and such child's such and such.

Oh, and all the nurses and aides that refused to do overtime because they had other jobs all got laid off from those other jobs.

Now everyone is mysteriously available! Heh!

This is a good time to be a staffing coordinator! WOOT! :yeah:

CoffeeRTC, BSN, RN · Apr 2, 2009

Happens alot in LTC esp since you might be the only nurse on duty and they only need one more nurse to come in for the 11-7 shift.

azhiker96, BSN, RN · Apr 2, 2009

Check with your BON. In Arizona, you would not have to stay. You'd just give report to your supervisor and they'd have to figure it out. That comes with that job. Now, they might be unhappy with you and threaten to fire you but your license would be safe. What if you worked when you were so tired that you were unsafe? That could jeopardize your license.

"It is the position of the Arizona Board of Nursing that for patient abandonment to occur, the nurse must:

A. Have first ACCEPTED the patient assignment, thus establishing a nurse-patient relationship; Accepting a

patient assignment varies from setting to setting and requires a clear understanding of workload and

agreement to provide care, AND then

B. DISENGAGED the nurse-patient relationship without giving reasonable notice and report to the qualified

person (supervisor, nurse, etc.) so that others can make arrangements for continuation of nursing care.

Examples of patient abandonment include, but are not limited to:

* Leaving without giving the supervisor or qualified person adequate notice

* Leaving without giving report to a qualified person

* Accepting an assignment of patient care and then leaving the nursing unit or patient care setting without

notifying the qualified person

Situations NOT considered to be patient abandonment, but are examples of employer-employee or contract

issues of which the Board has no jurisdiction (salary, work conditions, hiring and termination policies):

* No call/no show for work

* Refusal to work mandatory overtime

* Refusal to accept an assignment or a nurse-patient relationship

* Refusal to work additional hours or shifts

* Ending the employer-employee relationship without providing the employer with a period of time to

obtain replacement staff for that specific position

* Refusal to work in an unfamiliar, specialized, or "high tech" area when there has been no orientation, no

educational preparation or employment experience

* Resigning from a position and not fulfilling the remaining posted work schedule

* Refusal to float to an unfamiliar unit to accept a full patient assignment"

pagandeva2000, LPN · Apr 2, 2009

Yes, they fight for overtime in my hospital as well. Same stories...those that had several positions in different facilities have been thrown to the bus because of the recession and are now suddenly available. It has turned people into beasts.

I have been told in my facility that nurses must remain until someone else arrives. While that is not nice to experience, it does make sense...I mean, I have never heard of all of the nurses on one floor abandoning the patients at one time, leaving virtually no one responsible for their care. That is one of the things I expected as a nurse. As a CNA, I have been mandated occasionally and that seemed to just come with the job.

It'sMe, RN, BBA, MBA · Apr 2, 2009

I am sure it does happen in LTC or any non-hospital setting where the overall staffing levels are very low. In fact this is one of the components of the research into the nursing shortage. The impact of small facilities on the overall staffing availability across the larger spectrum of nursing. I plan to work on my MSN thesis (I already have a BBA/MBA) in the area of recruitiment, staffing and retention of nursing staff.

Now here is a variable that no one is considering in the nursing shortage. How will the elimination of small rural hospitals affect the overall RN shortage? There is a growing trend by the hospital corporations to convert the local rural hospital into an emergency center/23 hour outpatient center and all other cases get shipped to regional hospitals. We have one application here outside of Atlanta that is going to be a test case. Lots of small hospitals that were created by Hill-Burton will either be converted or will simply close. As those hospitals convert status and reduce nursing staff what will these nurses do for employment? That is a question that will impact the overall nursing shortage.

allnurses Guide · Apr 2, 2009

I just say NO to overtime. No way, no how. :nono:

As to mandating - the only time that has ever happened to me was when I was caring for a woman in labor with a baby who had died. At the end of my shift, she had not delivered and was going to have to go onto the general floor and away from the private room where I was caring for her, because there was not enough staff. I stayed. 19 hours in all. But it was worth it.

However, I'm not a fan of mandating and I wouldn't put up with it for very long.

steph

Atheos · Apr 2, 2009

In some states even CNAs can be mandated...

In some states, in certain emergencies they send the police to your house to bring you to work. We called our neighbor to come out and tell them we were out of the state.

allnurses Guide · Apr 2, 2009

In some states even CNAs can be mandated...
In some states, in certain emergencies they send the police to your house to bring you to work. We called our neighbor to come out and tell them we were out of the state.

That reminds me . . . . one morning (0300) when I was scheduled to be at work and was not there and did not answer my phone, co-workers came to my house to wake me up. One came into the house (we don't lock our doors here in this small town) . . she stood in my living room and yelled out my name. No response.

She called the supervisor - who called the cops - thinking my family and I must be dead or something.

But - we sleep with a fan in our room with the bedroom door closed and no phone! And I had forgotten to turn on the alarm. So, we were simply sleeping.

steph