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Low census/flex time

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Pixie.RN Pixie.RN, MSN, RN (Moderator) Educator Expert Nurse

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 13 years experience.

Thought I'd post on this topic as it's very relevant today -- I got called off for an entire 12-hour shift! Wow!! Now, I don't mind one bit -- I always have stuff to do at home, and I have some PTO to burn. Our census was scary-low in January/February, but rebounded nicely over the last few months. When it was at its worst, we were all trying to do our part to "flex" equally so that it wouldn't be the same people taking the hit over and over.

Just wondering what your experience is with this -- are you asked to flex? Forced to flex? Can you only cover the hours with your PTO, or do they just pay you at a reduced rate if you're called off?

This doesn't usually happen to me, as I typically work 11a-11p and it's usually crazy-busy when I am in the house! :D (Fecal attractor, anyone?!)

CaLLaCoDe, BSN, RN

Specializes in Cardiology, Oncology, Medsurge.

My past life of working for Legacy, Portland (which was the suckiest hospital on the planet) was to see my flex time PTO ripped out of my vacation funds (first and only hospital I know that got away with doing this!). So, sure, one could take vacations anytime. Expectation to be reimbursed for vacation time, nada! No money in the tinker. I don't know how they legally could get away with this?! If you are hired full time, you should work full time IMO and be given paid vacations period!

Edited by CaLLaCoDe

My past life of working for Legacy, Portland (which was the suckiest hospital on the planet) was to see my flex time PTO ripped out of my vacation funds (first and only hospital I know that got away with doing this!). So, sure, one could take vacations anytime. Expectation to be reimbursed for vacation time, nada! No money in the tinker. I don't know how they legally could get away with this?! If you are hired full time, you should work full time IMO and be given paid vacations period!

I volunteer at the Legacy in Vancouver, and I know the department I volunteer on has had census drop ridiculously low - 6pts in two units, with four RNs (two in each unit). They've been talking about being flexed tons lately - I'd be curious to see how that affects their pay.

Delaina

Specializes in Med/Surg.

Sadly, I'm a fecal attractor also. I call my scrubs "poojamas".

I just graduated in May and have only worked three days so far at my new job, but on all three of those days someone was asked to take off because the census was low. On the first day, I remember thinking, "I bet that doesn't happen very often, so I'd embrace those times." By the third day I started getting scared that I'll never be able to count on a full paycheck or make a budget.

I'd always stay, but the nurses that do stay are left without a unit secretary (those are sent home too) and a PCA that has to take practically the whole floor. It's more than double the workload for the ones that stay and they don't get paid any more money than normal.

This is scaring me, I don't mind saying.

pharmgirl

Specializes in ER, ICU, Medsurg.

This is currently a HUGE issue at the hospital I work. We have a low census at the beginning of the shift so someone is called off, and yes, this comes out of your PTO unles you sign the book that you dont want to be paid that day. By the middle of the shift we have 8 or 9 patients each, with no charge nurse because she was pulled to take patients. Then by the endof the shift we are back down to 4-5 patients because our original 3 are now being discharged after 4pm. Its' been a nightmare. Last paycheck I was short 3 shifts due to being called off. It really has been brutal. If we are able to get someone to agree to be on "busy call" they get $2 an hour until they clock in/out. Danged if ya do, danged if ya don't. One of the reasons I am changing departments

Pixie.RN, MSN, RN

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 13 years experience.

Our charge nurses tend to try to flex people to come in later, vs. flexing people to leave early. Sending someone home usually opens the floodgates, and we end up with a waiting room full of people to be seen and five ambulances arriving simultaneously. Never fails!! :)

My past life of working for Legacy, Portland (which was the suckiest hospital on the planet) was to see my flex time PTO ripped out of my vacation funds (first and only hospital I know that got away with doing this!). So, sure, one could take vacations anytime. Expectation to be reimbursed for vacation time, nada! No money in the tinker. I don't know how they legally could get away with this?! If you are hired full time, you should work full time IMO and be given paid vacations period!

Where else is it going to come from?

It's not going to come out of sick time.

It's either take PTO and get paid, or don't get paid.

CaLLaCoDe, BSN, RN

Specializes in Cardiology, Oncology, Medsurge.

Where else is it going to come from?

It's not going to come out of sick time.

It's either take PTO and get paid, or don't get paid.

Actually, hospitals generally have a separate account (VACATION) outside of one's regular PTO.

Pixie.RN, MSN, RN

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 13 years experience.

We don't. We have PTO, period. When we were acquired by another hospital system, our "vacation" hours were rolled into PTO, and our "sick" hours were rendered virtually untouchable in an "Extended Illness Bank," or EIB, that can only be accessed when PTO is exhausted. Annoying, because I have 233 hours of EIB time.

EmergencyNrse

Specializes in Emergency Medicine. Has 17 years experience.

I'm seeing it more and more. People sent home and forced to take mandatory PTO to fill in the weekly shortage. Many nurses without much in the way of PTO are hurting and now with the summer season can't afford to take off because their vacation time is depleted.

Me, I don't feel that it's right. If I agree to come on board for a full-time schedule I want to be utilized for full-time hours. Expenses, Bills, Mortgage, Car Notes all need paid. Can't just cut workers hours because census drops off. People depend on those hours.

It's a bad situation in an already stressful environment being forced to go home. As a traveler that is contracted for 4 12's/week. They can send me home but they gotta pay me. I'm not being sent home until they are ready to turn the lock on the front door. Basically, I'm guaranteed my shifts and to actual staff feel shafted. Creates some resentment for travelers @ these facilities.

I hate to gloat but I'm happy I'm a traveler these days. Sucks to be staff.

We get low censused without regard for whether we have PTO or not, too bad so sad is the culture. PTO is used until it is gone and then pay checks get hit.

ZooMommyRN, ADN, RN

Specializes in Med/Surg, ICU, ER, Peds ER-CPEN. Has 13 years experience.

Our ER is staffed regardless of census, all other units are staffed by census, somehow I never got called off when I was on Med/Surg and after transfering to the ER I still get called to pick up extra when census is booming lol

I work ER too, and they make every effort to run us down (low census) to 2 nurses and no tech (21 beds!) They have been doing it a few hours at a time and it's been pure luck that nothing untoward happened.

mmutk, BSN, RN, EMT-I

Specializes in Emergency Dept, ICU. Has 11 years experience.

I work in an ICU right now and we as well have had a very low census x 3 weeks now. But the ER is above census for the month.

This is a really big problem. I have tried to find labor laws which might address this issue, and I can't find any in the state of North Carolina. I work in a PACU where we may have a low number of scheduled cases for the day, but then add-ons from the ED double our projected workload. The number-crunchers who calculate our budget only use actual patient minutes to determine if we are overstaffed or understaffed, but that does not reflect the lull when 8 cases are not in PACU yet, but they are going to dump out and we must have nurses to care for the patients. I am beyond frustrated with the way nurses are being treated simply as a liabilities on the hospital's balance sheet instead of essential personnel required to keep patients safe.

The number-crunchers would freak out beyond belief if they were told that there paychecks may vary by several hundreds of dollars each pay period.

I work with one nurse who wants to have a baby, but she has no PDO because she keeps being flexed. I am certain she will not stay in my department much longer.

ER(notso)n00b, ASN, RN

Specializes in ER. Has 2 years experience.

In our dept, OT goes home first, followed by registry. Then volunteers, and if that doesn't get us there they force based on lowest seniority. I've only seen that happen a couple of times. Usually people are more than happy to leave a couple of hours early. I usually volunteer to go on my Friday so I can kick off my weekend sooner.

Pixie.RN, MSN, RN

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 13 years experience.

I just realized that I started this thread almost 6 years ago. And it's still a problem!

We have a low census/leave early list for our nurses. There are always nurses wanting to go home with or without pay, it is up to the nurse. But I have a concern and am curious what other facilities do. We have 3 shifts, 0530-1800, 0700-1930, and 0800-2030. The early shift has double the staff because more surgeries are scheduled in the am, averaging 10 nurses in the am, and 5 nurses in the evening. If one of the evening nurses places there name on the list before an early nurse, they should have priority on leaving first, right? But our early shifters get to leave before our evening shifters because there are more of them. My evening nurses and myself included feel we get the shaft because we work the late shift and we never get to leave early. Anyone have any suggestions or what does your institution do?