Low Census and Job dissatisfaction

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Specializes in Critical Care.

Hello all nurses,

After working in a COVID unit for practically 8 months in a floor without unit coordinators and CNAs (sometimes we have one CNA in a 30 bed floor) I decided to leave after feeling exhausted working 5-8’s= 40 hours a week. 
 

I got a new job but it is 4-8’s= 32 hours a week but after two months in this new job, I am finding myself feeling very frustrated with the low census in this small rural hospital in general. 
Most days, I care for 1 to 2 patients in med surg. But most days is just one patient and I have to give it up at 7 pm to the night shift nurse because they need to take of someone for the rest of the night instead of waiting for me to give report to them on this one patient at 11 at night. 
 

I don’t miss my old job but I haven’t been able to find a “happy medium” in nursing job. In my previous job, I had little help and about 4-5 patients to care for in a med surg floor, being the last one to leave most nights due to documentation and charting on late night admissions. 
 

Don’t take me wrong! Patient satisfaction is high in this hospital but I am not feeling excited to go to work. If we don’t have patients to care for, we are given the choice to take the day off with pay or not pay from earned time and optional to be placed on call. 
 

With the current pandemic and unemployment, I cannot afford to just sit home and use my earned time due to low census. But if I don’t use it, then my paycheck comes shorter that week. 
 

I though the situation was going to pick up and the census was going to get better. But I hate going to work to complete required “nursing education” instead of working because there are one or no patients. 
 

What would you do? Should I look at a larger hospital for a busier job? I can’t stand just sitting around...

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Specializes in Mental health, substance abuse, geriatrics, PCU.

I worked at a tiny rural hospital for a few years and I found that it was either feast or famine with the census. Being sent home due to low census got old real quick but I liked my job so I got a PRN position in another facility to make up my hours on the weeks I was short. That worked for me and I was a lot more settled when I started doing that.

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Specializes in Psych (25 years), Medical (15 years).
1 hour ago, TheMoonisMyLantern said:

I worked at a tiny rural hospital for a few years and I found that it was either feast or famine with the census. Being sent home due to low census got old real quick but I liked my job so I got a PRN position in another facility to make up my hours on the weeks I was short. That worked for me and I was a lot more settled when I started doing that.

Hmmm! Same story, different nurses!

In 1993, I was working at Buoy Memorial Hospital, a 19 bed facility, in med surg/ER. I didn't get low census that I recall, but wanted to do more and took on some shifts on hourly HH cases.

It worked out really well, because I ended up  becoming the NS for the HH agency!

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Specializes in NICU/Mother-Baby/Peds/Mgmt.

Why do you have to be the one to give up your one patient and not have a patient for 4 hours instead of the night nurse not having one for 4 hours?  They'll still have 8 hours with that patient.  If they don't want to be doing an assessment at 11-1130 which is understandable they can do it at 10.  If there's anything they want to update after the official report they can do that when they do VS.  

Are you thinking about getting an advanced degree at all? This job would be perfect for that.  Obviously you can't wait until the last minute to do stuff but I'll bet you can do a lot of the work at work, especially if you still have to give up your patient at 7.  Or ask to be on a committee or 2, that'll be a little work in most cases and it'll look good on your resume. Or ask the charge nurse if there's anything you can do for her/him.  The other thing you can think about is asking when there's this situation is if you can float to another floor, either to take a patient for 4 hours (which I think stinks but....) or to orient to a unit that you might know nothing about, like OB.  I worked a small NICU once and was mostly by myself on 12 hour nights, I would have loved someone to help out for 4 hours! And talk to! 

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Specializes in Critical Care.
On 2/10/2021 at 4:18 AM, TheMoonisMyLantern said:

I worked at a tiny rural hospital for a few years and I found that it was either feast or famine with the census. Being sent home due to low census got old real quick but I liked my job so I got a PRN position in another facility to make up my hours on the weeks I was short. That worked for me and I was a lot more settled when I started doing that.

Thank you so much for your input and recommendation. I am definitely consiering getting a per Diem position just in case if I am call off for the day. 
 

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Specializes in Critical Care.
On 2/10/2021 at 8:40 PM, Nunya said:

Why do you have to be the one to give up your one patient and not have a patient for 4 hours instead of the night nurse not having one for 4 hours?  They'll still have 8 hours with that patient.  If they don't want to be doing an assessment at 11-1130 which is understandable they can do it at 10.  If there's anything they want to update after the official report they can do that when they do VS.  

Are you thinking about getting an advanced degree at all? This job would be perfect for that.  Obviously you can't wait until the last minute to do stuff but I'll bet you can do a lot of the work at work, especially if you still have to give up your patient at 7.  Or ask to be on a committee or 2, that'll be a little work in most cases and it'll look good on your resume. Or ask the charge nurse if there's anything you can do for her/him.  The other thing you can think about is asking when there's this situation is if you can float to another floor, either to take a patient for 4 hours (which I think stinks but....) or to orient to a unit that you might know nothing about, like OB.  I worked a small NICU once and was mostly by myself on 12 hour nights, I would have loved someone to help out for 4 hours! And talk to! 

I think she was trying to steal a patient from someone. I had the admission patient and there was another pt who was CMO in the entire unit. She interrupted my dinner and ask if I wanted to just give her my admission and it took me by surprise. Now I know, what to say next time someone interrupts my dinner and wants to take my only patient: “it’s my only patient, I can give you report at 10, so you can get VS and assessment done early”. 
 

I have been seriously considering getting a higher/advanced degree. I’m currently finishing the last semester of my BSN degree online. But I have been a nurse for 1 year and 4 months. So, I don’t want to jump on the first wagon before considering my options well and getting more experience. But I have the itch to just continue education! 
 

This low census job, might be the perfect opportunity to study a little bit at work. The thing is that I am not a chatty person and some of the nurses like to engage in small talk. I rather be reading a book, watch Youtube or Netflix but I don’t want to be rude and unprofessional. I also don’t want to get in trouble because ‘someone’ told my manager that I brought homework to work, and I am not taking care of my 1-2 patients. There is always someone watching... and talking behind your back, you never know!  
 


 

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