Low census...please help!!

[sarapRN]

Hi everyone, just wanted to throw out a question. We are a unit that had everyone working 12 hour shifts, either 7a or 7p. We have just added an additional 12 hour 3a and a 3p shift to our rotation, and now are encountering some low census issues. We are having the problem of how to low census fairly. Just wondering if people could share their units way of doing low census. The problem we are having, is the overlap of the 3a or 3p person...for example, should the person who was low censused at 7p have to come in at 3am because it is the 3a's persons "turn" to be off. Any thoughts would be greatly appreciated!

Thanks =)

[Rose_Queen, BSN, MSN, RN]

We go alphabetically for people to be off involutarily, unless there are enough volunteers. If you're off, you're off for the entire shift. Working in the OR, we do have call people to utilize if it becomes necessary. There are times we've skipped over people because of the particular shift they work (only weekends, they're working nights that week) but come back and catch them at a later date.

[GM2RN]

Sorry I can't help. I work in the ED and have never been staffed since my shift is an essential one which would leave them too short in the early moring hours if they let me go. Some of the other nurses have been voluntarily let go a few hours early, but it's pretty rare for anyone to be staffed for the entire shift, so I don't even know how it's decided.

[Jdog19s]

In our unit, we go in order of who was sent home last or who was given the day off last during low census days. If a 7a to 7p person is at work and 3 pm comes around and you have 3 new nurses coming in, but the 7a to 7p person is on top of the list when compared with the 3 new nurses for going home early, then she is offered to go home first, if she declines then you move on down the list. If you send home the 7 pm-7 am person and then a 3 am nurse is coming in later but would be on top of the list, I would not call back in the 7 pm nurse- that would be rediculous and unfair, not to mention it would bring in a nurse for 4 hours to cover the 3 am to 7 am shift and then you change nurses again and its not good for continuity of care. Once someone is put on call or off, they are only called in if the patient situation changes, not if there is a change to which nurse is coming in or leaving. I'm sure the 3 am nurses will not like that rule as it is more likely that patient ratios change during the evening shift and not the night shift, but then again they signed up for the shift they have and can try to find a different time slot if they would like- For the 3 am nurses, perhaps they will be on top of the list when the 7 am people are coming in and they can end there shift early-but calling people in who are already home so another nurse can leave or not come in is never a good idea- hope that helps

[sahm02]

we keep track of when you took it last, PRN people are always offered first, then down the list, if no one wants it then PRN have to take it. if staffing is low during the shift, again we go down the list asking if anyone would like to go home based the last taken list.

[Moneymn316]

That is unfortunate that they added this overlapping shift.

In our ER the nurses over lap but that is because the patient load fluctuates.

In my unit (ICU) we are all 7-7. There is an occasion when we have low census. For these instances people can sign up for it in advance or if it comes about and no one has signed up then the manager will walk around the unit and ask who wants to go home. The most senior person has the first choice.

Being there only 2 years I never get it...unless previously signed up!