Low census policy at your hospital?

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I have a question that I am hoping to get answered here. I am a recent grad who is beginning to see the reality of working in a hospital, and the issues that I did not know existed when I was interviewing for work. One of the biggest that I can see at the moment is the issue of low census, and the policy at my hospital is as follows: I am scheduled for 36 hours per week ( 3, 12.5 hour shifts). At any time, if there is a low patient census, we are told (in rotation) to not come in, and will not be paid. However, we are expected to wait by the phone from 7 until 11, because they are able to call us back in any time during this four hour period. We are NOT paid for any of this time, and if called in, are only paid for the time we are clocked in once we get there, even though we were scheduled for and available to work for the entire shift. It also has happened once a person comes to work. You clock in, work an hour or so,and then are told to go home. However, you are also told that they might need you at 11, so you might have to come back. I saw a nurse actually do this two weeks ago. She was not paid for any of her time wasted on 2 trips to the hospital, waiting around, etc. Is this normal? Is this actually going on at other hospitals? PLEASE, tell me what your hospital's low census policy is. Are you paid for at least a minimum of say 4 hours? Do you have to wait around to be recalled? I am dying to know! This seems absolutely crazy to me. Thanks!

Specializes in SICU, MICU, CICU, NeuroICU.

WOW, just WOW. I can't believe that. If there's a union, what does it say about that?

At my hospital if there is a VERY low census they might close the floor for the weekend and re-locate the staff. My floor has a capacity of 36, and if there are less than 24 they can keep 2RN's on nights and use the 3rd on another floor if needed. Sometimes the whole hospital gets low on patients and the nurses usually use their sick, holiday or vacation time.

But they're NEVER told to stay at home by the phone waiting, that's insane. I know the OR on the weekends has something called the 3rd team backup in case the OR nurses are busy because they don't have scheduled cases. But they're paid and they're on-call. So they get paid to sit by the phone.

allnurses Guide

NurseCard, ADN

2 Articles; 2,847 Posts

Specializes in Med/Surge, Psych, LTC, Home Health. Has 13 years experience.

I'm fairly new at the hospital that I'm currently working.... I know that they have a low census policy, but I'm still not sure about the specifics of it.

At the hospital which I used to work, if we got called to take "standby" (or low census, whatever you'd like to call it), we were required to stay by the phone the ENTIRE twelve hour shift, not just the first four hours. However, it was rare to get called much later than like, 1 AM. Plus, we got paid a dollar an hour; not much more than not getting paid at all. However, I know of NO time in which a nurse got called in off of standby, worked, got sent home again, and THEN got called back in again! That is just ridiculous treatment/abuse of an employee, in my opinion.


417 Posts

Specializes in ccu cardiovascular. Has 12 years experience.

We have a low census policy at my hospital. We have a 21 bed unit so when we are below 18 one of three nurses are called off and usually put on call. We are expected to repsond to the call in less than 10 minutes and arrive at work within 30 min. We do get on call pay which is only 3.oo hour so i would rather get called off and just use my vacation time. I have been called in within a hour of my shift ending and asked to come in, which i refused because i live 40min away.

Specializes in Emergency Room.

that's crazy!!!! what's the point of having a job that "might" pay you? i think it is time to find anothe gig.


2,228 Posts

I no longer work at this hospital, but we would be put on call without pay, and many is the time I would drive all the way into work and then get canceled after I got there, with no compensation. They would pull a lot of other low down, dirty things as well. This was an HCA hospital.

Specializes in SICU, MICU, CICU, NeuroICU.

I can't believe I've never heard of this. Thanks for making this thread because this is definately something to consider when in a job interview.

Specializes in NICU. Has 18 years experience.

If that was the case at my hospital I would say SEE YA!

Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative.

My hospital cancels casual people first, many times in 4hr increments, so if your'e scheduled to work eve they can call you at 2 or later and tell you you're not needed but MIGHT be at 7 so call back about 5:30 and after hanging around may or may not be needed. this is fabulous when kids and babysitters are involved. They also give approved PTO to those who are coded based on rotation (for low census) . They used to give unpaid PTO (what an oxymoron) basically if all the staff refused or didn't have any PTO, you got cancelled..they stopped that a couple of years ago ....


38 Posts

I work in a child/adolescent Crisis Unit and census drops fairly predictably--ie summer/holidays. We are called 2 hours before shift if we are not needed to float to another unit and given the option of being cancelled. They cannot cancel a full-timer only per diem.

When you know the census is low, you can circle yourself to be called 1st or 2nd-but this is only if they don't need to float anyone. It ususally works because someone wants to be cancelled. We have gone to work to hear that someone has to go home and usually someone says yes, but there have also been times when everyone said no and we work with an extra person. They don't like it but so what?

We have the option of using vacation time or taking it unpaid. Once or twice they have realized they shouldn't have cancelled and called someone back but the person usually doesn't answer the phone or says no. They do not make you sit around by the phone after being cancelled.

Sounds like I have it pretty good. I wouldn't be able to stand being cancelled and told to sit by the phone.

locolorenzo22, BSN, RN

1 Article; 2,396 Posts

Specializes in Ortho, Neuro, Detox, Tele.

Well, it hasn't happened in a long time on our floor due to short staffing...as a matter of fact, I'm picking up bunch of days this month! Usually, if you are called off at 5, you have to be available to come in through the first 6 hours of the shift...however, you could use Earned time or write down that you were "Involuntarilary on call", which means you get your regular ET rate for time you haven't worked, but not much else. However, you write it down and everyone rotates in turns...and if you were there the previous day, you have "transferrence of care" so you cannot be pulled or called off.

I know of no cases where nurses come in, go home, and get called back in....if you get there and they "forget" to call you....they have to pay you for 2 hours anyways...and you usually wind up staying the entire shift...so you end up staying for 2 hours for sure..

OC_An Khe

1,018 Posts

Specializes in Critical Care,Recovery, ED. Has 40 years experience.

Either you are a professional or you are not. Hospitals that treat their Nursing staff non professionally and quite frankly like day laborers won't survive in the long term. No I take that back, they will survive as long as we, as professionals, accept this practice. By the way, being on call and not being compensated for it needs to be investigated with the state and federal labor boards as this is probably illegal. Any RN lawyers out there willing to investigate and maybe have a class action suit?

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