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Discussion

Low Census

How is low census handled around the country? A little low census is nice on occasion but when you need your income and low census is excessive what do most units do. Like for 8-10 week stretches you are maybe 2 to 3 days a paycheck short. Because a third of the staff are team leaders who are not required to take low census (or call, or holidays, or weekends) the remaining staff get more than they want of the low census. If you want to be paid you have to use vacation because you are not able to pick up extra work because you are still tied to unit by being kept on call while you are low census. Of course then if you are sick or had vacation planned your time is all gone.

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    • Admin

    I've been getting low censused the last half of a lot of shifts lately. It's the impetus that drove me to move into a new position.

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    When I worked in peds it would rotate and wasn't that often, but I only worked there for a few months. Working ER it's very rare we would get sent home. Even if the day is going slow, at best it might just be leaving a few hours early and there are always a lot of volunteers so it's never been an issue then either.

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    Our hospital is union, so low census call-off is based on seniority. Sadly, that means that the same people are getting called off all the time, unless someone wants the shift off and puts herself on the call-off list.

    The only thing that helps is if the nurse is trained and willing to float to a different department. One of the other departments can almost always use another nurse.

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    We have sign up sheets for low census. They rotate those on the sign up sheets so that the same people aren't always getting low. So if I'm scheduled Fri and Sat and am first on the sheet both days, if I get low on Friday then on Sat they start calling the second person on the sheet (providing the second person didn't get low on Fri as well, if that makes sense?) Holiday low census is a lottery-type deal. We have the option to take it unpaid or use PTO. If we get called in 4 hours or less into the shift it's like we never got low.

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    • Author

    We rotate too but half of our staff being charge nurses they work regardless so the rest of us rotate. If stays low awhile 2 to 3 days of a 6 day paycheck is a lot.

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    The full time staff does have a bit of protection because overtime gets called off first, then anyone per diem. The hospital is large, so there are lots of floating opportunities and that avoids some cancelling during low census.

    For the people who really want to avoid using PTO, around here there are a few units that stay full and never seem to have enough staff. There is always the opportunity to pick up extra hours in those units.

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    We rotate too but half of our staff being charge nurses they work regardless so the rest of us rotate. If stays low awhile 2 to 3 days of a 6 day paycheck is a lot.

    But they're not all charge nurse on the same shift, right?

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    • Expert
    How is low census handled around the country? A little low census is nice on occasion but when you need your income and low census is excessive what do most units do. Like for 8-10 week stretches you are maybe 2 to 3 days a paycheck short. Because a third of the staff are team leaders who are not required to take low census (or call, or holidays, or weekends) the remaining staff get more than they want of the low census. If you want to be paid you have to use vacation because you are not able to pick up extra work because you are still tied to unit by being kept on call while you are low census. Of course then if you are sick or had vacation planned your time is all gone.

    This seems like a really raw deal. Do you get Call pay? Can you become a Charge Nurse or Team Leader?

    Could you ask to be cross-trained so you could float?

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    Unless you work somewhere that has a defined and consistent census, the expectation of low census needs to be something that you expect to happen and your budget should be based on how much you're likely to actually work , not how much you could theoretically make if there wasn't any low census.

    I'm not really getting how half your staff is assigned to charge nurse on any given shift.

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    • Moderator

    Ask to be cross-trained to your stepdown or the ED. Then you can float. :) Or what about a PRN position in another hospital? You could work there on non-call days every other week or so (depending on their minimums) to make up for lost wages.

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    • Author

    We are not let off though. Always kept on call In case needed in our unit, so can't go to just any unit to work because have to be available for ours. Also most of us don't know enough about adults to float on adult floors and can't really float to "dirty" or areas in case we are needed back on ours.

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    • Expert

    We have the opposite problem: too many patients, sometimes not enough nurses :/

    For the times we do have a low census, the cancellation policy is as follows: any OT staff is always cancelled first. Then staff who volunteer for cancellation. Then registry staff. Then per-diems. Last to be cancelled the regular staff, and that's on a rotating basis--we keep track of who has been cancelled so everyone has an equal chance of getting the chop. If you get cancelled, you have the option of using PTO to cover the hours or taking it unpaid.

    Usually, it never gets as far as forced cancellation of regular staff. After the OT (if any) is cancelled, there's at least one or two staff who request to be cancelled if not needed.

    OP: if you find yourself being cancelled a little too often, you'd be wise to pick up a PRN or registry position at another facility, so you can make up any cut hours.

    We are not let off though. Always kept on call In case needed in our unit, so can't go to just any unit to work because have to be available for ours.

    I would hope that they are compensating you for being on-call then. Otherwise they are royally screwing you over, IMO.

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