Low Census

[allstressedout1]

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.

[allstressedout1]

Very rare to be called off without being kept on call.

[allstressedout1]

Not half of them on a given shift but if they are a designated charge they are treated as a charge even if functioning as regular staff for the day.

[Been there,done that, ASN, RN]

I have worked in many facilities. In all of them, a forced low census day off was rotated throughout the staff, charge or not. Never saw a staff with one third of them charge, either.

Whatever is going on, you are not going to change it. Time to move on.

[blondy2061h, MSN, RN]

This used to happen semi regularly about 4-5 years ago on our unit, but the last 1-2 years (especially this past year) it has been rare to practically non existent. We are more often short staffed with completely full census most of the time.

When we do have low census, (has happened maybe 2-3 times since september..) there is a list of when everyone has last stayed home. We look at the list for each person scheduled to work the next shift and write out the order from who stayed home most to least recently. Then we call in that order offering them the chance to stay home (usually home on call) if they want. This will come out of their stat/time in lieu/vacation. If they say no we proceed down the list. We are under no obligation to stay home, it's actually more of a privilege. If you don't want to, you don't have to- but since we are getting denied so many days off and shifts are so busy crazy and hectic, it's usually people clamoring to stay home!

If everyone says no, we just all come to work, we cannot be forced to stay home once scheduled for a shift. Often the supervisor will make us float to other areas and help with tasks we can do (simple things such as vitals etc). Sometimes the clinical leader or manager will have little projects they've been wanting us to work on and get us to do that (reading manuals, checking carts, transport bags, organizing side rooms and cupboards, etc etc).

This is exactly how it works at my hospital. Once I was a highly trained sitter because census was low and everyone came in. I've done a lot of sitting but it was my whole shift that time. We haven't had that problem in years though, as you said.

[blondy2061h, MSN, RN]

No if it is your scheduled day you get LC but are most often required to stay on call. I might say be scheduled 3 12hour shift and 1 call day of 12 hours. If census is down I might be LCOC 1st day, work next 12 hour shift, LCOC 3rd scheduled day and spend 4th day sitting home on call for 12 hours. So 4 days tied up and work 1 of them.

Do you get pay for being on call? Usually standard is around 25% of your salary.

[Meeshie]

Call is rotated through our staff with a few exceptions. Being called out means being on-call for the entire 12 hour shift. When on-call you can either use PTO time or you can be paid 1 hour for every 4 without dipping into PTO. Exceptions are:

1) PRN will get called off first since we don't have a 'required need'.

2) Any employee that picks up an overtime contract is never called off - it's part of the contract (you agree to work 4 days per week instead of 3 for six weeks - there's a financial bonus involved plus the guarantee of no call out)

3) Anyone currently precepting a new employee cannot be called out on a day where they will be precepting.

Other than that it's done in turn and we keep a log book of the dates everyone is called out/put on call. We also have a log book for the dates people are sent to float, on those truly low census days.

[Lunah, MSN, RN]

OP, just a note — if you have use the "quote" feature to respond, it's much easier to figure out quickly which post you're responding to. :)

[calivianya, BSN, RN]

Low census doesn't affect us at all. At this point, we're up to ten nurses short some shifts - so low census just means that we get to have the appropriate number of patients instead of having way too many.

Most of the time the only reason we're "low census" is because we've blocked beds because admitting a single patient means that we would start having assignments with four ICU patients, and even our ridiculous manager, who almost never allows beds to be blocked, realizes a four patient assignment is unacceptable.

Out of the five 12 hour shifts I worked last week (at least half of the unit staff is working 60 hours a week right now because the opportunities for overtime are limitless), every shift that I didn't have a 1:1 I was tripled. That's pretty much what my unit looks like right now. We are fighting each other tooth and nail for the 1:1s because we're all tired of three patient assignments.

They're not appropriate three patient assignments, either. :/

[allstressedout1]

$2.50

[allstressedout1]

A third of them charge to make sure one of designated charge is there everyday. Part of there agreement of being charge is they dont do LC, or holidays or call or weekends unless they want to.

[allstressedout1]

Seniority, what is that?

[klone, MSN, RN]

Do you get pay for being on call? Usually standard is around 25% of your salary.

I've never heard of on-call pay being that high. Ours is $4/hour.