Low Census

Editorial Team / Admin · May 23, 2017

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

I'd take your $4- it'd be an improvement over my $2!

blondy2061h, MSN, RN · May 23, 2017

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

Oh wow. Guess we're lucky. This also probably explains why we don't use call frequently.

guest974915 · May 24, 2017

To my mind, low census-'flexing' is a complete deal breaker for me and was my primary impetus to pursue travel nursing. Now, if I am called off, I am paid a full salary regardless. I am at a loss to think of another profession that can be treated in this manner-trading in a full day's wages to be 'on call' and being offered insultingly low compensation to do so. I realize that hospitals have a bottom line, but I feel that this practice is a breach of the implicit employment contract-I show up as expected and am a productive, competent employee, you (hospital) assure me full-time, not 'sometime' full-time or 'mostly' full-time hours. I'm sure that someone will interject 'lawyer speak' or 'at will states', blah, blah, blah to defend this is unacceptable practice, but when was the last time that one of the suit MBAs was forced to take the day off while offered $3.00/hr to be available at a moment's notice? Instead of balancing the books on the backs of the service line employees, how about trimming back the CEO's annual salary or unbelievable fringe benefits?

Here.I.Stand, BSN, RN · May 24, 2017

Usually they have somewhere for us to float to, although ICU RNs don't float to the floors. We do float to the other adult ICUs and stepdown units, or we can take post-pubescent pts in the PICU.

First called off are travelers, and then full-timers who are in OT.

We have a signup sheet for people who want to be low-needed; the charge RN looks at that. If several people are signed up, they take turns so that the same person doesn't get multiple days off.

If nobody is signed up, lots of times the charge RN will ask around or post on our social media group to see if any takers.

After that, everyone takes turns getting called off. That way, no one RN is stuck with drastically cut hours.

al2nc · May 24, 2017

I left a position in PACU for that very reason. I worked there 3 yrs never took vacation and had less than 40hrs of pto when I left due to the excessive low censusing. It worked out for me the last year I was there due to it being my sons senior year in high school and he was an athlete so I was able to attend everything without taking off. But I couldn't sustain in that so off I went... back to ER.

FolksBtrippin, BSN, RN · May 24, 2017

I'm in a union and low census is handled in a standard manner. You would not miss 2 or 3 days in a paycheck.

You cannot be called off for low census once you've clocked in. You must be accommodated for the rest of your shift.

Call offs are done in this order: volunteers, prns, then by seniority. If you have been called off before, you go to the highest seniority position for the next call off, this way you are never called off 2x in a row.

nursemols, ADN, BSN, RN · May 25, 2017

For my current unit this is an unfortunate common occurrence. It's been bad enough that they have started closing our unit on the weekend. I have since accepted a transfer to a different unit that does not close on weekends and tends to be a bit busier than my current orthopedic unit

catsmeow1972, BSN, RN · May 30, 2017

I work in an area that is very "snowbird-ish (is that even a word?) We are usually stuffed to the rafters in the winter. After Easter, we slow down considerably. We can float if the opportunity is available. Otherwise, the call-off list rotates. in the last 6 months, i've been low-censused twice. one was of day 3 of a three day stretch and the other was a day i picked up late in the schedule. My unit generally does a good job of not dumping the call-off on any one person too much. Can't complain. An unexpected day off now and then is a nice surprise. =-)

blah_blah_blah · Jun 3, 2017

My unit is actually closed right now due to low census (I work in peds). During the time we are closed (or if the unit is open and just low) and you're scheduled to work the supervisor will call (in order of high to low senority) before your shift and ask if you want to work/float or be on call. We always have the option to work if we want to (it's in our union contract that we are guaranteed our hours if we want it). If you're on call, you get paid for 1 hour for every 4 you're on call so if you get to stay home all night you still get 3 hours of pay. You can then use PTO to make up the other 9 hours if you want. If you choose to work and get floated, you get paid 2 dollars an hour extra for floating. If it's super slow they can offer to excuse you so they can't call you in at all but you don't get on call pay. They can't MAKE you be on call or excused. We still accrue PTO at the normal rate when on call.

No one gets cancelled unless they picked up an extra shift and/or they're in OT.

blondy2061h, MSN, RN · Jun 3, 2017

My unit is actually closed right now due to low census (I work in peds). During the time we are closed (or if the unit is open and just low) and you're scheduled to work the supervisor will call (in order of high to low senority) before your shift and ask if you want to work/float or be on call. We always have the option to work if we want to (it's in our union contract that we are guaranteed our hours if we want it). If you're on call, you get paid for 1 hour for every 4 you're on call so if you get to stay home all night you still get 3 hours of pay. You can then use PTO to make up the other 9 hours if you want. If you choose to work and get floated, you get paid 2 dollars an hour extra for floating. If it's super slow they can offer to excuse you so they can't call you in at all but you don't get on call pay. They can't MAKE you be on call or excused. We still accrue PTO at the normal rate when on call.
No one gets cancelled unless they picked up an extra shift and/or they're in OT.

Sounds like a nice place to work.

BadgerAlumna · Jun 3, 2017

At my place of work, they can't force us home once we are there and on the one or two times I can think that half our floor was empty, no one was called at home and given the option of coming in vs. using vacation time.

More of than not our unit is less than 4 beds open and we're usually full.

BumbleBuddy · Jun 3, 2017

Our census has been fluctuating a lot lately. People in overtime and PRN folks are usually canceled first. We keep a list of who gets canceled, put on call or floated and rotate through the nurses. If a nurse is put on call, especially for a night shift, we only keep them on call until 11pm, even though I think hospital policy allows up until 3am. Every unit I've worked on at this hospital doesn't call someone in after 11 or 12.

Our full-time charge nurses never get put on call or canceled unless it's an extra shift for us. There are only 4 of us (2 on dayshift, 2 on night shift) on the unit. Relief charge nurses are rotated through like all the other nurses unless they're the only person trained to charge on the low census day.

If you like your job, my advice would be to get a PRN/flexi job to supplement your income. If not, you could always try moving to another unit that has a more stable census. Before accepting the position I have now, I interview for a charge nurse role at a smaller hospital in my area. On the day of my interview, I noticed nurses were transferring patients and cleaning/bagging equipment. I asked what they were doing and was told that the unit was closing because the hospital census was low. The nurses and nurse manager I interviewed with were very nice, but I ended up passing on the job offer because I needed a more stable income.