Low Census- To Take Cancel or Not?

[nurse678]

I'm a new RN and was given the option to take cancel on Christmas, which I happily took in order to spend time with family. Now there is low census in the unit. If asked if I want to work or be cancelled again, does it look bad if I say I'll take cancel? To me it doesn't matter whether I work or take cancel. I'm at a point in my life where I don't NEED to work to pay the bills. So, is it better to say that I want to work, but wouldn't mind being cancelled if no one else volunteers? What would you do?

[Susie85]

I was wondering if someone would mind explaining what you mean by low census. I know what the word census means but the different ways I have seen it used have confused me a little. I think I know what some people mean but even if the number of patients may be low in a hospital at a given time you still can't be sure the number could not go up significantly. I may be over thinking this but hopefully I don't sound stupid. Based on my question it's probably clear I am not yet a nurse :)

[ImThatGuy, BSN, RN]

From a supervisory perspective, albeit I've never been a nursing supervisor, I couldn't have cared less if my employees opted out for the holidays. If you're entitled to time off then use it!

[military spouse]

I was in a similar position to you a few years ago and always volunteered for first call-off. The bad thing, was we were on an hour recall, so if the census went up we had to go in. Didn't like that part!! I don't think it reflects badly on you at all. Many people are in situations where they REALLY need all their scheduled shifts, so if you don't you might be helping somebody else if you take the cancellation.

[Meriwhen, ASN, BSN, MSN, RN]

If you are offered cancellation, there is absolutely no reason why you should feel bad if you want to take it. And you shouldn't have any reason to feel bad should you refuse it and opt to work instead.

[locolorenzo22, BSN, RN]

if I'm first up, and it is offered, I happily take a turn. Not fair to me to make the shift call around to find someone to volunteer to lose hours, then call me back and I have to come in....

However, if someone else really NEEDS to have the time off even though I'm first, or really NEEDS to work cause they've been losing hours, I'll think about it.

[DoGoodThenGo]

I was wondering if someone would mind explaining what you mean by low census. I know what the word census means but the different ways I have seen it used have confused me a little. I think I know what some people mean but even if the number of patients may be low in a hospital at a given time you still can't be sure the number could not go up significantly. I may be over thinking this but hopefully I don't sound stupid. Based on my question it's probably clear I am not yet a nurse :)

At it's most basic meaning, "census" is simply to count, or a count of something. When it comes to the floors or units, unless a major event happens usually it isn't hard for management to make a good "guess" as to how many nurses are required versus filled beds. Much of course will depend on what sort of ratio's the facility uses.

Remember many patients within a hospital are coming to floors/units from someplace else in the facility. Admissions from the ER, transfers to units from floors and vice versa, patients coming down from or being sent to OR, and so forth. Therefore management simply makes calls around to whatever departments/units they interface with to see if how many, if any patients are likely to be sent.

For other floors such as Med/Surg, L&D aside from emergencies, admissions are scheduled, so again management has a pretty good handle on staffing required.

If things suddenly get very busy, management has several options. One is to simply deal with things with staffing in place until the next full shift of nurses starts. To this can be added float nurses from other departments, and finally call back in nurses who were sent home.

While not perfect, many hospitals are going more towards "just in time" staffing and or sending home nurses whom are felt to be surplus to requirements. Again absent mandated staffing ratios, just how many nurses are needed for the amount of patients on a floor/unit is up for debate.

[regularRN]

You may want to suggest a "system" to your staffing office, such that they have a list of people who voluntarily want to be "called off" on that shift - first come first served; people on this list are called in order after all people scheduled to work "extra shifts" (i.e., over and above their contracted number of hours). Then, if still more staff have to be called off, the staffing office calls those who work per diem (being called off when one is per diem is not unusual) and then finally they call off scheduled staff depending upon whose turn it is.

You can inform the staffing office if you do not mind being called off, even if you haven't officially put your name on the list or you can put your name on the list - either way you are helping the hospital and your colleagues, because you are in a fortunate financial position - many RNs are their family's main or only breadwinner, and losing a shift to call off makes an impact on their budget.

Opting to be called off or accepting call off is not viewed negatively. However, at times of high census be prepared to take an extra shift if necessary! Staffing is all about staff being flexible...