Low L&D Census, losing hours. Does this happen often?

Ruby Vee, BSN · Mar 2, 2017

I've never worked L & D, so I have no information that is specific to your unit. I used to work in a CCU where we had a large influx of staff from CCU in a neighboring hospital because this sort of thing was happening to them. In general, I've noticed it seems to happen more in smaller community hospitals where they pull their patients from the surrounding community. Large teaching hospitals it's a little more rare, although it does happen occasionally -- when the doctors all go to Reno for their "conferences", for example. Or around the holidays when no one schedules surgery because they don't want to be in the hospital over the holidays.

klone, MSN, RN · Mar 2, 2017

As Ruby Vee said, this is more likely to happen in smaller hospitals that staff a separate OB department. The really small hospitals don't have enough births to sustain a discrete OB staff, so the nurses work in all areas and float to a different department when there's nothing happening in OB.

Let me ask you this - what is your "on call" policy? If this is happening very frequently, I would say that your department needs to utilize more "on call" staff, and staff fewer nurses for the shift. How does your department determine who gets "opted" as you phrased it? Is it a rotating list or based solely on seniority? Do you maintain a list of nurses who will take voluntary "opt" for a particular shift? Is your unit a closed unit, or do the nurses have the option to cross-train and float to other units?

quazar · Mar 2, 2017

Yeah, in my experience, as the PP stated, that sort of thing happened to me at smaller hospitals. Working in a hospital that does 400+ deliveries a month, it doesn't happen nearly as often (but it does occasionally happen!). If you're getting cancelled a lot, either go to a different hospital, or ask if you can float to a different unit to help out to keep your hours. In the smaller hospitals where I worked, I found that L&D often became the hospital wide float pool, so it wasn't unheard of to be floated to a med surg floor or the ED when census was low.

ashleyisawesome, BSN, RN · Mar 3, 2017

I work in a mid sized teaching hospital. We do around 250-300 births a month, but we do have some slow periods where people get put on call or sent home early. We go by request. So they will first send home or call off people who requested to be called off. If no one volunteers they will send people who are in overtime or over budget home first, then they go by who was last called off (so someone doesn't keep getting called off several days in a row). I know some nurses that rarely if ever get called off because they don't want to be. I personally get called off whenever I get the chance because I'm not usually hurting for money and a free day off is always a pleasant surprise for me!

Our charge nurses usually leave one or two extra nurses on staff in case something comes in, plus at least one person on call at home in case the s*** hits the fan.

We also occasionally get floated to our other campus' L&D floor if we are slow and they need extra help. I've never been floated to another floor like med/surg (thank god!).

Lauraingalls, BSN, RN · Mar 4, 2017

I am sitting here on call right now. We go by dates of last call. Our numbers have slowed recently and I am getting put on call at least one a pay period. I honestly dont mind because like another poster said, I am not hurting for money. But if I was the sole provider for our family, I would not be happy.

klone, MSN, RN · Mar 5, 2017

I am sitting here on call right now. We go by dates of last call. Our numbers have slowed recently and I am getting put on call at least one a pay period. I honestly dont mind because like another poster said, I am not hurting for money. But if I was the sole provider for our family, I would not be happy.

I wish our facility went by date of last call. However, we're a union facility and call goes by seniority. Which means that most of the time, it's the same 2 or 3 nurses getting put on call all the time. There are a few nurses that, during low census times, get put on call 40-50% of their shifts. It sucks. Luckily, many of the nurses really look out for each other and are willing to share the burden and take a night off, even if they don't have to.

mtnviews · Mar 5, 2017

I work for a unit that does about 250-300 deliveries a month. This time of year it just seems to fluctuate more day to day. The other day they were offering emergency staffing pay because it was so insane. I was tempted but didn't take it, because I was scheduled to work 5 12s in the next 6 nights. Then I ended up called to stay home for my shift 2 nights later because there were literally no patients on the unit, which almost never happens. In hindsight I wish I had picked up the emergency staffing, but who knew? :)

They take volunteers first, then call off registry, then go by a combination of how many shifts you've been cut for and dates of the last, if more staff need to be trimmed. It usually doesn't get to the point that regular staff is forced, for us anyway. Registry is definitely feeling the hit lately though. But it picks up closer to summer.

Orientees don't get cut at all, and can't get cut for quite a while after orientation. Our last batch of new grads can't be cut or ask to be cut until they've been working for 6 months on their own. Occasionally they'll keep more staff on than needed just to keep a good experience mix on hand.

BSNbeauty, BSN, RN · Mar 8, 2017

OB is feast or famine for us at my hospital. There was a time when we were really really slow. Some nurses even split shifts rather than having to use all of their PTO. We have a list, that goes by last call date. So it is not by seniority which is a plus.

jenrninmi, MSN, RN · Apr 4, 2017

We have on average 50 deliveries a month. So, yes there are going to be times we place a nurse on call. But those are also the times we welcome gyn surgeries. We are only a 10 bed unit. Now saying this, there are a few of us that welcome a day off work. Me included. :)