LTC staffing

We have on call for licensed staff. There are 8 of us on the on call rotation. If someone calls out we are expected to go in and take the cart even though we might have already worked our 40+ hours that week. Frankly it sucks.

Worked a small NH. No agency. We had a policy that nurses were paid 'time & half' for any shift they covered for which they had less than 24 hours notice.

For example, if a nurse called out for the next 11-7, any nurse could stay (or come in extra) for 'time & half'.

No hassle! No questions. No need to call the Pope for approval. Easy peasy coverage. And payroll never screwed up your check (even if you were under the 40/80 'worked' hours rule. You stiill got your 'time & half).

Seems we had several nurses who didn't mind staying extra or covering extra. Didn't happen often, but it seemed NOT to be a problem to get someone to cover. The little extra pay was nice once in a while.

Where I work the steps are as follows: First try calling in staff to cover the hole. By policy we are supposed to first call the casual/on-call employees, then the regular employees that would not get OT by picking up the shift, then the regular staff that would be on OT if they picked up the shift. All these calls with the exception of the on call/casual staff are supposed to be made in order of seniority offering the shift to the most senior staff first.

The next step is to offer the open shift to staff that is working. Since our CNA union policy provides for OT after 8 hours the shift would be OT for anybody that worked it so this is also supposed to be offered to staff by order of seniority giving the OT opportunity to the most senior staff first. Nurses are not union so this is skipped for us.

Last step if nobody voluntarily takes the shift is to mandate staff to cover the hole. This is also done by seniority, but in reverse. The staff mandated is the one that has the earliest previous mandate date on the "mandate list" unless two or more employees share that date. Then the mandated employee is the person that is the least senior if two or more staff have the same previous mandate date.

If it sounds complicated that's because it is. If the scheduler is in the building the steps are usually followed as they are supposed to be but when the call ins are after business hours or on the weekend we usually just go straight to the mandating step as nobody has the time to sit on the phone to make all those calls that most likely wouldn't result in anybody picking up the open shift anyway. Technically the CNA's could file a grievance if all steps aren't followed but nobody has ever complained formally that I'm aware of. Be aware though that if your facility is unionized you will need to hammer out a mandate policy with them before implementing one.

We call all available nurses and all the agencies to get shifts covered. Once in a while we have to work short but all efforts are made to get it covered.

Are you are in a position to offer bonuses for picking up the shift? Our policy says that it’s the employee’s responsibility to find coverage for their shift. All of our nurses and caregivers work 12 hour shifts. I typically offer a $50 bonus for caregivers and $100 for nurses. I try to maintain a healthily relationship with each of my staff so when the need arises, I have a multitude of associates willing to pick up.

I worked at a LTC facility who had the DON work as the 3-11 and 11-7 Supervisor while the ADON worked as the 7-3 Supervisor .

There was always a short staffing problem where I worked. DON used to do the Floor at times when I first started to work at one LTCF. then she retired...and I never saw any of the new DONS(which we had many after the first one)took the floor. CNAS quit, fired or just never showed up... some long in the tooth CNAS stayed and duked it out. Most always...if a  Nurse  called in any management nurse, Care planner, ADON, or Nursing Educator would come in . I always had coverage.....but sometimes it was very hard to get those management nurses to come in even though  they were supposed to.They would try their darnest to get you to stay.