New Nurse, On Call, Called Off My Scheduled Shifts

[Owlseye, RN]

So I'm a new nurse, graduated in May 2020. I went back for my ADN at 30, and working on my BSN now, so I'm a little older than a lot of new grads. I also have a part time job tutoring A&P at my old college.

I'm currently working nights on a TCU/cardiac unit, supposedly full-time at 36 hrs/week. Twice in the past month, since census is lower, I've been put on call and then they've called me off my regularly scheduled shift. So basically they told me I have to use PTO if I want to be paid for what were my regular scheduled hours. Or I can just go unpaid, other than a few bucks an hour for the time I was on call.

Is this a standard practice in hospitals? I mean, I signed up for a full time job, not to waste a day sleeping for a shift I don't even get, and losing pay or having to use what should be my earned vacation time.

I really don't know what to do. I've been here since September, so just over six months nursing experience in total (four if you don't count floor orientation). I have two kids and a partner, I'm the primary breadwinner, and this is not financially sustainable for us longer term.

Is calling nurses off and making them use vacation time/PTO just to make ends meet a normal practice at most hospitals? I literally have no idea, as this is all quite new to me.

I'm really anxious that this is going to ruin me financially, like I budget everything already to the penny and save everything I can, but if this keeps up it's gonna be a problem. It's infuriating that I'm supposed to be working full time but it's actually just whatever they deign to give me.

Thanks for reading y'all, I appreciate it.

[verene, MSN]

Low-census is a thing at hospitals, and may results in being "called off" sometimes (particularly once an RN is through the probationary period) you can be trained to cross-cover or float to other units and may then be "floated" rather than called off if your home unit has low census. At other times there can be plentiful overtime and you may even be mandated to work over time. 

The specifics of low-census polices and pay, floating policies and pay, and mandating, should all be spelled out in your employment contract.  It is always good to ask how often you may be low-censused or floated when interviewing - some units go through regular feast/famine cycles where you can predict that a certain month will likely be low hours and another month excessive overtime.  Other units may keep more stable census numbers and rarely have either low census or mandates.  Either way - I'd recommend you reach out to your manager and find out more about what is typical for your current unit and schedule AND to let them know that you would like to be working full-time hours consistently and see if there are any opportunities (floating / cross training to alternate roles, moving to different unit) that would allow for this. 

You may also want to talk to your scheduler - some people like to volunteer to take low census / be called off - others like to be available to work overtime or to float - if your scheduler knows which you are - you're a little more likely to get called for whichever is available. 

[socal212, CNA]

Yes that's how it goes in my hospital.  It sucks, but if there's no patients, what else are they supposed to do?  My hospital rotates cancellations based off when you were last cancelled.  This is pretty typical for the Spring/summertime.  It usually picks up again in the fall.  Unless you move to a busy hospital I imagine it's going to be the same everywhere.  I second talking to your manager about it.  There are often people who do want to be cancelled first if possible.  

[Sour Lemon]

Yep. That's totally 100% normal. The places I've worked swing back and forth between overstaffed and understaffed.

Nurses are usually started in groups and take a while to push through orientation. I suspect they hire more staff than they need because of the length of time it takes to get a new employee off the ground. Beyond that, some quit before their orientation is even complete. And some don't even show up for the first day of orientation.

[HiddencatBSN, BSN]

Very common. In the ED that’s happened to be once because our census can shift quickly and the unit generally likes to hold on to staff to be able to handle potential shifts but when I worked med surg it was common especially during the Summer. We rotated who was called out and honestly it was nice to sometimes have an extra day off. Much better than having to be floated to NICU. Twice in a month doesn’t sound excessive either. I agree to see if there are opportunities to cross train or float and see what the policy is on who gets called out. 

[LovingLife123]

Yes, it happens.  I always try to keep 12-24 hours of pto around for that and a call off.  It hasn’t happened for so long on my unit with covid, I’d love for it to happen again.  I always felt like a kid with a snow day!!

But, it should not be happening often.  If your census is that low all the time, it could be a problem for the unit.  

[JKL33]

This is the usual, and isn't a great situation. [I think we can stipulate/agree that it's better than xyz like not having a job].

While people have pointed out that what you have experienced in the past month may not become a consistent pattern throughout the year, you are correct that it amounts to significant money or loss of your ability to determine what you do with time off that you have earned. In effect, it lets them have more influence over what you do with time off that you have earned (or else just flat out give up money).

Some people say that the time off they allow you to accrue per hour worked already accounts for the called off hours that they expect per employee, and that if they paid this time (being called off) through other means you would simply earn less PTO per shift worked with that aspect out of the equation. But one way or another it works out to their advantage or else they would have no need to commingle these two things.

Yes, talk to your manager. And when they call to put you on-call tell them point blank you'd prefer to work and ask if there's anyone else who might be interested in being on-call. But ultimately this boils down to a matter of personal finance. It sounds like you are working hard on that, so if you're not thrilled with this situation that you posted about (as I also have never been) then let that be your motivation to do everything you can to get into a solid position. That's what will give you more choices and more control. ??

[Hannahbanana, BSN, MSN]

There should be a “call-out /OT book” where there’s a record of who got called out or mandated on what day and whose turn it is next (allowing for normal rotations). If you think you are getting called off /mandated more than others, or some people are rarely if ever called off /mandated, there should be data one way or another as a matter of basic fairness. bring it up in staff meeting with a few supportive colleagues and see what happens.
 

Some people may fuss about it but if folks are allowed to trade days between themselves without prior approval PRN the basic fairness of it all will become second nature to everybody sooner rather than later. 

[JBMmom, MSN, NP]

We also have a volunteer list, usually someone is willing to be cancelled. When the census is unexpectedly low, they may not have filled out the book. If no one has volunteered, it's usually on a seniority basis in my unit. Sometimes you're unlucky enough to be the least senior more than once, but fortunately for us, low census is pretty infrequent.

I still pick up per diem on the med surg floors so I can usually get floated to another unit if we're low. You can ask about cross training to make yourself more easily floated. Good luck. 

[SilverBells, BSN]

Without having any hospital nursing experience, I can't say for sure whether or not this is common.  It does make sense to call-off nurses if there aren't enough patients, but this should not be a regular occurrence.  

With that said, if this continues, you may want to look at applying at LTC/SNFs in your area.  I can almost guarantee you that you would have more hours and shifts than you could ever imagine or even want ???

[amoLucia]

2 hours ago, SilverBells said:

With that said, if this continues, you may want to look at applying at LTC/SNFs in your area.  I can almost guarantee you that you would have more hours and shifts than you could ever imagine or even want ???

Not necessarily!! This also happened when I was working LTC/SNF a while back. NH census can fluctuate for various reasons and calling off staff is quite common. A common rule in NHs is 'they don't get paid for empty beds'. So o then it means facilities won't pay for unnec staff when census is down. And there could be various reasons for low census. So staffing needs may fluctuate down too.

I, for one, liked to take the day off and use a PTO day.

I guess it all depends on the facility and timing.

[JBudd, MSN]

I am the most senior one in my department, which means I have tons of PTO hours banked.  We all get called off, or sent home early these days, and other nights are swamped because the house is full and our ED admits aren't going anywhere.  We are supposed to rotate who gets called off or sent home, but doesn't always happen that way.  The midshifters tend to lose hours at the end of their shift, as we who overlap are coming in (rather than being told to come in later).

I tend to get called off more because I can cover my hours more easily, than some of the younger ones who don't have much chance to accumulate PTO hours (the amount we accrue goes up every 5 years until 15 years of employment).  I don't like it, but I do see the financial strain it puts on others that it doesn't on me..... so, I take the time off.