Published Nov 1, 2005
Monica RN,BSN
603 Posts
As the DON in my facility and understanding the realistic side of the profession, (I work the floor too if needed and help with all aspects) I am not a sit at the desk manager. I am catching heat to make certain no one has a second of overtime in the building.. now, nurses have times when this is not realistic... what about when I get a call in and someone has to stay, or actually volunteers to stay.. as is the case most of the time.. I have been in LTC for many many years.... from all of you other seasoned LTC nurses... what ideas have worked in your buildings to mimimize OT?? (besides unaviodable to totally eliminate!? can this be for real??)
violetrose
23 Posts
Monica::rotfl:
I am having the same problem with NO OVERTIME!! I'm a chg nurse in a 78 bed facility. I do all the MD calls, updates ect. I try to get my faxes out if the fax machine works or calls by 10AM. Invarabily the Docs don't call back until 4:00pm or later. Now I take the orders, have to chart and do them put everything were it belongs and order the meds. I'm overtime!! What to I do?? My DON says to pass it along to the next shift, but I took the orders, some nurses will not do them or will they do them correctly. Either they don't get done until the next day which is not legal, I'm stuck!! Besides it the trickle down effect, then they are overtime doing my work. I don't have a lot of control over my day, it's never the same.
I also do admissions, most of the time they come late afternoon. Now what, no overtime, an admission from start to finish takes about 3-4hrs if I do the Care Plan and orders are correct on the PPOC, I don't have to clarify to many of them with the MD.
My day is so stressfull, I have families, residents in my office to chat or address concerns, answer call lights, do all the MD rounds usually the first two weeks of the month. Help the other nurses with assessments and the DON with all her overwhelming jobs. She is excellent willing to help where ever she can if able.
I'm an older nurse, not quite retirement but close, I would hate to end my career by my licence being suspended or taken away for failure to be a my work properly and correctly eg: Negligence
I would even work off the clock but our administrator says that would be deciplinary action. I don't know what they expect, do 12hrs work in 8hrs but don't make a mistake!!
Hurry, Hurry, Hurry
I've worked in LTC for 25yrs, this is the worse it's been, the resident are sicker, we have many difficult dementia residents with behaviors. I'm just rambling now.
These are my thoughts, NO OVERTIME!!!
Gail: angryfire
CoffeeRTC, BSN, RN
3,734 Posts
Hire dependable nurses (Were or how do you find them...good luck)
Permit staff to trade shifts with permission from DON...that way no one will call off.
Have a few PRN staff that you can call just in case...Pay them well and they will come in. Would be less than OT.
Mister Chris, MSN, NP
182 Posts
Monica::rotfl: I am having the same problem with NO OVERTIME!! ............................ .....................................These are my thoughts, NO OVERTIME!!!Gail: angryfire
I am having the same problem with NO OVERTIME!! ............................ .....................................These are my thoughts, NO OVERTIME!!!
I have been in a similar situation but now work for myself as an independent nurse. I make it quite clear that the hours I work are the hours I will get paid! Sounds a bit bossy but it works and I do get called back again and again.
Good luck and thanks for your input. (I retire in a couple of years too!)
Mister Chris:specs:
I have been in a similar situation but now work for myself as an independent nurse. I make it quite clear that the hours I work are the hours I will get paid! Sounds a bit bossy but it works and I do get called back again and again to the same places. Also I am told that the nurses know just how I stand. I get paid for all the time I work but my rate not theirs, and therefore no overtime!Good luck and thanks for your input. (I retire in a couple of years too!)Mister Chris:specs.
Mister Chris:specs.
StNeotser, ASN, RN
963 Posts
To be honest, it's not realistic.
I left long term care after being put in the spot that I had to do a 6-2 shift after working 10-6. I was horribly unsafe as by the time I left the building I'd been up 26 hours, and all because they didn't want to pay a pool nurse or horror of horrors, have someone from the administration take the floor. As I didn't work 40 hr weeks they didn't have to pay me overtime. You don't keep dependable nurses by doing things like that to them.
If someone has to stay thirty minutes to follow up and chart something that will later legally save the nursing homes licensure, then they have to. I realize you already know this. Sorry you're being put in this position.
dian57
50 Posts
I sit at those budget meetings and believe me, they aren't pretty. When the directive comes down NO OVERTIME, what is actually meant is, No Unecessary Overtime. On review of my staff time sheets, the worst overtime offenses are leaving a few minutes late. Every day. Enough people do this on a consistent basis and it adds up to an enormous waste of money.
When your manager enforces Get in on time and clock out on time unless you're authorized to stay, she/he is serious.
No one will question a nurse staying because of a call-out on the on-coming shift or a nurse staying because of a late admission. That can be justified and if the manager's a good one, they'll argue successfully for it. It's the 6 minutes here and 4 minutes there because someone stopped to grab a cup of coffee or chat with a coworker before punching out that kills the budget over time.
jodyangel, RN
687 Posts
I'll tell you what. I've not seen any nurses where I worked just chat each other up in order to get overtime. The ONLY reason anyone stayed after 7:15pm was to finish their work. I worked there almost 2 years and probably only left a few times right at 7:15. Typically, I wouldn't be able to clock out until about 7:45 or 8:15pm. Because.....you can't leave til you're done documenting ect. There is just too much to do in your 12 hrs. Then hubby is calling saying Why can't you leave on time? LOL. Well when you work in an understaffed facility and you usually don't have Nurses aides to help with pt. care...its all on the nurse.
So yeah, they came around the other week saying they were cutting down on overtime. HA. How can you do that? And you know, if they Ever ask you to clock in and finish your work theyre in deep doggy doo. Don't ever do that!!!
Daytonite, BSN, RN
1 Article; 14,604 Posts
What about overstaffing each day with a prn nurse? If you get a call off, that's the hole the prn fills. If you have no call offs you have two choices: offer a day off to one of the regular staff and use the prn. Or, call off the prn nurse. Either way, you end up not paying overtime. An added bonus is that if one of the regular staff decides to take the day off, you can give them the option of getting paid for the day out of their vacation pay bank. This is how we used our prn nurses in the acute hospital. You need to make sure that the prn nurses understand that they may have to float to different units each day and that there may be times when they will be cancelled. The trick is to walk a fine line between the prn working and getting cancelled. If you cancel them too much they don't get many work days and they end up leaving. The way the hospital worked with prns was that we let them sign up to work any days and times they wanted. Only the nursing office and the supervisors knew which prns were on the staffing list for each day and shift. That would be something a nursing home would want to do. If the regular staff realize that there is a prn nurse waiting in the wings, your call-offs may increase. (But, those are people you track attendance on and boot out the door when they've abused it.) You could also do this with a part timer. If your overtime is being eaten up by a lot of call offs and holes in the schedule, this may help you out immensely.
In the hospital we had to keep a book (similar to a float list) to make sure no one felt like they were getting passed over in the offer to take a day off. The smart nurses realize that when they need to take a day off and don't want to get charged with a sick day, the thing to do is work a deal with one of the prn nurses.
With the right prn nurses and part time nurses and making sure they were getting work from the facility, you could really turn this into a lot of plus advantages for you.
mar326
10 Posts
It seems to me that most LTC facilites have this same problem. Why isn't the budget made to reflect the need for some overtime? With all the paper work it takes for a new admission or a readmission from the hospital it is crazy to think that it can be accomplished is regular work time. What does administration think nurses do when they have no admissions during the day?
How about schedule a nurse to work like a 4 or 6 hr shift. At one time we suggested this and we almost got it. Maybe a 11-5 or so shift. They would help with calls to docs, new admits and family situations. Schedule all the admits/ discharges for around this time. I would love to work somthing like this. For us it would work well. We have 2 nurses for 48 pts, no secretary or charge nurse.