Preventing call-ins

[Brandi,RN]

How do you (attempt) to prevent call ins at work? It's becoming a real problem where I work (CNAs more than nurses), what is everyone out there doing to prevent that? Attendance bonuses, having to work another shift, etc

[needlesmcgeeRN, ASN, RN]

It may seem...trivial or whatever...but I would start by examining the workplace. I think when you have a positive and supportive work environment, your staff have more buy-in. When staff feel appreciated, more buy-in. More buy-in, more dedication to their position. Of course, this is just my experience. I worked at a LTCF many years ago - there was a high level of employee appreciation (employee of the month, attendance incentives, etc.). We had low turn-over, we had dedicated staff who all worked to provide the best care for our residents.

[FolksBtrippin, BSN, RN]

I'm with emergent. Hire relief staff. I am relief. I love getting a call asking me to come to work. If you micromanage or punish, you are likely to have more issues.

[Here.I.Stand, BSN, RN]

Hmm, I call in how many times I require. No more, no less. I call in when I am sick (BAD pratice to work while sick) or my child is sick (not leaving my sick child. Sorry, not sorry.)

Clearly this is not what you want to hear, but sometimes there is no solution but a miracle healer. Since they don't exist, your staff must call off until their immune system or antibiotics perform the healing.

[Here.I.Stand, BSN, RN]

And SourLemon, I hope you feel better soon!

[Rose_Queen, BSN, MSN, RN]

So, why are people calling in? Are they legitimately ill? Then you don't want them working, where they will spread germs to staff and patients- and that's just going to end up creating even more of a headache. Are they calling off because requests are denied? Then general staffing needs to be increased or per diem staff increased so that those denials happen very rarely. Is it a toxic environment? Then the environment needs to be dealt with.

I called off recently. Primarily to go to a job interview, but also because I ended up spending the morning sitting in my doctor's office hoping for a standby appointment to open up due to an issue that didn't require an ER visit but did need to be dealt with. Why the job interview? Because management at my current job has created an unbelievably toxic environment, including extreme reduction of hours. I seriously dread going into work. It needs fixed (unlikely) or I need a new job- and that means taking time for interviews. I'm not proud of calling off, but I feel absolutely zero guilt because the toxic work environment made me prioritize my mental health and financial security.

[JadedCPN, BSN, RN]

As long as people stay in their "allotted" amount of calls off per year (or whatever time period your facility goes by), it really doesn't matter WHY they call off. Your facility should have enough staffing to cover for those occurrences. If people are calling off way above and beyond what is allowed per policy, then as others have stated you need to look internally at your facility and the environment/culture to see what you (the facility) may be doing to contribute to this, and then make adjustments. Only after that would I say you move to the next step of taking disciplinary actions as necessary.

[Been there,done that, ASN, RN]

That is definitely most of the problem. I just got a job as a nurse manager at a facility new to me. Our policy is that after so many call ins/write ups it's termination. I'm honestly a little scared that if we fully enforced the policy we would have to fire a good chunk of our staff and being in a smaller, rural town in Iowa we struggle to find applicants.

So, what I hear you saying is, you are afraid to enforce policy. If I can hear that, so can the staff.

I would tighten the policy to no more than three call-offs in a year and strictly enforce it.

[needlesmcgeeRN, ASN, RN]

I took it to mean the call-ins were excessive, or a pattern. Obviously if an employee is ill, or an employee's child is ill, they should call-in. But, if it is happening repeatedly, over a relatively short amount of time, that is an issue that should be addressed.

[guest52816]

Wow. Glad I don't work at your facility. I would probably call-in too.

It was simple enough to understand that Sour Lemon is REALLY sick. The Magic Healer comment should have clued in you in to that.

You are clearly part of the Nurse Manager problem, not the solution.

I completely agree with the poster who suggested that excessive call-ins are the direct result of a poor working environment, i.e. poor management.

I speak from experience. The facility where I work likes to understaff and when nurses ask for help, they are talked down to, accused of poor time management skills, etc. Of course, the problem could never be that the facility works nurses like dogs.

As a result, I NEVER offer to work OT. And if I am called in tomorrow, as I am on call, I will call in sick during the week because I have no intention of working in subpar conditions for seven straight days.

If you want the answer to your question, it is look in the mirror and ask yourself what actions you are taking to create a better work environment for the employees that you are responsible for.

[LaCutiePie]

That is definitely most of the problem. I just got a job as a nurse manager at a facility new to me. Our policy is that after so many call ins/write ups it's termination. I'm honestly a little scared that if we fully enforced the policy we would have to fire a good chunk of our staff and being in a smaller, rural town in Iowa we struggle to find applicants.

Maybe you need to look at your employees' working environment. Facility is understaffed and employees are overworked? Positive surroundings? Offer incentives for staff taking an extra shift? Start hiring more PRN. :)

[River&MountainRN, ADN, RN]

Hello! Long-term lurker here, but I have to second (third? fourth?) what so many others have said about staffing morale. I've seen this happening at my facility. When I first came here, there was competition just to be hired; people would apply for whatever shift/amount of hours they could get...just to get their foot in the door. It wasn't because pay or benefits were that great compared to other nearby facilities; as a matter of fact, pay is notoriously lower (with no differentials for off-shifts) than other facilities and benefits are just average. However, it was the *morale* of the facility and the notoriously happy/comfortable (as comfortable at SNF work can be) working conditions that drew people in.

Now? We are hemorrhaging staff. Because of managerial issues, morale is in the toilet. Those who haven't left outright are burning out and calling in more. Management is turning to blackmailing staff into staying. Staff are starting to turn paranoid and shifts are beginning to turn on each other. It is well known in the community now that this is now NOT the place to work. They can't fill open positions even with hiring incentives.

So, yes, morale has a TON to do with call offs.

[djh123]

I'm not a 'hard ***' in general at all, but where I work, we have such a problem with call-ins - and even 'no call, no show'(s), that I've told a few co-workers (who DO come in) that I'd fire them on the second no-call/no-show.

One of my 'favorite' (I'm being sarcastic) CNA-calling-in stories was one who asked, over the phone, if so-and-so had come in - in other words, they didn't really have a problem, but they just wanted to see if their unit was going to be kind-of covered that night - and if it was, yep, they weren't coming in. They didn't say it that way exactly, but whomever was talking to them told me they could tell that's how it seemed.