q's- end of shift relief, meal/break relief timing, inservice relief

[scrubs12]

hi all,

i have burning questions about getting RELIEF! please let me know what is the practice in your hospital!

End of shift relief:

the last 30 minutes end of shift in the OR. i work in a unionized hospital in los angeles. we have staggered shifts but the majority is 700-1530 and 0700-1930. this question is not addressed in the union book.

we are expected to be dressed (in scrubs), clocked in and ready by 0700. relief nurses are expected to to be the room by 1500 or 1900. there is a 30 minute overlap for what i believed was used to get report and for the outgoing RN to change.

a fellow nurse complained b/c she did not get a pm break. i grieved it to management but they came back saying that she was relieved at 1510 and so had time to get her last break before the end of her shift!

Lunch relief:

how many hours do you have to wait to get lunch relief? sometimes we've waited more than 6 hours to get a 30 minute meal break for an 8 hours shift. again, union book does not address timing of the meal break. california labor law is vague about it.

Inservice relief:

inservice is 1xwk at 0700- am staff and 1400- pm staff (1500 start). surgery starts at 0800 for inservice days. relief rns ( 0900 and 1100 start) often times do not get a chance to go to inservice b/c they are still giving afternoon breaks to the am staff. this is a known issue but management isn't doing anything to make changes for relief rns to attend inservice.

what is the relief practice in your hospital?

[canesdukegirl, BSN, RN]

We are not unionized in NC, but we are supposed to get one lunch relief for any shift, and we typically do not get breaks at all. Lunch relief comes whenever the relief nurse gets there. Sometimes it is at 1400, sometimes later. The 1500 relief nurse is supposed to be there at 1500 to get report, but when we call to the front desk to see where our relief is, they tell us (and sometimes I am charge nurse and I am told myself to say this) that we are on the clock until 1530, so if the relief gets there at 1530, so be it. Sometimes we are so short staffed that we are forced to stay over, even if we already make it known that we are unable to. We don't typically stay over very late; maybe 30-45 minutes late, but it sure does wreak havoc on any plans that we have made. It is especially difficult for our nurses that have kids to pick up at daycare.

Although we are expected to start our assigned day at 0700, the 1100 relief nurses usually clock in at around this time, have to change, get lunch assignments from the front desk, and then report from the nurse in the room. So that means that our lunch relief doesn't usually start until 1120. This pushes back lunch times, and that is why we don't get lunch relief until 1400 or after. Some of the nurses being relieved are not accountable for the longer lunch breaks that they take, making it even more late for the nurses that have not had lunch. Management knows about it, but nothing is being done to correct it. There is one nurse who is from Cali that comes in at 1045 and starts lunches at 1100. I LOVE HER!

The nurses that work 12 hour shifts typically do not get lunch relief until 1300 or later. No breaks either. This has always confused me. Why would a nurse that is working a LONGER shift not be offered lunch at an earlier time? Most cases end or are wrapping up at 1430-1530, so breaks can be taken after or between cases. It is difficult to go without a break for such a long time. It all depends on staffing and call outs.

Management is unsupportive of break times. I actually had an anesthesia attending ream me out one day when I was doing charge, asking why we can't use the 1100 nurses to open a hold room to finish up cases instead of giving lunches. I was so shocked by this that I could not respond. The anesthesia department is very well staffed and the relief staff are excellent at giving many breaks and timely lunches. I wish the surgical staff worked the same way.

[daVinciNurse]

I work in an OR with 8 and 10 hr shifts. We try to get everyone a 20min break in the morning. Lunches (30 min) start at 11am. It is not unusual to go on break at 10:30, report back to your room at 10:50 and then be sent to lunch at 11. If you don't get a morning break, you get 20 more mins at lunch (for a total of 50 mins). There are days all lunches are done by 12:30, there are days when its 3pm and 2 people still need lunch. We have 7-3:30, 7-5:30, 9-5:30, and 11-7:30 staff, as well as a few 1-9:30 or 1-11:30 and 3 teams 3-11:30pm. Non union, 12 ORs. Of course ,no one enoforces 30 min lunches, and they are often stretched to 35-45 mins, which just backs things up. We also have nurses "refuse" lunch if its a time they don't want to go (its one thing if the case you are involved in is at a point where relief is not practical), so then the relief person can waste up to 30 mins trying to "find" someone who will go to lunch. Which is why I don't put up a fight if I just got back from break. If staff didn't get a break, we try to get them out to lunch (and break combined) at 11am--unless they are scrubbed on a long case and state they are OK and do not need relief--then we relieve them at the end or will have a 1 time scrub change around 1pm by somone who will likely be there to finish the case.

We also have the 1/2 hr overlap on shifts--and still see late relief. Its human nature I guess, but facility policy on tardiness is not enforced either...

I think our labor laws state that after working 4 hrs we are entitled to a 30 min meal break, though it doesnt say it has to be at the 4 hr mark....but you are not eligible for one until you've been on the clock 4 hrs. If we dont get lunch, we fill out a payroll slip so we are not docked for teh lunch break we didn't get. Facility policy says breaks are at the discretion of the manager--we usually get them, either by themselves or combined with lunch. If we don't get a break, there is no compensation as it is a "courtesy" not a "mandate" like lunch is.

As far as inservice, we videotape most of them so that those not in at 7am on inservice day can get the info.

[Argo]

LOL. Breaks?

[PetiteOpRN]

Large OR, 10-hour shifts (all of us), starting at 0630.

If the schedule is light, about half of the staff might get a 15-minute break in the morning. This is rare. Also, there are certain specialties that never get breaks.

Lunches start promptly (ha ha) at 1200. The last people to get lunch every day leave their rooms at around 1430 if people are assigned to 4+ rooms and some people take longer than their allotted 30 minutes.

Afternoon break? Maybe, if some rooms are done, and the room staff feels like giving a break.

End-of-shift? My shift ends when the surgery's done or 1700, which ever happens later.

[Rose_Queen, BSN, MSN, RN]

We're supposed to get AM breaks for 15 mins. They've been really cracking down on having extra people, so I don't know if that still happens since I've moved to second shift. Lunches start at 1100. Some surgeons get 2 rooms, so one room will be at lunch while the other is working. Otherwise, we have at least 2 RNs and 2 STs who come in at 1100 for lunch breaks. We're supposed to relieve (in the room for report) no later than 1505, but sometimes that doesn't happen because things are crazy, and the day charge is still trying to figure out what staff goes where or what rooms have a chance of finishing by 1530. As for inservices, we have a "late start day" where day shift and night shift have the inservice at 0700. For everyone else (0830-1700, 1100-1930, 1500-2330) the inservice starts at 1430. It's not mandatory for second shift to come in early, and sometimes the other shifts (especially the 0830-1700) are stuck in rooms and can't be relieved.

[Mr. & Mrs. RN]

We clock in 15 min before scheduled shift and 15 min following scheduled shift. You get those 15 min to change, although most nurses are dressed by 15 min till start of shift. 8 hour workers get one 30 min lunch break, and one 15 min break. 12 hour workers get this, plus one more 15 min break...stated specifically in our hospital wide policy breaks can not be taken at the start or end of a shift.

[MereSanity]

Yeah, sometimes we are lucky to get breaks...lol.

[Argo]

honestly, after a while of working in the OR you should know how to find time between cases to grab a quick bite to eat or use the toilet. I could go for days without a true break with relief.... I dont care because I like where I work. IF you cant handle it and want to cry to the union every time you dont get a 15/30/15 in your day, you should find a new area to work in. Thats reality. Remember, there is a big difference between theory and reality.....

I have worked in the OR for 13 years now....

[Scrubby]

Our new EB agreement has now been changed that if you haven't had your half hour uninterrupted meal break you automatically go on overtime rates until you get your meal break.

[4_Sq]

Only in Canada Eh... just kidding..

Shift 0715-1545

1st break always between 0900-1000 for all staff, float has last break.. If you are in a long scrub eg.. spinal fusion, you will get 2 half hour breaks later in the day, plus a 30 min. lunch break.. It is rare that we don't get our breaks so I guess we should consider ourselves lucky.

On evenings, we have 3 nurses on until 2230 so we always get our breaks here.

It is important to sit down, put your feet up and have a "real" break when you are working so hard... Work towards this goal because everyone of you deserves it...

Words of wisdom from a Canuck!!!

[BridgetJones]

We are supposed to get a 15 min break am and pm (in reality they're more like 20), and for lunches the 8 hour people get 30min and the 12 hour people get 45. When it works that way most people are happy, but lately staffing has been tight, we've had to open extra rooms in the afternoons (added cases, one room is behind, etc), so a lot of times the day shift people don't get afternoon breaks. 1300-1915 is a looong time without a break!

I like my shift now (1100-2300) because I can pee/grab a bite when I need to in between giving other people breaks and I'm not just stuck somewhere! Sometimes in the evenings we can put our feet up a bit if things are slow, so that's another perk. I don't feel guilty about it, because there are always those nights where I run my little tail off in a hepatic resection where the patient is bleeding, don't get a break, have to do an emergent crani, and get out late!