Scheduling in the ED

Specialties Emergency

Published

My department is thinking about making some changes to the way the schedule is made. I was just wondering how other EDs do it.

My ER is a level 2 trauma center that sees around 300 patients a day.

- Do you work a set schedule? Do employees self-schedule? Or something else?

- Are you required to be on-call? How often?

- Is staffing adjusted for high/low census? How?

- Are you required to work weekends? How often?

- How are holidays scheduled?

Any feedback is greatly appreciated!

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Specializes in Emergency Medicine.

Everything hinges on the FTE's allocated.

You have to work within the budget/parameters the facility gives you.

I think that each and every ER has it's own personality. Each has individual needs, it's own concerns, and capabilities. There is no ONE template for all of us. There are just too many unknown variables to answer your question.

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Specializes in Cardiovascular, ER.

For mine, we are a smaller ER (about 200 pt/day seen). We have 29 beds.

Our scheduling is a bit funky. 7 and 8am's self schedule, mid-shifters do as well but they have to alternate with the other set mid-shifter for that time slot. Us on nights, we have a set schedule. There are only 3 nurses after the last mid-shifter leaves at 1am.

No call, no weekends for weekday nightshift - the weekend program nurses work all weekends.

Our staffing is the same, no matter what the census is. People can leave early if they want to if it is slow - but our hours are guaranteed.

Holidays? For those with a set schedule, depends on the day of the week whether we will be off or not. Dayshift is different, they rotate holidays.

Whew! I think I am done : )

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We are a TINY ER, about 60-70 pts per day, 8 beds available. We rotate 2 on 2 off 3 on 2 off. I hate it, but it works for us I guess. It makes us work 84 hours a pay period. We only have 2 day and 2 night nurses 7-7. Rarely we get a float from 3-3. No techs, 1 Doc.

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Specializes in Emergency.

Our "average" is 150/day, but running higher lately. Our schedule varies. You have a shift (7-7, 7-3, 11-11, 3-3, 7-7, 11-7) but not self scheduling. Very rare to get 3 in a row, usually 2 on, 2 off, 2 on, 3 off, repeat.

No on- call. Can get called to come in if we're getting slammed but no reprisals if you decline. If census is low, they ask if anyone wants to leave, only per-diems will be sent home.

Work every other weekend. Management looking at how to do every 3rd instead. Would be great.

Everybody does holidays. Alternate years so everyone suffers equally.

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Everything hinges on the FTE's allocated.

You have to work within the budget/parameters the facility gives you.

I think that each and every ER has it's own personality. Each has individual needs, it's own concerns, and capabilities. There is no ONE template for all of us. There are just too many unknown variables to answer your question.

I know every ER is different. At this point, we are brainstorming and it's helpful to hear the many different ways other places do things.

Management has sent people in our department to contact nearby facilities to see how they schedule their employees. I figured this would get a good place to get some info.

I'm not asking for one template, just asking how things work in other ERs.

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Specializes in Emergency Dept.

We seen about that many patients but are not a trauma center.

1) FT works 3 12 shifts

2) every other weekend

3. We are on a holiday rotation with A team, B team, and C team. We rotate holidays so every we work the same holidays every 3rd year

4. We have part time and PRN that pick up other hours.

5. Are are 4:1 ratio from 11a-11p

6. We do not flex

7. We do not do call

8. We do self scheduling

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Ours is a frustrating combination of self scheduling and manager scheduling. We get a book to sign up forshifts in on a first come basis. Night sign up opens first, then evening, then day shifts. Then management takes that book and makes a schedule that might not match requests. Then a needs list goes out of extra staff needed to make numbers in addition to the official sign in. No seniority is considered. I think there must be a better way to do it.

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I work in a peds ED that sees about 200 kiddos a day. We have many shifts to help with volume levels. 7a 11a 3p 7p. Some weekend option but not a ton so we do work weekends. 20+years = no weekends. 10-20 years = 1 of 6 weekends >10 years= 2 of 6 weekends. We recently changed from a set 6 week schedule to self scheduling, ***SUCKS*** According to senority by shift. Group A signs up first, all shifts, then B, C, D and finally PRN. No call taken. Holidays are divided into groups that rotate: groups1 works holiday set 1 then next year 2 then 3. So that the 3 summer and 3 winter holidays are rotated, Don't work xmas 2 years in a row.

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Level 2 trauma center, 175/day average. We have set schedules and per diems. If we have low census, someone gets to go home. If we have sick calls, calls go out to staff to see if they can come in.

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Specializes in Emergency, Critical Care (CEN, CCRN).

My department: 45 acute beds, not a Level II center yet (working on it!), and we see about 230-260 a day.

We do a combination of self- and set scheduling; you have your assigned shift (they're all 12s: 0700-1900, 11-23, 15-03, 19-07) and your assigned status (PT, FT, or contingent). You can either request certain shifts on/off via a request book, or just let the scheduling staff do it for you. We're on every third weekend, one summer and one winter holiday per year; the assignment is done via three rotating teams, so you don't work the same holiday multiple years in sequence. Admittedly someone might get screwed if a major holiday falls on a weekend, but Scheduling tries to avoid that if at all possible.

We don't officially take call, but the Charge RN, ANM or Scheduling can call and ask you to come in for shortages. There's also a departmental text message that goes out to staff every week with the available pickups, and most weeks you can pick up as many hours as you care to. For low census, Charge RN makes the determination of who goes home and when; preference goes to people who are already into OT, and then it's in order of last call-off. Usually if we're in a low census situation, people will start getting sent home around 0400-0430.

Hope this helps!

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Specializes in ER.

My ER is a level 2 trauma center that sees around 300ish patients a day.

- set 3wk pattern

- no call requirement

- if they are short staffed they start calling ppl to see if they want to pick up time....if they're slow, then they send ppl home early (sometime in the last 4hrs of ur shift)

- every 3rd wknd

- ABC holiday schedule, work same holidays every third yr.

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