Scheduling lunch breaks in the ED

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by Elle2 Elle2 (New) New

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ltvixen

ltvixen

70 Posts

we try and relieve each other for breaks. zone 1 (minor side) is 2-3 nurses with 12-14 rooms. breaks are supposed to start at 0830,1130,1630 for days (each lasting 30 mins) and 1 30 min break and 1 1hour break on nights (although it's more likely to miss those breaks due to less staff - why is it that there is less staff on at night in an area that is open 24/7???)

edprincess

edprincess

Specializes in ER. Has 5 years experience. 27 Posts

My thoughts exactly! :rotfl:

I agree. There are no "scheduled" breaks in the ED. Some nights you're lucky if you get to pee though I does also depend on if you work days or nights. And if you have a swing shift. In my ED, we have nurses that work 11a-11p so that they can relieve day nurses for breaks and help during the busiest time but nights....HA we're lucky to pee usually. If you get to eat, that's even beter.

I just started a new job in an ER. I'm not completely clear on the staffing but it works so everyone gets 1/2 hour lunch and their breaks.

The shifts vary - 12-12, 3-3, 6p-2:30a, 8-3 . . . .(there may be more, I'm not sure yet).

I've orienting on the 12p to 12a shift. When we come in at noon, we take over another nurse's patients so he/she can have their 1/2 lunch. It looks like the same thing happens with all the shifts. There is also a nurse who does admits and helps with discharges and she can take on patient care if needed. The charge nurse is actively involved in patient care if need be and all the charges I've worked with so far are very organized with assigning patients to nurses. We have a 3:1 ratio most of the time - sometimes 4:1 for the more experienced nurses if we are slammed.

When my preceptor and I come in and take over another nurse's pts and then the nurse comes back from lunch, THEN we get our own patient assignment. At 6p, the next shift covers for us to have lunch.

It works really well - I'm sure I'm leaving parts out, it is only my 4th day. I'll be working "the princess shift";) after orientation. . . 6p to 2:30 a.m. The other princess shift is 8a - 3p (I'd like to move to this one if it ever opens up). :balloons:

steph

RNinED

RNinED

Specializes in ICU,MCU,HOMEHEALTH. 16 Posts

The facility is mandated by law to pay a large amount of money for missed lunches as well as a fine to state or federal agencies for each incident. My facility choses not to pay that fine and does every thing in it's power to get us our 30 minute lunches on days. That usually means the House Supervisor with a min. of ACLS will come down and relieve each of us. It is on us to be ready if possible for that relief. The smaller breaks are grab 'em as you can and usually you can't. Follow the money. If it costs too much they will fix it. Of course for that to work....we can't lie and sign out for lunch when we don't take it. I do often go back earlier than my 30 minutes as a courtesy but am in no way required to.

Oh...that goes back to ratios of 4:1 and that we can not be required to cover other's pts if the ratio/acuity is met. I forget that Ca. may be different than other places. best of luck and take your breaks as it reduces burnout and improves pt care/outcomes.

ZippyGBR, BSN, RN

Specializes in Spinal Cord injuries, Emergency+EMS. 1,038 Posts

team nursing helps with breaks a lot

(before moving to the assesment unit i curently work on) the ED i worked in up til christmas06 we used team nursing there were 3 basic teams major A , major B and minor - each with 3 members of staff (2RNs + HCA on the major teams, and ENP, RN @triage and RN or HCA for minor) + a shift leader (assuming we were fully staffed )

breaks withi nthe major teams were covered within the team i.e. 1 from A and 1 from B would go to break wihile theothers covered ) - and depending on staffing on minors and mworklaod ewe either covered internally or someone from amors or the shft leader coered triage whiel the traige nurse had his/her break

MAISY, RN-ER, BSN, RN

Specializes in ER/EHR Trainer. Has 6 years experience. 1,082 Posts

:lol2:LUNCH? Sometimes we get a break-this summer was amazing! We actually had coverage. Our ER is 55+, when our later shift 11a to 12 comes in, if we are semi quiet those nurses break the 6:30a-7:30p shift for 45minutes. If not, you can bet we all put in for the overtime. While it seems unfair, nights doesn't fare as well. They don't usually have sheduled break, although they usually have only a couple of patients (or none) in am when I get there.

Last winter we went from 5:1 (or more) to a definitive 4:1-with that we lost our floaters. Something has got to give.

Maisy;)

teeituptom

teeituptom, BSN, RN

Specializes in ER, ICU, L&D, OR. 4,283 Posts

I carry little zip lock baggies for snacks that I munch on and I have a coffee cup thet never empties

edprincess

edprincess

Specializes in ER. Has 5 years experience. 27 Posts

I thought I worked at the only facility that did that. At my old job we aren't not allowed to say "no break" either unless the charge nurse signs off. When I was charge, I'd write in our log under every staff member that worked no lunch and sign it. If I wasn't, I'd bug the charge nurse to do it but usually they're pretty good about it. We all covered each other.

We did what I'd like to call a drive by eating. Send a tech upstairs to the cafeteria and have them buy several plates of finger food - chicken fingers and fries usually. We all take a small plate and leave it at our desk. Then, take a bite and run. Walk by the desk again, take a bite and run. It stunk but at least we got to eat.

My father, who was a director of personnel at another hosp would yell at me, why don't you take your break? I'd tell him, noone to cover. Can't leave my ICU pt on 2 different pressers because I wanted a grilled cheese. Yeah, I'm sure the judge would've loved to hear that one.

I don't think employers should be able to do that. I know working in the ER means hi stress level, a million and one things that need to be done NOW, and no breaks (usually) but at least admin can pay us for it. THey just don't want to pay and don't want to be held reliable if haeven for bid something happens to a pt because the nurse wasn't able to pee never mind eat. It sucks!:down:

Mobeeb, RN

46 Posts

ED + Meal Break = Oxymoron :cool:

erinbethg

erinbethg

Specializes in ER,Surgical floor,Same Day Surgery,SICU. 6 Posts

We have lunch buddies in our ER. Every nurse covers 4 rooms so it is really hard for your lunch buddy to watch 8 patients. The best time to eat is when you have done all orders and the patients are just waiting for results...this way there is nothing major to be done. If you wait till you have a discharge or two you are in for it when you get back! 15 minutes is about all I can take, otherwise I am punishing myself with being behind when i get back!

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