Scheduling

1 hour ago, cbullock said:

I am a nurse manager for a privately owned oncology clinic.  We work M-F and have apx 10 clinics through out the state.  As we continue to grow, time off request and scheduling have become an issue.  Fortunately we do have Holidays figured out.  It is the vacation request that are a challenge. 

1) As of now, we only allow 2 RN's off at the same time. 

2) Currently allow request 2 months in advance.  This makes it challenging to plan a future vacation. 

3) Approving / denying is not done immediately to allow request to come in and the scheduler to review request.  This also makes it difficult for staff to plan accordingly.

4) Seniority does come into play when it comes to multiple request for same time frame. 

I would love ideas on a more efficient and fair guidelines we can put in place. 

Thank you! 

Could you implement self-scheduling? (along with a reiteration of the staffing grid/number of staff that must be on...) That would allow people to negotiate with their peers to help deal with conflicting requests, and maybe prevent some conflicts to begin with.

One place I worked had a vacation notebook. Each month had its own page and the book was started every January. Everyone could put their vacations in the book at any time and it was first come first served. It allowed for everyone to see which spots were already taken and could choose accordingly. This was only for vacations, not days off etc.

I don't think two months in advance is enough, especially if the request isn't approved right away.  Some trips need more lead time.  I've worked places where requests open up 6 months ahead of time and it's first come, first served.  It would be announced at what time the request book was open, one place was midnight, one was early AM so if you really wanted it you got your butt up to work.  And it was a notebook so you could see other requests and ask accordingly.  And you knew right away if you got it, as long as you had the hours.  Two people max and seniority DID NOT come into play, which I thought was fair.  Seniority did come into play with allowing extra people off on holidays if census was low.

Our vacation requests are open a year in advance.  Two months is not near enough time.  

We have a leave roster that shows how many leave days are available each week. When someone gets leave approved there name goes on the roster. So you can apply for leave anytime of the current year, that has leave available and know you pretty much guaranteed to get accepted. It is a First in, first serve bases though.  

the only time you can’t apply for is the 2 weeks over Xmas and New Years, which is dealt with differently. 

When you say only 2 RNs off at most, is that per clinic or for all total 10 clinics?

I worked for a similar type set up here in Florida up until early this month. Outpatient Oncology practice with 100+ clinics state wide. The staffing was good at the cancer centers but the more rural clinics like mine was awful. They always staffed the cancer centers before staffing us. Our ratio was supposed to be 10 patients to one nurse but I was often at 15 patients to one nurse. There was recently a mass exodus at my office, including myself, because the company would not hire PRN workers for our site. Three nurses quit within a week. The nurse manager also kept the  scheduled number of patients the same instead of trying to reschedule them. 

Do you have PRN staff to support vacations? Do your PRN workers have a mandatory number of days they have to work, I.e. 8 hours every 2 months?