Staff Scheduling

[Altra, BSN, RN]

I'm curious ...

When nurses bring up the concept of a "set schedule" (days and/or shifts) the immediate almost universal response is "IT WILL NEVER WORK".

Why?

I have 3 law enforcement friends, who work for 3 different agencies. One is a memeber of a local municipal department. One works for a regional specialized unit. And one works for a large governmental agency. The commonality with nursing is that all 3 of these require 24-hour staffing with a predetermined number of staff.

In all three cases, newly hired/transferred staff request a shift, and a "weekend" of 2 consecutive days off. Assignments of shift and weekend days are made according to seniority and staffing needs. But in the end, everyone receives a more or less permanent schedule of a steady shift, and a consecutive work week and weekend.

On an annual basis, requests can be made to change shifts or change days off. These are reviewed and implemented if workable to maintain staffing and according to seniority.

So ... why doesn't this work in clinical nursing?

[SonorityGenius]

Cause nurses call out much more frequently and if you have mentality of certain days for certain staff, on short ones u wont get anyone to cover.. thats summarizing it! but can go into pages of detail if discussed

[Altra, BSN, RN]

Cause nurses call out much more frequently and if you have mentality of certain days for certain staff, on short ones u wont get anyone to cover.. thats summarizing it! but can go into pages of detail if discussed

No, you've misuderstood -- the entire schedule is covered, permanently, by staff being assigned to a set shift, for set days.

Call offs are covered by those looking for OT, in order of seniority. And some mandation. Scheduled vacations are covered by those looking for OT.

As for nurses calling off more frequently ... no, I doubt that as well. My discussions with my friends have indicated that they have upwards of 6 sick days per year, and the culture is more accepting of their use, versus the "you better be here unless you're dead" mentality often found in nursing.

Nurses in clinical positions tend to work for private employers with policies where anything above 3 or 4 call offs per year results in discipline.

[hiddencatRN, BSN, RN]

I don't know why it couldn't work either. DH is a paramedic and his company gives everyone a set schedule. It's on a two week rotation so he works every other weekend, all days. There's an all nights crew, and a swing shift crew too. The only thing that sucks about it is he never has a consistent day off from week to week that he could use for a class or something. But it means that we can plan things around his schedule because it is consistent, which makes working per diem elsewhere easy to fit in.

Call outs are handled by their part time/per diem pool staff or folks looking for OT.

[Dalzac, LPN, LVN, RN]

The last place I worked had 4 predetermined schedules all 12 hour shifts. when I first started I was given a choice of which one I wanted. If you didn't care for a shift schedule you had to request in writing the shift you wanted. If it was possible and left no holes or any short staffing on either shedule, you could have it. Another place I worked would throw down an empty schedule and you filled out your own schedule with the understanding that holes would be filled whether you wanted to work them or not. So we were always pretty good to make sure the holes were filled.

[HouTx, BSN, MSN, EdD]

There is a pretty significant factor that distinguishes health care from the other 23X7 environments.... patient volume. Police officers & Fire Depts do not adjust staff based on the number of calls that day... instead, they have a set staffing based upon historical levels of activity. Nursing operates with real-world numbers. Nurse staffing is based on "hours per patient day" - that is also how it is budgeted & managed. I'm not saying that nurses don't have a legitimate gripe - I'm just saying that it's better to do your homework & understand all the factors going in.

Nurse staffing is always a moving target and a major stress for nurse managers. In addition, very few organizations actually monitor and account for "admissions, discharges & transfers" (ADT) which can consume a huge number of work hours. Instead, they staff based on an archaic standard of 'midnight census' - which has no relation to the actual work that needs to be done.

I have worked a set schedule at various times in my career. Full time people got a set schedule, and staffing adjustments were filled in with part-time, and prn staff. It worked very well and I got a 3-day weekend once a month. It can be done.

[noahsmama]

At the peds hospital I worked at, senior nurses had set schedules whereas less senior nurses had less set schedules, though still somewhat predictable (not quite predictable enough to take a class on one's off days though). Nurses with 20 or more years of seniority did not have to work weekends (though some chose to), all others worked every other weekend.

At the hospital where I did my NS preceptorship, most if not all of the nurses had set schedules.

I'm sure there are a lot of variables that make it harder or easier to have set schedules at any given facility. These would include things like the total number of nurses on each shift in each unit, total number of beds and max patient/nurse ratios, average number of call outs per shift, whether or not there is a float pool and how that pool is utilized, policies about floating of non-float pool nurses, etc., etc.

Anyway, I guess the lesson to learn from some other threads that discuss this topic is that, if it's really important to you to have a set schedule, this would be a good thing to ask about during a job interview, and not after you have already accepted the position.

[loriangel14, RN]

Where I work everyone has set schedules.Full timers and part timers alike. All shifts are covered and call ins or requests for time off are covered by part timers who get called on order of seniority.If you want to pick up extra you can.They never mandate anyone to work.If you want a day off you can switch with someone.It works just fine and you always know when you are working.

[canigraduate]

For the unit I work on, it isn't possible because few people can/will work a set schedule. Most of us are students, getting RNs, MSNs, NPs, etc., and our schedules change each semester. Also, a lot of us need flexible scheduling to accommodate a second/third job.

[solneeshka, BSN, RN]

I have a nurse friend who works every Tuesday and Friday, and every other weekend. I am so envious of her schedule! She can arrange to take classes, and when she wants to schedule something non-work, she already knows whether or not she has to work that day.

[Ruby Vee, BSN]

i worked in a unit that actually tried set schedules and it worked -- for awhile. then some of the original nurses moved on and new nurses were hired into one of the available set schedules. before too long, they were complaining that the set schedule they were hired into didn't work for them because of their family responsibilities, church, child care or school. then management was in the position of trying to accommodate susiie's requests for a day off or a change in her set schedule without upsetting norman's set schedule. and then a new nurse was hired into brad's old schedule but tuesdays ended up not working for her and could she have wednesdays instead? management then had to shift archie's set schedule to accommodate all the requests from new nurses and then archie quit and no one wanted to work his set schedule so they went back to the drawing board. what ended up happening was that as long as the original folks with set schedules stayed and demanded them, they could keep their set schedules. but as soon as they started making requests for days off, they were considered to have given up the set schedule, and new hires weren't given the option of set schedules.

[gymnut]

It really is interesting to see how hospitals schedule everyone.

One local hospital everyone loves to work at because of the scheduling. They have Monday - Friday shifts for a lot of the RNs because they offer Baylor shifts on the weekends (2 16's paid for 40 or 2 12's paid for 36). They also offer a schedule were if you're a parent you can have June, July and August off to spend time with your kids. Although you have to work like crazy the rest of the year. Sounds pretty decent to me.

I have no idea what the hospital I'm at does for it's shifts. Right now it seems to be the traditional every other weekend ordeal, but they hire a ton of part time workers to fill in the gaps everywhere. So who knows?