Staffing for sick call/ not enough nurses

[MomBabyUnitRN]

I'm curious how your OB floor staffs for sick calls or when there just aren't enough nurses?

Do they float from somewhere else?

Do you have a resource pool?

Do you have PRN staff you can call?

Do you bring in travelers?

Also, if you're called in extra, how is your pay adjusted?

I'm just curious how your hospital does this. Ours in not a big hospital and it seems there are never enough OB nurses to go around and if someone calls in sick, we're just in hot water.

I admit this weekend, I was selfish. I had no less than 10 calls for staffing this last weekend. I was a chicken and just didn't answer my phone. In fact, I turned my ringer off... I just didn't want to go in on my precious weekend off.

• There aren't enough trained OB nurses to float from PP or from NICU.
  
• We do have a resource pool that might contain about 3 nurses and if they say no, it's back to square one.
  
• Our PRN nurses are about the same as our resource pool. Most work elsewhere and may already be working elsewhere and can't come in.
  
• We don't use a staffing agency.
  
• if we're called in with less than 24 hour notice, we're paid 1.5 times our usual wage.
  

We've tried to get our manager to hire more nurses for this type of situation, but she states she can't because administration won't authorize it. I don't know if this is true, but it seems she's constantly hiring and someone is always quitting. (College town and when the husbands finish school, they're outta there!)

[babyktchr, BSN, RN]

Budgets are tight now a days and I am sure that your manager is telling you the truth. While PRN staff isn't budgeted, per se, you do have to have the positions available.

Some things to think about. Your PRN staff, or your resource staff. Has anyone tracked how many times your PRN staff has been called and been available to fill in? This is important, especially if they are not fullfilling their requirements. This is kinda what they are hired to do. Your manager can hire a whole staff of PRN folks, but if they don't come in when there is a need, what is the point? What is the reprocussion for calling in on a weekend? Is there any consequence for that? Sometimes people think twice before calling in on a weekend if you have penalties. Do you have open positions and that is why you are so short staffed?

It is hard to float in a staff member from another unit. They don't know your procedures and its nerve wracking to everyone involved. Seems your PP staff could be cross trained to help out, and could be your best resource.

Time and a half is pretty standard for this, though not required. Our unit is "closed" so we do not float nor do we float in when help is needed. The staff agred to cover THEIR unit when the need came. It is tough sometimes but they do for the most part fill in when needed. Some managers have a little wiggle room and may be able to offer a bonus if you come in. Just depends on their budget.

It happens everywhere, you are not alone.

[ejm RN]

We have a system where we are required to sign up for 8 hrs of call every month - it is broken up into 4hr blocks, so there is some flexibility there. We're paid $8/hr just to be on call, and get paid time and 1/2 if we are called in. The system works well for us, but that's mainly because we have a large staff. Because of our call system, there's no need to float other RNs to us, but LDR nurses will sometimes be floated to PP or high-risk perinatal if our staffing allows.