You always stay at least 20 - 30 minutes to just tie everything up, make sure everyone has incoming report etc. Then of course you have days where you get a new admit 20 minutes prior to shift change, or a patient or more than one patient goes bad, or is a chronic issue patient. You can't sit down with a chart until its almost time to go home. If its a new admit your putting the chart together after your supposed to be gone.
This week they have started a new thing where they want everyone clocked out no later than 30 minutes after shift end. I actually had to sign a paper stating I have stayed after x amount out of the total shifts I have worked, and will do better. Which is weird considering almost all of those I was with a preceptor, and was staying after because she said we had to.
I was a little confused because do I just walk away from an incomplete chart. Not chart what happened during the night. Do I not get the chart ready for the patient who is going to surgery right after I leave (This will mean the new nurse must have the charge ready or pre op 5 minutes after she arrives).
Many nurses are still having to stay later than 30 minutes, but are clocking out and working off the clock so they don't get written up. I don't want to work for free. In most cases I am tired. I have been working 12 hours straight with maybe a 30 minute break that was more than likely interrupted, and maybe its my 2nd or 3rd in a row, and I want to go home more than they don't want to pay me overtime, but if I have to stay I want to be paid.
Its seems like a lose-lose situation. If I stay on the clock written up for staying over and them having to pay overtime, or just leave, and it trouble for not charting what I did on the patient.
I understand that in the economy they are trying to tighten their belts, but we have even more patients for fewer nurses, and more charting so thats not going to get us out of the door any faster.
we are currently undergoing a "crack down" on people that sign out 15 minutes plus after the end of the shift. The hospital does not want to pay this erroneous OT. We sign in and out, no punch clock. I am determined to get paid every minute whether it be due to a co-worker arriving late, late report or a patient issue. The ironic part is that we just went through a "training session" about the labor laws and the importance of accurately documenting when you arrive and when you leave so that you are accurately paid. We are encouraged to take our 30 min. unpaid lunch but many never take the paid 15 minute breaks. I firmly believe we give a lot of free time as it is.
Don't do it. If something were to happen to you, where you would become injured or ill from something at work, you would have no recourse with workman's comp because you weren't on the clock.
Not only that, but once your workplace sees that you are willing to do this, then they will expect it all the time.
Your managers also need to take into consideration that fact that you are a new nurse. You are not going to have the time management skills of a wiley veteran. There is a learning curve and they just have to accept that. You also need to have them remove the write-ups from when you were on orientation. You were doing what your preceptor instructed you to do. They also shouldn't enact something today and punish you for occurances that happened before the policy was enacted.
before i became disabled, i worked for a state mental hospital. i live 32 miles away over rural (narrow bumpy) roads, traveled frequently by huge log trucks that were so wide and long that passing them was next to impossible. the trip could take 25 minutes or close to 90 minutes in snowy weather.
clocking in late was dealt with very firmly and being on time was preferable by far. my solution was to assume each trip would take an hour in good weather and 90 minutes in bad. that way, the trucks could cruise along at 10 mph and i'd still be on time.
i kept a paperback in my locker and either read in the locker room or, if one of our many repeat pts.
had been readmitted or an existing pt. had had a bad day, i'd review the chart quickly about 10 minutes before punch-in time (in the locker room.) otherwise, i just read out of sight until my shift actually began.
Yeah, this is corporate management at its worst. They are putting you in an unrealistic situation. Please don't work for free (I think it's actually illegal). If you are off the clock you have no right to be reviewing protected patient information (i.e. the chart). Would you come in on your day off, out of uniform and open a chart? This is a huge safety issue. They are encouraging the practice of A) not charting or B) spending more time charting and less on patient care. Neither is a palatable choice. It would be best if a number of you got together a prepared a list of issues with clear and reasonable justifications. Send it to your boss, the chief nurse, risk management, and legal. You don't want to appear like a mob with pitchforks but simply concerned, professional nurses. Otherwise you could find ways to be more efficient like cluster your care, document more often, and delegate tasks. Good luck.
Specializes in Peds, Tele, ICU, ER, Orthopedics, Psych,.
I think that other nurses have hit the nail on the head...time management skills need to be improved. I don't know if you chart on paper or in the computer, but I have found that the best way to keep up is to chart as you do it - for example I go in and assess a patient while I take in their meds and do any other tasks needed, then I either chart on the computer in the room (or would leave to go to the paper chart if at another facility). My charting would take all of 5 minutes, if that, and was fresh in my mind. Then I moved on to the next patient. If I had something that interrupted that pattern (code, emergency response, etc) I would handle the emergency and then go right back to that pattern. Otherwise I would find myself juggling at the end of the night to read the scribbles I had all over my paper and pray that I wasn't forgetting something.
As far as a new admit 20 minutes before shift end, I would simply get vitals, settle them in, and check to see if there were any emergent things to be done like meds to be hung, blood sugar to be checked, etc. How many times have you come in to admissions waiting for you? As much as we don't like it, we have to draw a line somewhere, and learn that we are a team. My loose ends would be to double check that I gave all meds required, and doccumented responses to any prn's I gave. Not sure if this helps at all, but hope it does.
We are now undergoing a mock, "fake oh" review. Management is scrambling and treating this as real, of course I am sure the fee is significant. I am just a little confused overall. These people come in and help us to prepare for realistic questions and concerns. They are helping us prepare. We are more or less told to be evasive with a real JACHO survey. Don't offer any opinions or concerns. Isn't this dishonest?????
We have computer charting, and what I've found is that time management skills are the key to whether you will be able to get out on time. I made myself a time grid with different words like MEDS DUE, IV, TREATMENT, etc. After report, I go to the computer and look up when things are due and highlight those words in the column/time for that patient. Additionally, charting as you go is crucial. Don't put everything until the end of the shift or you're done for. DO NOT stay late and not get paid. That's just asking for trouble.
I don't know where you work, but staying 20-30 mins after every shift is not normal. Sounds like your facility is understaffed or overworking everyone. I only stay late maybe once a month, tops.
I worked at a facility like this for a few weeks (before I smartened up and left). It was EXPECTED that you would 'donate' time at least 2 shifts a week, and no one was exempt from this expectation. I'm told that the week after I left, one of the CNAs was helping a resident back to bed while they were officially off the clock and 'donating' time, and hurt her back, and there was a big to-do over Worker's Comp refusing to pay because she was not "on the job". Just don't do it. I don't care if your time management skills to blame or what - NEVER work off the clock. If you need help, ask for it. Beyond that, stay safe and legal.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I work night shift, from 6pm to 6:30am. I ended up clocking out at 7:30am because I was pushed to the limit with a total of 11 patients, 5 new admissions, charting up the wazoo, and a lady with complaints of chest pain right before shift change. And, of course, we operate with a skeleton crew during night shift, so there are few (if any) resources to assist if something goes wrong.
I'm able to leave by 6:30am if certain conditions are met, such as lower nurse/patient ratios, ample supplies, and adequate staffing to meet everyone's needs. With a high ratio of patients per nurse, a lack of supplies, and inadequate staffing, good management of time is simply not enough to get out on time.
However, I'd rather get "counseled" than work off the clock for free. If nurses clock out while still having more work to do, management is under the impression that it can be done within an 8 or 12 hour shift. If I am forced to clock out on time, then the unfinished work will be passed on.
At the hospital I work for we usually have 5-7 patients. We chart on paper, but will be going to computer sometime next year. Its the biggest hospital system in my area, and from what I hear its one of the best.
When I say we chart on paper I mean we chart on paper. We have these giant charts that are like volumes in a library. We have a sheet for vitals, we have a 24 hour assessment, we have to chart in narrative format long hand in our focus notes section for each thing we do. Then there are dozens of other little sheets for every little thing. In addition the Dr's long write orders. We are responsible to enter the information in the computer off the Dr's order sheets, and print them. Each nurse is also responsible to review each chart for all orders and make sure they are all entered for the past 24 hours every shift, and check of the chart. If something was missed even if not on your shift you are responsible for those 24 hours.
If we have a pre surg patient we are responsible to collect all the paperwork, fill it out, and print it up, and have the chart ready for surg. Post surg is even worse...so much more paper work. Discharges aren't too bad. For an Admit we basically build the chart. We have to get all the personal info from the patient, fill out the sheet (10 pages worth), put it all in the computer system, fax all the meds to pharm, order everything the patient needs from the different areas of the hospital through the computer system, focus everything, assess everything....on and on and on.
This is in addition to patient care. And if you have a patient who is crumping off and on all night, and you spend every 5 minutes calling the Dr, and keeping him afloat. You have another pt. who is pain management issue and requires pain pills every 4 hours, a pain shot every 2 hours, and your in there once every hour telling him your sorry he can't have more. Add a confused patient who is in restraints, keeps trying to get out of bed, taking clothes off, yellling, moaning, and a handful. Then jump in with the guy who has mental issues to go with his broken back, and throws his mashed potatoes on the wall for fun, tries to cut off his picc line dressing with his pocket knife, and keeps trying to get up even though he needs to stay in bed, and lay flat. Then you have meds..meds... and more meds. Assessments, reassessments, fires to put out, PCAs to monitor every two hours, restraints to monitor every 2 hours, finger temps every 4 hours, dressing changes, central line dressing changes, etc etc etc. And then your long hand charting it all.
You are responsible for all of your orders during the time of your shift. It will not print on the nurses kardex for the next shift. It just wont get done and its your fault. In addition if you get a new patient you are responsible for getting his chart done before you leave. It takes seasoned nurses 2 hours to do a new admit.
massrn116
117 Posts
we are currently undergoing a "crack down" on people that sign out 15 minutes plus after the end of the shift. The hospital does not want to pay this erroneous OT. We sign in and out, no punch clock. I am determined to get paid every minute whether it be due to a co-worker arriving late, late report or a patient issue. The ironic part is that we just went through a "training session" about the labor laws and the importance of accurately documenting when you arrive and when you leave so that you are accurately paid. We are encouraged to take our 30 min. unpaid lunch but many never take the paid 15 minute breaks. I firmly believe we give a lot of free time as it is.