Teamplaying or Enabling?

[GardenDove]

Lately there have been some holes left in my unit, with last minute calls appealling staff to fill them, by pulling on our heartstrings. It happened last night that I got to work (in two nurse, small hospital ICU), and no one else was scheduled. They ended up doing a last minute float of one fellow who works ER and ICU, but he had to come in two hours sooner because his ER shift was only 10 hours. He was crabby all night because he's getting floated on his ER nights too much lately and he likes his ER nights.

Some of us decided that if we continue to cater to irresponsible staffing plans, we are actually being enablers, don't you think? Why should managment put the onus on the staff nurses because they aren't doing their own jobs properly. It seems like we nurses need to unite!

[llg, PhD, RN]

That's a good question. My take on it is that .... if it's a long-term problem and the management is not making much effort to solve the problem, then supporting their short-staffing strategy is enabling and nurses should STOP going along with it. However, if it is a temporary crisis caused by some unforseeable causes and/or the management is making sincere efforts to solve the underlying problem, then staff should step up to the plate and pitch in for a while to keep things afloat while the problem gets solved. Your original post didn't say what steps the hospital is taking to improve the situation, if any.

[GardenDove]

I emailed my manager to outline our concerns, she's pretty good at responding.

[RunnerRN, BSN, RN]

At different times of the year, it seems like I get called with requests to come in every day off. I generally say no (I like my days off!) but will go in if they offer overtime or other perks. If they need people that bad, they need to put their money where their mouth is, or just schedule better!

[kidznurse]

bottem line always has to be how safe are the patients

[classicdame, MSN, EdD]

the perfect schedule does not allow for illness and other emergencies. However, I feel a points system should exist for calling in, whether ill or not. Otherwise, someone has to be make the decision "is this justified"? I worked with a nurse who had health problems and could not be depended on to be at work, or work the whole shift. I got tired of taking up her slack and was glad when her points accrued to the level where she had to choose between no job or prn. She went prn.

[rn/writer, RN]

bottem line always has to be how safe are the patients

To a point. The sad truth is that there are managers who will hold that over their employees' heads, in effect, taking the patients hostage. "You have to come in or the patients will be the ones to suffer." If they are that concerned, let them pick up a shift now and then.

I agree with Ilg. If it's a short term problem caused by illness or some other unforeseeable calamity and you want to step up, feel free. If this is an ongoing situation because of insufficient staff, poor planning, and lack of incentives, don't feel any obligation to throw yourself into a gap that management should be filling by hiring more people, using in-house pool, contracting with agencies, or providing decent compensation for those who take on extra hours.

Agree to help out now and then, if you choose and are able. Do not agree to be exploited.

[GardenDove]

my manager stated that this had not been left to the last minute on purpose, but she had exhausted all avenues. However, the nursing supervisor seemed to be clueless about the whole thing.

Yesterday I was able to turn the tables when the same situation presented itself. The nursing supervisor called me to ask me to work last night. I informed her that I was scheduled to work the following dayshift (today). She was surprised, but checked the schedule and confirmed it.

A half hour later she called back and asked if I would be willing to work the 12 hour night instead of the next day. I could hear the desperation in her voice and said that, yes I would, for time and a half. So, she put me on call, with the agreement that I would be called in, and I came out smelling like a rose.

[Rabid Badger, BSN, RN]

This happens routinely on our ward. Baseline staffing is not filled by the manager and she leaves it up to the float pool to make up the baseline. So, inevitably, the float pool is exhausted and spread too thin so they have to start calling us in. I get called almost everyday to pick up shifts, and I am full time. If I choose to accept the shift, I get paid double time. Only rarely have we actually had to run short on the ward.

However, it irritates me to no end that the manager fails to exhaust all avenues to fill baseline to prevent the stress on our staff and the float team. Because when we have sick calls on top of baseline needs.....well you can imagine the stress on our team. Grrrr.

[Ruby Vee, BSN]

if there are financial incentives in place for working overtime, and you want to work it, do so. don't worry about "enabling." when you no longer need the extra money, you'll stop doing the overtime and either someone else whose car needs a new transmission will pick up the slack, or your manager will have to figure out an alternative. but if you don't want to do the overtime, don't feel guilty about not doing it. it isn't up to you to staff the unit 24/7, and as long as you show up when you're supposed to, you're doing your part.