Published Apr 7, 2014
My client (an adult) stays up all night on computer and wants to sleep all day. He requires a liot of care but refuses to allow me to begin until the last minute. No nurse follows me. Mom says all work has to be done before leaving. She will never voluntarily take over. I am often stuck there 1 1/2 hrs late. One nurse on the case can finish on time and the other stays over for hours. I mentioned iit to supervisor but she says i am not assertive enough. I dont mind staying to chart but 1 1/2. -2 hours is crazy.
I'd talk to your office about it more. There's no reason to be working that long & not get paid for it. They should be paying you OT or you should be able to leave on time.
I agree with your supervisor. You need to tell them you only work the hours scheduled. Its continuous care and care extends beyond our shifts sometimes. You are also setting up the next nurse to come in after you leave the case for failure because they will expect this from every nurse. They are taking advantage of you and you are allowing it.
Sometimes you just have to put your foot down.
Elektra6, ASN, BSN, RN
I know. I have to stop being so nice.
Try being firm.
"I have to leave at my scheduled time. If we do not start your care at X time, I will not be able to complete it and have to leave you incomplete or not done at all. Which would you prefer?"
"I am required to leave at my scheduled time. If you would like care today we need to start now."
Leave at your scheduled time. If the care is incomplete contact your supervisor and tell her he refused care etc.
Staying later than scheduled is a big no-no. If you were injured while caring for him after your scheduled time you won't qualify for workman's comp.
imintrouble, BSN, RN
It's not being "nice" to let other people walk on you. It's what we tell ourselves to make being taken advantage of more bearable.
If you were making a choice to be "nice" you wouldn't be here upset because you have to work unpaid overtime.
The client is only the boss for the scheduled hours.
What YOU decide to do after that is up to you.
You're right. I need to be more assertive about this and stop worrying. I am going to start today.
brillohead, ADN, RN
Wow, no way in heck would I stay beyond my scheduled time without pay! Sounds like you need to have a sit-down with the patient and the mom and spell out the parameters of your service.
Explain that you can ONLY be there for scheduled hours, barring an emergency.
Explain that when you are off the clock (when your scheduled hours are over), you're no longer in their home as a nurse/employee of but rather as a guest in their home, and if anything were to happen (such as a work-related injury or even just a slip-and-fall), they would be liable, not your agency. THIS is why it is imperative that they allow you to leave when your scheduled hours are completed.
Explain that the patient, as a (presumably) competent adult, is allowed to refuse care if he so chooses. However if your charting continually notes "pt refused care" and no skilled nursing duties are performed, then the insurance company (or Medicaid or whoever) will cut the hours that are covered and they won't get nursing care at all.
Also, if it's something that you'd be willing to consider, you can offer to adjust your shift by an hour or two, to accommodate the patient's personal schedule. For example, instead of working 1900-0700, you could offer to work 2100-0900 instead. (ONLY make that offer if it's something you don't mind doing, however!) That way, you could be home for the first two hours of your shift without pay, while getting paid for the last two hours that you're staying over anyway.
I'm guessing that the patient doesn't really care much about anything, so your main issue will be with the mom. Stress the combination of "off the clock liability" and "loss of insurance coverage" to her, and she'll probably bend over backwards to bring him into compliance so that she doesn't have to take over his care!
Good luck, and let us know how it goes!
Things are better. I don't know if it is because I spoke with client and mom, or it's nice outside and he wants to get out. Either way, client has been getting up earlier so I can leave on time. Thanks for the replies.
My agency told me that Rn's do not have to be paid OT.
I also remember reading about this on Allnurses.
Any truth to that?
I was not on salary with that agency either;i was hourly.
akulahawkRN, ADN, RN, EMT-P
My agency told me that Rn's do not have to be paid OT.I also remember reading about this on Allnurses.Any truth to that?I was not on salary with that agency either;i was hourly.
It depends upon your state's wage orders. I would imagine that very few RN's are OT exempt.
In California, Registered Nurses are not generally exempt from OT. The IWC has orders, specifically, Articles 4, 5, and 15 should cover almost any way that a Registered Nurse would be employed in that capacity. It generally wouldn't matter if the RN was salaried or not. Being salaried doesn't automatically make a person OT exempt. An individual RN would have to meet some very specific criteria to be considered OT exempt and those situations are encoded into those orders. A valid collective bargaining agreement would/could easily preempt the wage orders though. However, those employed by a governmental entity and not pursuant to a bargaining agreement very easily could be, and probably are, exempt from quite a bit of those wage orders.
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