What to do when the census drops...

Our PRNs will go up to Peds or the nursery.

Our prn's are the first to be called out when we have low census. They look for work in the well baby nursery or on pediatrics too. A couple of them worked on mother-baby in the past and will take easy post-partum/newborn couplets. Yes, NICU is very specialized. One of our prn's goes to another (smaller) hospital and works in their critical care unit where they occasionally have babies (no Pediatrics ward there). Wishing you the best of luck and a high census situation soon. These high and low census times often come in waves...

Agency!! Get an agency job. If you are in a smaller town, may require travel.

Our level III NICU has been very slow for the past 2.5 months as well. I work Regional Float Pool and have been working my 3 shifts or more if I want. The NICU nurses float to newborn nursery or peds but for the most part verbalize hating it so they are now down to the very last of their PLT hours and when vacation time comes, will not be able to if they do not have the hrs. If they have a bad attitude when floated, they are placed on a list and sent to their dept. as ones not welcomed back. They are supposed take turns floating and/or staying home. There are a few each shift that are constantly floating and are kept busy no matter what the census.

I would advice you cross train. My last NICU job, I cross trained to post partum and other units. When low census time came around I took it if I wanted to, if not, then there was always plenty to do in the other departments and I stayed busy while my coworkers worked 2/3 a week and took turns.

Take a deep breath since it doesn't happen very often. We float to other areas in the Women's Division if they need help but if they don't, we take "Cost Effective" days. We have such a large staff that there are many requests for a CE before we have to resort to a mandatory CE. If we are in a mandatory CE situation (it has happened once in the 10 years I have been here), the nurse has the option of contacting Nursing Ops and floating to another unit in the hospital as an extra pair of hands if they need help. First, we cancel overtime, then requests, then above your FTE (ex. part-time picking up extra shift but still not in overtime), PRN's, and finally by last date cancelled. This has worked well for us.