Work load question.

This is a reality today. Shrinking reimbursement will make the situation even worse in the future.

In my organization, most facilities operate on a flex system that ties worked hours to patient census - for ALL departments, no matter whether they are clinical or not. When census drops, managers have to cut hours and people are sent home. They do have the option of using vacation hours if they want, but it is up to each person to make that choice. Each department keeps track of who is 'called off', and has a rotation system so that it is equitable. In clinical departments, the first action is to cancel prn staff first - then cut part timers before affecting the full timers.

But from what I hear, most departments usually have a list of 'volunteers' who want to be called off or sent home early because they like having some extra time off.

Although, at first glance this seems like a system that is most fair to clinical departments, I think it is a very difficult situation for those administrative departments whose workoad does not vary depending on patient census.

Anytime a unit's census drops a manager will start sending home staff in order to not be overbudgeting on payroll. Typically any PRN nurses are sent home first since they have the highest salary. Depending what sort of floor you are on you may see cancellations as more of an issue than others. I don't see ER or Step-down being canceled as much as I do specialties (ie peds) or post-op nurses (surgical floors and ortho).

I wouldn't be too concerned. If you are canceled ever you can typically use vacation time that day to make sure your paycheck equals full-time.

I work in the ED and have never been cancelled or sent home early, and I never will. I work for a union hospital and staffing has been negotiated in the contract.

My shift is from 5P-5A. What that means is, since we are required to have X number of nurses in the ED during the last few hours of my shift, and cancelling me or sending me home would mean there would be too few nurses to be safe if we had something serious come in or too many patients, I will never be cancelled or sent home.

Census in the ED is projected based on trends, and thus how they determine the number of nurses that should be working at different points of the night. But census fluctuates constantly and you can never really know how many patients you will have at any given time. The ED is unique in this way, which is why that department (in my hospital at least), and my shift in particular, rarely, if ever, cancels shifts or sends nurses home early.

I work three 12-hour shifts per week at a rehab hospital, and when census is low, peoples' shifts are canceled. In fact, two of my shifts were canceled last week due to low census, and I fully expect to be canceled again this week if my workplace doesn't receive a bunch of new admissions on Friday (I am scheduled to work Friday).

Full-time staff are scheduled for three shifts per week, but will be canceled in an orderly fashion if there are not enough patients in the building.

Respiratory staff has not been canceled, but are being forced to clock out six hours early in order to keep the facility under budget. Unit secretaries are being canceled and/or sent home early. Housekeeping staff and environmental services staff are being sent home early. Hourly dietary staff are being sent home early.

Basically, every hourly worker at my hospital is subject to cancellations and being sent home early. Since the folks in upper management are salaried employees, they never see a short paycheck due to cancellations or being sent home.

This is exactly the case at my hospital.

Never. Union employee. However, we can technically be sent to another ward to work if they are over census and your ward is under. Doesn't happen often though.

Never. Union employee. However, we can technically be sent to another ward to work if they are over census and your ward is under. Doesn't happen often though.

Our contract permits the cancellation of casual staff. If the unit knows before the shift (ie, nights knows days will be over staffed) the staffing office calls and cancels the casuals. If they arrive at work with out being cancelled they are entitled to four hours pay and are sent home after the four hours. Other managers cancel casuals upon arrival, keep them for four and send them home.

Staff with permanent lines are never cancelled. Technically, managers can't even ask us to take vacation time and go home. They can float us out to another unit that is understaffed.

Where I work, once in a while someone gets sent home early if it is nearly the end of the shift and there are plenty of empty beds and no admissions expected.

Usually that person is me since I work per diem.

The per diem and overtime staff are the first to go.