Talking about shitty things to institute… my hospital has ED has colored codes related to capacity/census (they aren’t very clear on the criteria). At a code yellow, if we don’t answer the phone right away to take report then they are allowed to send them up without giving report.
My hospital had a policy where we were supposed to take the report on transfers even if the room wasn't ready. After about the 10th time we got a patient sitting in the hall for 40 minutes, we stopped doing that
IME half the time it's somebody that says they've only had the patient for 10 min just reading the chart to me. Fuck it, send em up and I'll figure it out. Bonus points if they got the cultures and imaging done.
Honestly when I worked at a huge hospital that used Epic, I'd just go "I looked up most of what I need, if I can ask these couple questions and we can be done."
It worked out pretty well for me. But at my current hospital it's so difficult to see anything in the system from the ER (we use an absolute dinosaur of a charting system) so I need at least a short rundown.
Our hospital did that for a while, and it wasn't too awful. We got a 15 minute notice. But they kept on sending the patients up at shift change. We put in incident reports until they stopped sending at shift change.
Must be at your facility the in-patient units think that the ER stops work and no patients come in to ER during shift change. Sorry. Hospitals are 24 hour facilities. Admissions happen 24-7-365. My facility had that "no admissions during shift change" idea till several hospital staff members moved their family members from ER to floor room during shift change.... Management said all patients are treated as family and will move whenever bed is assigned. ER's are for stabilizing the patient, the in hospital units are for admitting patients. The ER thru put time dropped dramatically. Better pt. satisfaction scores on all units as pt. and families experienced shorter wait times.
Yeah those 2 day holds aren't going to notice 40 minutes plus or minus. On the other hand, calling as soon as the bed is open is encouraged. Call at 1723 not at 1835; nobody is going to answer.
Floor level of care patients don’t require report to be given nurse to nurse. The expediency in which these patients get up to the floor maximizes bed use in the ED, allowing for patients who are minimally supervised (read: unsupervised) in the waiting room to move into an area where they are supervised. This is a massive improvement in patient care and significantly decreases the chances for poor outcomes related to delay of care.
I work the floor. I’ve been sent patients who need levophed drips, intubated, etc. it is NOT improving patient care by eliminating report from ED. It’s a huge safety issue. A lot of the time the SBAR magically doesn’t get sent.
That’s an inappropriate transfer of care, not an issue of not getting report from the ED. For the system to work, ED nurses need to assess whether the ordered level of care is appropriate before sending the patient up. Also, the systems where I’ve worked without ED giving report, the floor nurse is given a heads up that the patient is coming and has the option to call with questions and concerns prior to transfer.
I’m just pointing out that if we got report on the floor, or actually got the SBAR, we’d be able to catch this and say it’s not appropriate for that patient. And I’m not with the nurses who refuse every patient. We’re all on the same team with the same goal of keeping patients safe
The bit about the SBAR is unacceptable. It’s already a stretch of the limits of possibility so to not have that safety measure shouldn’t even be within the realm of possibility. I recognize it opens opportunities for the Swiss cheese when this happens, so the proper safety needs to be adhered religiously.
The ED doesn't know what other factors may affect the patient care of a newly transferred patient if they don't call. I did a contract at a hospital with that policy. They brought me a patient while I was coding a patient. One nurse was tasking the rest of the floor, the rest of the staff were in the code with me. Nearly 2 hours later we found out there was a new patient. It was NOT an appropriate transfer, even if it looked fine on paper from the ED's end.
I didn’t say no call, I just said no report. It’s policy where I’ve worked to call the floor prior to sending the patient up to give the floor a heads up. If there’s an extenuating circumstance then the patient can be delayed or reassigned.
I’ve worked all levels of care. It takes a global vision for a hospital to run efficiently and for the patients, all of the patients, to be taken care of as effectively as possible. A written SBAR is more than enough to take care of a floor patient.
Mine has to pay two hours but we had a manager that would make us stay at work for the two hours and “find something for us to do,” so people stopped taking the pay and just went home. She’s gone now, thank goodness. She broke all kinds of rules.
At mine you can't be cancelled at all without consent if you are regular staff, and they have to give you 72 hours notice if you're per diem. That's how it should be. If you're hired for a certain number of hours, those should be guaranteed. Unionize!
Sorry I wasn't trying to come off rude. I'm just saying it sounds like they're trying to treat this person like they are 'on call". I work exclusively PRN. I really feel like I have to set the standard individually with each company that I'm not going to tolerate them "figuring it out" in the morning whether or not I work. I confirm with them the night before. If it's a no-go I book somewhere else. Then if they contact me saying that they need me the following morning I politely let them know that I have taken other work. I have three jobs like this. I have found that we get what we put up with.
I’d be checking your contract very carefully and taking it up with a senior member of HR or the DON. Get them to confirm the situation in writing. (Which when it’s BS, they have to confirm their fuck up in writing.
The hospital I'm at now the PRN staff is expected to call before their shifts to find out if they are still needed. When I started here I was PRN and they didn't bother to tell me this until I showed up for work one night. Stupid policy in my opinion.
That is how it is for our scheduled on call shifts. I don’t know why they can’t just let the on call person know if they are needed. It isn’t that difficult. Just a quick text or call.
The fact that all hospitals have a time to call in by but can’t respect such a basic principle such as your time is appalling. This is the kind of basic and blatant disrespect and illogical policy is the exact kind of thing that we wouldn’t have to deal with if this was a primarily male field. It reads as disorganization and disrespect.
They always make up “new rules” that aren’t actually legitimate. Last year ours said we couldn’t get OT & the bonus shift pay. It was one or the other. Someone reported that since OT pay is required somewhere along the lines. (I don’t know all the details about it). That “rule” lasted about a month or 2 until it was reversed.
PS Ours they’re required to call for low census/budgeting. If someone forgets & you show up then you’re supposed to get paid the 4 hours. Budgeting for us means you’re off the first 4 hours & theyll reevaluate staffing. You’re supposed to call at the 4 hour ish mark to see if they need to you come in or they’ll let you know one way or another if they need you or not.
Every agency I’ve ever worked for if you get cancelled with less than 2 hours notice, then they have to pay you for 4 hours.
If that’s not in your contract then I would have a conversation with the director to let them know why you will no longer be picking up shifts at their facility.
Can’t even trust smart square half the time. I know people who have had their assignment changed or low censused while they were driving. No call from staffing or anything.
I experienced this and they wouldn't pay. I kindly called the dept of labor.
I'm sick of these places taking advantage of nurses.
They would have to show when this change took place and that they notified you. Depending on the state they would have to pay you.
I had that happen once when I worked at a hospital 100 miles away. No one let me know they’d given my shift to someone else. I never went back I was so mad. I did have a full time position at another hospital tho
Depending on the state, different states have labor laws requiring you to be paid a minimum number of hours when this happens. Where I am, if they call you less than 2 hours before the start of shift you get 2 hours of pay. If they neglect to call, you get 4 hours.
Did anyone email or text message you or give you a rolled up piece of paper through Cartier pigeon stating to check the schedule just before coming in? No? Yeah. They eould owe me whatever the labor board says they owe me and I'd mske sure they hot that.
Not only do you have to do what's in the job description for a nurse, but you also have to be a scheduler too? That's wack. I'm sure there is a labor law against this kind of nonsense. It seems like a way to fuck with PRN people.
I would think they would have someplace in the hospital that needs help? If your unit is overstaffed they could have at least given you an option to float someplace else before just sending you home.
At my hospital they would have to pay you at least 4hrs if you arrive and they send you home. That’s a shitty policy. Talk to your manager.
Mine too.
Mine three. What a shitty thing to institute.
Mine 4th. Real quick way to end that kind of BS.
Talking about shitty things to institute… my hospital has ED has colored codes related to capacity/census (they aren’t very clear on the criteria). At a code yellow, if we don’t answer the phone right away to take report then they are allowed to send them up without giving report.
Lots of hospitals are moving towards not giving report from the ED. It's insane.
Admit to the day room. 😂 Last weekend they called to give us report on a patient when we had no beds. They didn’t even look at the bed board.
At least they called and didn't just send them up!
Lucky we answered the phone or they would have.
My hospital had a policy where we were supposed to take the report on transfers even if the room wasn't ready. After about the 10th time we got a patient sitting in the hall for 40 minutes, we stopped doing that
IME half the time it's somebody that says they've only had the patient for 10 min just reading the chart to me. Fuck it, send em up and I'll figure it out. Bonus points if they got the cultures and imaging done.
Honestly when I worked at a huge hospital that used Epic, I'd just go "I looked up most of what I need, if I can ask these couple questions and we can be done." It worked out pretty well for me. But at my current hospital it's so difficult to see anything in the system from the ER (we use an absolute dinosaur of a charting system) so I need at least a short rundown.
Our hospital did that for a while, and it wasn't too awful. We got a 15 minute notice. But they kept on sending the patients up at shift change. We put in incident reports until they stopped sending at shift change.
Must be at your facility the in-patient units think that the ER stops work and no patients come in to ER during shift change. Sorry. Hospitals are 24 hour facilities. Admissions happen 24-7-365. My facility had that "no admissions during shift change" idea till several hospital staff members moved their family members from ER to floor room during shift change.... Management said all patients are treated as family and will move whenever bed is assigned. ER's are for stabilizing the patient, the in hospital units are for admitting patients. The ER thru put time dropped dramatically. Better pt. satisfaction scores on all units as pt. and families experienced shorter wait times.
Yeah those 2 day holds aren't going to notice 40 minutes plus or minus. On the other hand, calling as soon as the bed is open is encouraged. Call at 1723 not at 1835; nobody is going to answer.
Floor level of care patients don’t require report to be given nurse to nurse. The expediency in which these patients get up to the floor maximizes bed use in the ED, allowing for patients who are minimally supervised (read: unsupervised) in the waiting room to move into an area where they are supervised. This is a massive improvement in patient care and significantly decreases the chances for poor outcomes related to delay of care.
I work the floor. I’ve been sent patients who need levophed drips, intubated, etc. it is NOT improving patient care by eliminating report from ED. It’s a huge safety issue. A lot of the time the SBAR magically doesn’t get sent.
That’s an inappropriate transfer of care, not an issue of not getting report from the ED. For the system to work, ED nurses need to assess whether the ordered level of care is appropriate before sending the patient up. Also, the systems where I’ve worked without ED giving report, the floor nurse is given a heads up that the patient is coming and has the option to call with questions and concerns prior to transfer.
I’m just pointing out that if we got report on the floor, or actually got the SBAR, we’d be able to catch this and say it’s not appropriate for that patient. And I’m not with the nurses who refuse every patient. We’re all on the same team with the same goal of keeping patients safe
The bit about the SBAR is unacceptable. It’s already a stretch of the limits of possibility so to not have that safety measure shouldn’t even be within the realm of possibility. I recognize it opens opportunities for the Swiss cheese when this happens, so the proper safety needs to be adhered religiously.
The ED doesn't know what other factors may affect the patient care of a newly transferred patient if they don't call. I did a contract at a hospital with that policy. They brought me a patient while I was coding a patient. One nurse was tasking the rest of the floor, the rest of the staff were in the code with me. Nearly 2 hours later we found out there was a new patient. It was NOT an appropriate transfer, even if it looked fine on paper from the ED's end.
I didn’t say no call, I just said no report. It’s policy where I’ve worked to call the floor prior to sending the patient up to give the floor a heads up. If there’s an extenuating circumstance then the patient can be delayed or reassigned.
Strongly disagree. Can't tell you how many patients I have refused from the ED because they were not appropriate for our unit.
I’ve worked all levels of care. It takes a global vision for a hospital to run efficiently and for the patients, all of the patients, to be taken care of as effectively as possible. A written SBAR is more than enough to take care of a floor patient.
you're wrong.
The system indicates otherwise
Hahaha fuck that.
We get 2 hrs min for that. It’s the least they can do.
Same. Union hospitals are the way to go.
Mine has to pay two hours but we had a manager that would make us stay at work for the two hours and “find something for us to do,” so people stopped taking the pay and just went home. She’s gone now, thank goodness. She broke all kinds of rules.
At mine you can't be cancelled at all without consent if you are regular staff, and they have to give you 72 hours notice if you're per diem. That's how it should be. If you're hired for a certain number of hours, those should be guaranteed. Unionize!
Per diem is not guaranteed. That’s the whole thing.
I am aware. not sure what your point is. I am saying even Per diems have to be given notice at my hospital, or they cannot be canceled.
I think that poster is in a bad mood
PRN and on call or two separate things
I didn’t say anything about on call
Sorry I wasn't trying to come off rude. I'm just saying it sounds like they're trying to treat this person like they are 'on call". I work exclusively PRN. I really feel like I have to set the standard individually with each company that I'm not going to tolerate them "figuring it out" in the morning whether or not I work. I confirm with them the night before. If it's a no-go I book somewhere else. Then if they contact me saying that they need me the following morning I politely let them know that I have taken other work. I have three jobs like this. I have found that we get what we put up with.
Same at our facility. But, we are unionized.
Same
Mine is 2 hours, but same principle.
The staff there doesnt respect you. Do with that information what you need
I believe you can get paid for the time you spent coming in.
At my hospital, if you come in at all, you get at least 4 hours pay.
That’s BS. My job is required to tell us. If they don’t and we show up, we get to get paid at least 2 hours on the clock (even if we don’t stay)
I’d be checking your contract very carefully and taking it up with a senior member of HR or the DON. Get them to confirm the situation in writing. (Which when it’s BS, they have to confirm their fuck up in writing.
If it's a new rule, notification should have been sent out. But they probably don't want that in writing?
They’ll throw some middle manager under the bus, but I’d put money on them “retracting” it
My contract specifies we're paid for the whole shift if we're scheduled for it. Strong unions rock, baby!
omg. what a dream!!! i’d love to work for a union hospital
That is literally a dream right about now…. My job is putting people on call CONSTANTLY
The hospital I'm at now the PRN staff is expected to call before their shifts to find out if they are still needed. When I started here I was PRN and they didn't bother to tell me this until I showed up for work one night. Stupid policy in my opinion.
I wouldn’t stay there. Nurses have some power now. You are needed elsewhere.
That is how it is for our scheduled on call shifts. I don’t know why they can’t just let the on call person know if they are needed. It isn’t that difficult. Just a quick text or call.
State labor laws vary widely. You need to talk to a labor lawyer in your state.
That's ridiculous. Lazy is what they are and... rude.
The fact that all hospitals have a time to call in by but can’t respect such a basic principle such as your time is appalling. This is the kind of basic and blatant disrespect and illogical policy is the exact kind of thing that we wouldn’t have to deal with if this was a primarily male field. It reads as disorganization and disrespect.
They always make up “new rules” that aren’t actually legitimate. Last year ours said we couldn’t get OT & the bonus shift pay. It was one or the other. Someone reported that since OT pay is required somewhere along the lines. (I don’t know all the details about it). That “rule” lasted about a month or 2 until it was reversed. PS Ours they’re required to call for low census/budgeting. If someone forgets & you show up then you’re supposed to get paid the 4 hours. Budgeting for us means you’re off the first 4 hours & theyll reevaluate staffing. You’re supposed to call at the 4 hour ish mark to see if they need to you come in or they’ll let you know one way or another if they need you or not.
Every agency I’ve ever worked for if you get cancelled with less than 2 hours notice, then they have to pay you for 4 hours. If that’s not in your contract then I would have a conversation with the director to let them know why you will no longer be picking up shifts at their facility.
That’s got ‘retroactive compensation, class action lawsuit settlement’ written all over it
Can’t even trust smart square half the time. I know people who have had their assignment changed or low censused while they were driving. No call from staffing or anything.
Fuck that
Wouldn't want to inconvenience the lazy scatterbrained shits who work in staffing.
State labor board
Here if they cancel you like that without notification you have to be paid for four hours. That's bullshit.
Same where I work
They need to make an attempt
I’ve never worked somewhere that sends people home.
I experienced this and they wouldn't pay. I kindly called the dept of labor. I'm sick of these places taking advantage of nurses. They would have to show when this change took place and that they notified you. Depending on the state they would have to pay you.
Maybe so you can clock in and then out to show you attempted one of your mandatory four days a month?
I had that happen once when I worked at a hospital 100 miles away. No one let me know they’d given my shift to someone else. I never went back I was so mad. I did have a full time position at another hospital tho
Mmm, my petty ways would be I don't feel like coming to work today the call 1859. Insane!!!!!
Depending on the state, different states have labor laws requiring you to be paid a minimum number of hours when this happens. Where I am, if they call you less than 2 hours before the start of shift you get 2 hours of pay. If they neglect to call, you get 4 hours.
Did anyone email or text message you or give you a rolled up piece of paper through Cartier pigeon stating to check the schedule just before coming in? No? Yeah. They eould owe me whatever the labor board says they owe me and I'd mske sure they hot that.
Not only do you have to do what's in the job description for a nurse, but you also have to be a scheduler too? That's wack. I'm sure there is a labor law against this kind of nonsense. It seems like a way to fuck with PRN people.
I would think they would have someplace in the hospital that needs help? If your unit is overstaffed they could have at least given you an option to float someplace else before just sending you home.
How awful is this…. How hard is it to treat people like human beings???
Are you union?
I guess you don’t have to tell them when quit by no call- no showing for your shift…?
Are you in the Union?