I've been told that we were going to be moving to 12 hour shifts 'soon' ever since I got hired. Hell, they mentioned it during my first interview in March. One of the nurses I worked with was told during HIS interview that they would be going to 12 hour shifts and that was the final selling point to him. You see, on 12 hour shifts we'd work three 12 hour shifts one week and three 12 hour shifts plus one eight hour shift the next week. Those extra days off allow nurses to take on another job that will give them one or two days a week at a hospital or some other facility. He wanted that. He is extremely upset that it hasn't happened in the 18 months since his interview.
I found out that they had been on 12 hour shifts years ago and had been on them for a LONG time. It seems that going to 8 hour shifts was an experiment that was almost universally hated.
In the time before 8 hour shifts the nurses worked only one out of three weekends (although I honestly don't see how that's possible as staffing levels don't change and currently half of the nurses work each weekend). They also had very little overtime as evidently they were better able to cover every shift. The big benefit for most nurses is that the extra days off left more room for trading shifts. So once the schedule was posted, nurses began lining up the days they really wanted off and finding people that were willing to trade with them. The eight hour shifts don't really let that happen as the other nurses only have a single day off during the week meaning that there is a good chance that nobody on your shift has the day available to trade.
It seems that scheduling 12 hour shifts is a real pain for the supervisor in charge of making the schedule. He's tried on multiple occasions and has yet to come up with a schedule that works for everybody. One problem is that there are several nurses now that don't want to move to 12 hours. Some for family reasons, some for health reasons (one nurse is back after a round of chemo and simply couldn't work for 12 hours straight).
One note of contention seems to be staffing levels. I just heard that the plan so far is that they will move down to a single RN every evening in addition to a single Med room nurse (normally an LPN, but not always). That means while the med line is going (normally takes between 45 and 90 minutes) there would be no nurse in the clinic. If an emergency came up during that time (and it's not all that rare for that to happen), the Med Line would have to stop while the RN comes out to handle the crisis. Most times that would mean getting the person into the clinic, a set of vitals, then telling them to wait while they return to the Med Line, but sometimes those emergencies can take an hour or two all by themselves. One of the nursing supervisors says thats unacceptable as it's below our current 'critical staffing' requirement. Another supervisor says it shouldn't be an issue, but if it turns out to be one then we can adjust to it later. Neither of these is the actual supervisor making the schedule, so he seems to be the rope in a tug of war.
I personally don't have a dog in this fight. I can see advantages to both sides. Over a two week pay period 12 hour shifts would mean going to 7 working days from 10. Three extra days off would be nice. But it would also mean that on the days I do work, there would be nothing else going on.
Let me set the stage as to how my work days go now. I wake up (generally between 5:30 and 7:00 and always without an alarm) and do my morning web crawl while drinking my two big cups of coffee. After I'm done with that I do 'something else'... that can be posting here, working on a cap, paying bills, making phone calls that I have to make, writing letters to people... just something I can do before jumping in the shower. Around 10am I'll get my act in gear and take a shower. After the shower I get my lunch made and ready to pack, then sit in front of the Boob Toob for about an hour. At noon I change into my scrubs, pack my lunch and get everything ready to leave. At 12:15 (yes, I'm anal enough that I have an exact time) I gather up my things and take off to work. After completing my shift (most of the time at 10pm, but occasionally I have to stay over for a bit), I leave and arrive home around 11pm. I will often eat something and wind down in front of the TV again until I head to bed between midnight and 1am.
So on a work day I have plenty of time to do 'stuff'. I can get together earlier and go out shopping if I need to, or I can be completely lazy and do 'nothing' before work. I get as much sleep as I need as I would only need to set an alarm if I felt that I was going to sleep in past 11am (something I haven't done in ages).
How would a 12 hour shift change that? Well lets take the 'leaving' moment and work backwards. My shift would start at 9:30 am (currently it starts at 1:30pm), so I'd have to leave here at 8:15am. To ensure that I'd have enough time for a cup of coffee, a shit/shower/shave and lunch packing I'd have to get up by 7am. Now most days that's not an issue, but I wouldn't want ot rely on my internal clock to keep that schedule. So I'd set my alarm. That alone would be a big change. Right now I wake up when my body tells me to wake up. But if I knew there was an alarm I'd just roll over and go back to sleep instead and wait for the alarm to tell me to get out of bed.
Getting up at 7am, I'd have time for some coffee and web surfing but would have to quickly shift into a higher gear to shit/shower/shave, pack my lunch and be on my way by 8:15. I'd then work, drive home, eat, and get into bed between midnight and 1am. In other words I'd have time for nothing else. Work days would simply be work and the activities around it (getting ready before and winding down afterwards). Sure, I'd have an extra day or two off but instead of having the opportunity to do something 14 out of 14 days, I'd only have my 7 days off to accomplish anything.
I also have an issue with the additional days off. You see, if I don't plan something for days off I can quickly get bored. I've had weekends off that plans fell apart on and by Sunday afternoon/evening I'm pulling my hair out. 12 hour shifts would have the possibility of four days off straight. Maybe even more! Yeah, I'd have more time for hobbies, but I don't currently have hobbies that take up that much time.
Advantage wise, there is the less driving. Less wear and tear on Fiona and less gas down her throat. I'd also have more time at work to... well... work. It's surprising how constraining eight hours can be. Plus I would be more in line with how the nursing world works. Trust me, 12 hour shifts are the norm in the nursing world and my current 8 hour shifts are the exception. If/when I move on to another job I'd already be used to the shift I'd likely get. I'd also smoke less. There is just no smoking at work. I can't even go out to the car for a 'quick' smoke (it actually couldn't be quick even if they allowed it, as I would have to go through the security bubble twice). It would be nice to have something else pushing me to quit, but until I do stop smoking it will be an issue. After working and being away from my beloved nicotine for 8+ hours I'm desperately in need of a fix. I generally smoke two or three cigs on the way to work... I smoke five on the way home.
With all of that being said, we were told that we'd be moving to 12 hour shifts on our next schedule which starts on January 5th. We normally get our schedule about a month in advance, but only yesterday did we get it. And the schedule we got yesterday was for two weeks as opposed to six we were expecting. It seems that getting 12 hour shifts to fit hasn't worked out, so they offered these two weeks as a stop gap. A stop gap using eight hour shifts. I honestly don't mind, but the people foaming at the mouth for those 12 hour shifts are majorly upset. The guy I talked about earlier that was promised 12 hour shifts almost two years ago? Well he was upset enough that he said was going to spend the weekend putting out applications.
I imagine he won't be the only one. I said earlier that I don't have a dog in this fight, but if leaving us on eight h our shifts takes good qualified nurses away, then damn it GET IT IN GEAR AND GET IT DONE ALREADY!!!
That's about the only dramatic thing going on at work. I did work Christmas Eve and Christmas Day (and will be working New Years Eve and New Years Day). Christmas was SLOW. I only had three callouts and they were as easy as they come... vital checks. Get the person in, get a weight/bp/pulseox/pulse/temp and then send them on their way. One of the time filling tasks we have at the end of each month is prepping the MARs.
A MAR is a Medical Administration Record. It's a piece of paper listing the patient (inmate), their important info (name, number, birthdate, allergies...) and their prescriptions. Each time the patient (inmate) is given a med, the nurse has to put their initial down as having done it. For legal reasons this is very important... we need to know if they are getting their meds, refusing their meds, or not even showing up to get their meds. If they end up injured because they didn't get their meds we have to have proof of why. So each individual MAR has to be checked twice. In our side of the facility that means going over about eight hundred MARs. Twice.
One of our main med room nurses had done the initlal check on hers and was about halfway done with her second pass (others had helped a little, but it was mostly her). On Christmas Day I finished it off. The amount of 'checking' that I did took her about two days, and I got it done in a single shift. And understand I can't have the MAR for the entire shift... she has to have it while passing meds. That's how slow it was. I expect New Years Day to be about the same. As I was working (and actively trying NOT to gouge my eyes out with a spoon) I realized that this was the very first time I worked on Christmas Day. The First. The holiday overtime will help soften that blow (I actually get holiday overtime for each of those days; CE, CD, NYE, NYD), but it still sucks.
I've also spent the last few weeks working up a replacement for our intake form. The form is used by the RNs when we have a new inmate. We have to make sure their doctor visits get set up (actually transferred from their old facility), their lab work gets scheduled, meds get checked in and/or passed, give them an overview of our health facilities, give them information on how to request health information, let them know how and when they will be charged for services.... and a whole lot of other things. The form isn't something that we save, it's more of a guide to make sure the nurse doesn't forget anything and covers all the bases. Well, our form hadn't been udpated in years. Some of the things on the form were no longer done. Some new tasks had been added, but had to simply be remembered. And most frustratingly the order of the tasks made no sense at all. So I put my head together with the other nurses on 2nd shift and we set it up how we wanted it to be set up.
Last night it was put into use for the first time as a 'test run'. It seems to be working really REALLY well. It was even shown to our supervisor and she was impressed enough with it that she's going to be sending it over to the other side of the prison (once we've run it a few times and made sure there are no mistakes) for them to use too.
Evidently while everybody was complaining about the form, I was the first person to suggest we make a new one. I don't know if that makes me smart or everybody else just dense... but the thoughts from my coworkers and supervisor seem to be the former.
I also had a busy day yesterday. I had 11 scheduled call outs and got all of them done in addition to an emergency. It's not all that special, but it's the first time they scheduled me that many call outs. And if they'd been scheduled better I would have been able to get more done. The scheduling of call outs IS difficult. You see, there are several points in the day that I can't see any inmates. The first half hour is out as it's shift change and the inmate's aren't allowed to move around. The same goes for the final half hour. There is an hour in the middle of the day where all inmates are being counted. There's the med line. Inmates can move around during med line obviously, but we have to have a CO in the clinic for an inmate to be there and during med line our assigned CO is outside directing the med line itself. There's also lunches to consider... I get a half hour and our CO get's a half hour. We can take our lunches at the same time, but more often than not I'm taking that 'quiet' time while he's not there to catch up on documenting.
So 11 callouts (and an emergency) may not sound like a lot, but considering that I can see inmates for only about half of my shift, it IS a lot. To compare, I was working along side a far more experienced nurse yesterday and he had 8 callouts, three transfers, and two emergencies. In other words he had one more appointment than I did. He also finished about 20 minutes after I did... the time it takes to do one assignment.
I certainly don't consider myself fast, but I can no longer consider myself slow either.
That's about all that's going on with work. Oh... one last thing. I've enjoyed most jobs I've had. But there is always that hill of momentem to get over when starting a day at work. Most morings when I worked else where I'd be thinking 'Damn it, I don't want to go to work today!'. But that doesn't happen now. It's 9:30am as I'm writing this and I have to get ready for work in a couple hours... and I'm looking foward to it. It's not a special day... it's not an easy day or a challenging one... there's nothing out of the ordinary for today's shift, but I'm still looking forward to getting there. Hell, I think I'm just about as excited to get going to work today as I am about watching Michigan take on Kansas State in their bowl game tonight (thank you scheduling gods for having them play so late in the day!).
Above and beyond having this nursing job change my life, it is also a GOOD job and I'm really enjoying myself on a day to day basis. Being able to say that about a job has been rare for me.
Why is it that virtually ever blog I read of late has me feeling like Morpheus in the Natrix when he turns to Neo and says "I know *exactly* what you mean"? Anyway, yes, the joy of work, I am right there with you. I get the idea that one can be enthusiastic about going into work. I haven't known that for a while but it's come back and so, yes, absolutely, enjoy it. It could last forever, it could not.
ReplyDeleteAlso, on the shift thing, there are parallels all over the place. Bottom line is: when making changes, you need to ensure that the change won't fail or, if it might, that you have the necessary backing to maintain it 'til it doesn't. Sounds like your place has failed to properly back a change or made the current system a bit broken. Hard to tell. Hope it sorts soon, but, like you say, no dog in the fight means that you can take a more analytical approach.
Back when I was single, I loved doing the 10 hour overnight shift at the mental health facility. I mean, 3 days a week and one 6 hour day shift gave me "full time" which included insurance (at a job I was making 8 bucks an hour!) I was on by myself, ate the leftover food I was supposed to throw out (rules said if it was 24 hours old or more, its garbage!) and usually washed my laundry there after I was done with the residents clothing. More often than not, I'd have a GF call me around midnight and we'd chat for a few hours or I'd bring in some movies to watch.
ReplyDeleteEven better was getting those Christmas Eve/Day or New Years Day shifts. Double time was awesome for literally doing half the job you usually did. People would FIGHT over who got to work them!