Looking back, it seems I've been ignoring updating this blog about work. It looks like my last real update was in June when I was thirteen nurses down. Well, I'm very happy to say that we're nearly fully staffed! And yet I still had some of my most stressful times this past few weeks. It IS related, but damn, why does it feel like I get rested up on Vacation only to come back and have the stress backed up and waiting to catch me right back up!
So let's start there. Vacation. When I got back I had Thursday and Friday (November 21st and 22nd) to catch up. BUT, the Wednesday before I returned my boss texted me and the other supervisors to see if we wanted to join her at the HUM meeting. Reminder, the HUM or Health Unit Manger, is my boss and their monthly meeting is between the HUMs of one DON or Director of Nursing... meaning it's a meeting between several HUMs that go over any health related changes. For this meeting the HUMs were encouraged to bring a nurse supervisor so that we could use it as a networking opportunity, which is exactly what I wanted to do. While there we found out that we had to screw over our acting nursing supervisor.
We have three nursing supervisors at our facility. The last I talked about them (us) was to mention that we had me and two acting nursing supervisors. That is, a floor nurse working as a supervisor, but not truly in that position. If we like them we can open the position, interview everybody, and hopefully hire the nurse that's been in the acting position. If we don't like them, we send them back to their floor position and then either bring up another nurse to the acting position or just open it up and hire someone else.
We filled one of the supervisor positions with the nurse that had been in the acting position. She had been in and out of the acting positions and even trained me to be a supervisor, so she was a natural choice. The other acting supervisor.... well, he had to be convinced to take the position but ended up liking it. The problem is that he seemed to like it because it was 'easy'. If the job seems easy then you're probably not doing it right and that's what was going on with him. He was slow at almost every task and had no sense of urgency. I mean, there's 80 hours per pay period with no option of overtime and I swear to the Goddess about 100 hours worth of work to get done in each pay period. He wasn't even getting half of it done. When the HUM told him he'd be stepping down his first and only voiced concern was having to start working every other weekend again.
That's your problem? The schedule? I knew she'd made the right decision then and there. The problem was his replacement. The HUM wasn't ready to hire anybody as the only person to interview for the position was from another facility and she didn't like her. I didn't think that the HUM had a good reason for disliking her, but that's her call and not mine. I'll stick with trying to keep up with the 100 hours worth of work.
Anywho, we didn't seem to have another natural candidate for the acting position, so I just assumed we'd have to open the position up and hire that other supervisor. Then the HUM told me we'd put another nurse up into the acting position. Let's call him C. Reminder, there's me, the other 'new' supervisor who actually has far more nursing experience and more nursing supervisor experience than me that we'll call K, and now C.
C is a young guy. He's been a nurse for under a year. He's smart and knowledgeable but not experienced. Not with nursing nor with corrections. I had my doubts as a big part of the job is understanding and implementing the corrections policies. But he quickly impressed me. He was a real hard worker and realized quickly that this job would be difficult. He got upset at himself when he couldn't keep up which is exactly the attitude I like to see. That's going to keep him focused and working to keep up, not blaming the system that's keeping him behind. He cleaned up the mess left by the previous acting supervisor and I figured after only a couple months that we'd found our new supervisor.
Then we found out that he couldn't be a supervisor. He didn't meet the basic requirements which are at least three years experience in nursing management or two years in the department as a nurse. He'd been a contract nurse for a few months and only a state employee for a few weeks (before stepping up to the acting position). Both the HUM and I agreed, however, that he would be great at the job so our compromise was to keep him in the acting position for a year then pray that we could make the case that he was worth overlooking the basic requirements. It had been done before and seemed like a good way forward.
Now that you know his situation, lets get back to screwing him over. So we're at the HUM meeting when the supervisor that had interviewed with our facility before (I'd say 'us' but I wasn't part of those interviews) comes over and says happily that she's looking forward to working with us. It seems that she and her HUM had talked not only to their DON but the health administrator ABOVE the DONs and the administrator agreed that she could transfer into our open position.
Fuck.
Our DON tried to argue against it, but that was HER boss making that decision. So our 'golden boy' acting supervisor was going to have to step down to the normal nursing position with almost no hope of returning to an acting or actual supervisor position. I don't plan on moving on for years and will only really transfer once I'm really good at my position (I figured 3 or 4 years) or ready to take a position as a HUM myself. K has no plans to transfer or move up to HUM and she's years and years from retirement. K is going to be the rock at our facility. And now our new supervisor, let's call her R, is younger than me and a local to the area. She, to our knowledge, will be there for a long long time.
C is screwed. And he's screwed just before Thanksgiving.
When I got back from vacation I had to catch up with a bunch of stuff. My email, the overtime equalization list (OEL) which C hadn't been updating, the daily schedules, and then 6 week schedule. I'd say that took all of Friday that week but I honestly didn't get done with it that day.
The next week was a short week due to the Thanksgiving holiday. I was only at the facility for three days as we get both Thanksgiving and the day after off. I kind of caught up but was just treading water... then the holiday. That's two days off for the holiday, a weekend, then I didn't return to the facility again as I had two days of training off site. The training is on our new software and is a MAJOR change to the way our workflow will work. It obviously doesn't change the actual nursing, but half of nursing is documenting what we did and this is the software we use to document.
When I got back, I was behind the 8 ball again. I had three days to catch up again and knew that I would have to be starting the next six week schedule as that was due to be published in a couple weeks. When I got back, the HUM was away on a week's vacation, our new supervisor started but didn't' get an introduction from our HUM (who was being pissy about her even being there), and C was kind of lost with what he'd be doing. You see, his normal schedule is as a 12 hour afternoon nurse. He works from 10 am to 10 pm and he picked having his schedule as 7 days in a row. As an acting supervisor though, he had to change over to what we needed, which was an 8 hour a day MORNING supervisor. He now worked 5:30 in the morning to 2 in the afternoon. And he's on that schedule for another month. BUT he's losing the 'acting supervisor' job immediately.
We can't just toss him back as it will take our new supervisor a few weeks to get up to speed. Yes, she knows how to be a supervisor but every facility is different and she has to get her feet wet. So C is orienting her. Yeah... he's teaching his replacement. So the plan is to put him back into the floor position on the next 6 week schedule. The day I got back, the day the new supervisor started, the day C lost his 'acting supervisor' title (and bump in pay!), I realized that he had the book.
The mother fucking book.
I've railed about this before, but it's worth a quick recap. We have to have a supervisor on-call at all times. On most days we have supervisors in the facility from 5:30 in the morning to 8 at night. But if someone calls in and there are no volunteers, it takes a supervisor to mandate someone to work the missing shift. And there's just the whole situation of having the supervisor available to answer questions like "Hey, the count is off, what do I do?" or "I think this guy needs to go to a hospital but the on-call doc disagrees, what do I do?". Being on call is part of the job and technically we're lucky as we have 4 supervisors (in this area, the HUM is also a supervisor and she takes her turn on call). The book is what we use to keep track of who is on shift each day, who is available to take emergency volunteer overtime when there's a call in, and who is up to be mandated if no one volunteers for the emergency overtime. This sucks as most call ins that require our attention are obviously overnight. We're not there, the floor nurse calls all the volunteers but no one is answering their phone at 3 am, and we're going to have to mandate the midnight nurse to stay over or worse... come in to cover a shift our self. Coming in to cover is rare, but it can happen.
Did I mention we go on call for 24 hours a day, for six weeks at a time, and we don't get paid anything extra to do it? It SUCKS!
Technically it's the HUMs turn for the book but she's on vacation. I couldn't stand the thought of the former acting supervisor being on call when he's not even being paid an acting supervisors pay... so I took the book. It's only for a week, it's the good and right thing to do, and what are the chances I'll get called at night in that week?
100 fucking percent chance. I grabbed the book this past Wednesday. That night THREE nurses called in and we were at critical staffing. I had to mandate BOTH midnight nurses and thankfully got a nurse to come in voluntarily for a couple hours... but that was THREE calls that night. I didn't get any good sleep so I was practically a zombie at work Thursday. Thursday night? Another call in, another night of mandating the midnight nurse. And it was worse than normal as she had gotten screwed over in some voluntary overtime she had picked up the evening before. Last night (Friday)? ANOTHER MOTHER FUCKING CALL IN! And yes, another chance to mandate our midnight nurse.
I'm actually expecting another call in tonight/tomorrow, and then another one that night for Monday morning. Monday morning I'm going to throw this damned book at the HUM.
Some of what really sucks about this mandating is that the OEL list is where we find out who is up next... and that had been out of date since I was out on vacation. C was supposed to update it and I was going to dig into him about it... but why bother as he isn't an acting supervisor anymore. The screw up with the voluntary overtime the previous night? That was C calling in our nurses to fill in for a clinic nurse that had called in. But it turns out that part had already been filled and we needed a replacement for the med room. Those are two vastly different jobs and when you sign up for one and get the other, it can really piss you off. And it DID piss off that midnight nurse. It pissed her off enough that she took herself off the voluntary overtime list. She can still sign up for all the overtime she wants (and she DOES want a lot of it!) but we now can't call her to pick up some hours when someone else calls in at the last minute. And she's the one that most often picked up those hours.
That means MORE mandating people as I've lost one of my most vigorous nurses in picking up last minute overtime. But what am I going to do? Yell at the former acting supervisor? Sure, he messed up, but he can't improve form that situation. I'll mention it to him as he might still have to do that in the next few weeks, but I certainly won't put any effort in getting him on board or figuring out why he made the error.
And looking forward.... I'm still screwed. There's the vacation book and the next six week schedule to go over.
The vacation book. We pass around a book where nurses can sign up to use their vacation time. They ask for it off and no matter what it does to our scheduling those days, they get the days off. That's fair. But I swear, the state has made this about as difficult as possible. First, only one nurse can have any day off in the vacation book. They did separate the RNs from the LPNs so one of each can have it off, but I have 25 RNs. Rules are rules though, so I prep the nurses and move forward. Second, we have to pass the book around three times and they can take differing amount of time with different rules each pass. First pass they can take off days in two different weeks. If they want one day off in this week and one day off in the next week, then that's their entire first pass and the same thing as if they wanted every day off in those two weeks. BUT, they make some weeks more special and call them Prime weeks. Prime weeks are the most desirable... think of like spring break or memorial day holiday. So you can get either ONE prime week and one non prime week or two non prime weeks. And then there's the fact that the week is Monday through Sunday and not Sunday through Saturday. It's great that they wanted to put the weekend together, but of course there's complaints that it should be the weekend BEFORE the week that the nurse wants and not the weekend AFTER. Grrr. The following two passes they can select any 5 days that aren't already taken, but not more than 5 days.
Now, this can work fine at facilities that have like 8 nurses. But again, we have 25 RNs. After the first pass, most of the days are already taken.
Now that's all hard enough but two more monkey wrenches pulled in to screw me over. First, that rule of only one nurse getting the day off? Yeah, that's more of a recommendation. More than one nurse can ask for a day off. The first one GETS the day off while the other nurses MAY get it. What rules define if they get it? Well, it's up to the DON. I can't make the call, the HUM can't make the call.... it HAS to come down to the DON. Because of this, I have days that three different nurses signed up for. So, I have to keep answering questions with "I don't know, it will be up to the DON".
The other monkey wrench? We have two months to get the book done. All three passes. Again, with like 8 nurses this isn't a problem. You try to wrangle 25 nurses to get their selections in. Oh, and they ate up 2 weeks of that time by changing the rules. It was supposed to be selecting for a full year and the passes had different rules, but in October they said to hold off on passing the book around and then changed the rules so I had to completely change the book before putting it out.
The vacation book was supposed to be done on November 30th. The RNs just yesterday (December 6th) got done with their first pass and the LPNs just got done with their second pass.
Oh, and the vacation book covers January 1st through July 6th. My next six week schedule? December 29th through February 8th. In other words the vacation books NEED to be done before I can put out the schedule. Grr.
Part of putting out the schedule is moving nurses around. We have two clinics, three med rooms, and the two Mental Health units. Nurses get comfortable in a particular position and like to stay there... so naturally I've been told to move them around. This was done because the nurses complained HOW I was moving them around before and the higher ups decided I needed to be more consistent with it. So where I was trying to be gentle and use a rock hammer, I now have to be gross with it and use a sledge hammer.
The way I work out a 6 week schedule is break it down. I put everybody in their place for a two week period. By everybody in their place, I mean that I put a nurse in one clinic then cover the remaining shifts. The next higher seniority nurse gets put in her place, then back fill the remaining spots. It's tedious, especially when I have to move nurses around as I can't just copy the standard layout. Once that's done and I've done a basic job of making sure all clinics and med rooms are filled, I copy that over to the remaining two 2-week periods, then add in the 'extras'. Extras include vacation days off, planned sick time, family leaves, training days, and of course holidays. Don't ask me about holidays... filling them is it's own nightmare scenario. The last thing to do is to take that big schedule and break it down into a schedule for each day. That lets me see where any holes end up where I can then put it out for overtime. That part takes hours as it's just tedious work, and I generally do this at home. I don't get paid for it, but it has to be done and I do it FAR faster at home where I can work on my big monitor and fast computer and listen to my music and can smoke and drink my tasty beverages (non alcoholic) and take breaks by watching youtube or a snips of TV or movies.
This past week I more or less made the two week schedule and was done checking it. I moved three nurses from their 'home' position and was more or less happy with how it laid out. BUT, remember me talking about that new documenting software? That goes live in the middle of our schedule. I absolutely don't want a nurse out of their comfort zone when we take half of their job and change it up. So all the work I've done so far is going to be thrown away and I'll have to make the entire two week schedule next week. No problem as I can probably squeak it out in one week. I know what you're probably thinking... yeah it sounds difficult but it shouldn't take 40 hours of work. And you're right... but the schedule is what I do when I'm not answering emails, clearing inmates for leaving, doing my supervisor counts, putting out daily schedules, and working on the dozens of other tasks I have to do each day. I'm lucky if I get an hour a day to work on it.
So getting it done in one week. Well.... not one week. I'm at the facility on Monday. Part of that day will be talking with the HUM. She'll have gotten back from her vacation and I'll have to catch her up, but she'll be distracted by her hundreds of emails and that talk will take hours. Tuesday and Wednesday I was voluntold (I was told to volunteer) to go to the facility that's first to transfer over to the new software. I probably won't get to work on the schedule at all on those days. Thursday I'm going to be with Mom at the hospital as she gets her heart cath. I might make a post about that later, but for now just know that she has diminished heart output and they're going to go in and take a look and probably put in some more stents. Then I'll finally be back to the facility on Friday.
I don't have a week. I have two days. And I have to get the vacation books done first and the RNs took over 6 weeks to get ONE pass done. AND I can't delay the schedule as it's in the union contract that it's put out at least two weeks in advance if it taking effect.
I'm screwed. There's just no way around it. I'm screwed.
Do I like my job? Yes. Do I hate my job? Yes.
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