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The census is low; someone needs to take the day off. Across the country, as hospitals struggle to maximize efficiency and meet increasingly tight budgets, full-time nurses and other healthcare professionals are frequently being asked to take an unplanned vacation day or a shift off without pay. The practice is demoralizing and is gradually increasing turnover and contributing to the growing shortage in nursing and allied health fields. And it has to stop. No other occupations or professions would tolerate this, for any reason. What would happen to the teaching profession if teachers were asked to take a sudden vacation day when a larger-than-normal number of children were home sick? Police officers aren't told to go home when the crime rate is down. Reporters aren't sent home on a slow news day. And neither are most administrators. It's just not the way you treat full-time employees. No manager likes telling employees to burn a vacation day or lose eight hours of pay. It's justified as a necessity to make ends meet in tough times. But in the long term, it's not only not right but also a bad strategy; the real and ultimate cost of such practices is hard to measure and thus often not factored into the total equation. Asking full-time staff, month after month, to take a day off without pay works against the organization. Staff opt for other jobs or even take a second position so they can better meet their own financial obligations. Some even change careers. People get tired of consistently working with just barely enough staff, and morale takes a dive. And the vital sense of trust between the employer and the employee is ultimately jeopardized. Low morale has real costs, measured in the price of turnover, increased errors, and reduced patient satisfaction. The trouble with most of these cost indicators-because they're hard to measure-is that they appear late. When managers tell employees to take a day off without pay, it is because they are worried that their budget reports, which show the direct costs of salary per patient day or unit of service, will show inefficient staffing and so-called unnecessary expenditures. In many healthcare organizations, this data is compared among hospitals and similar units, and managers are on the hot seat to show they can achieve efficiencies on par with their competing colleagues. these costs are easy to monitor and reports appear monthly or even weekly, so in the short term such policies can look like a good financial move. But the real cost of such efficiency is harder to capture. Morale costs are insidious, yet the long-term impact on the bottom line can be significant. Health care is hard work even in the best of times. We can't make the work much easier. But we can-and must-ensure full-time employees full-time work. It's only fair. Barbara
Bronson Gray, MN, RN |