Call Incentive

Q: I have been asked to check what other institutions are doing as added incentive for taking and/or coming in on call. This would be above and beyond call pay and pay (1 _) for working. What are you doing?

A: We pay $2/hour for a call rate for nurses and techs if they do not get called in. If they get called in, we pay their regular rate.

A: We had a severe shortage within our department with staff burnout from too much call. We are a small Community Hospital but have a very busy OR. We are also non-union. We have temporarily offered the staff $55 per case in addition to their time and a half. Lot more people volunteer esp. since it is the Xmas season. This however is only temp until staffing is back up.

A: At our facility, everyone receives the beeper pay and time and a half for coming in on call. When staff comes in when they are not on call they keep a log of when and why. After five times, they can choose between a cash payout or additional hours in their holiday bank to be used at a later date. In addition, they receive double time for hours worked between 11 p.m. and 6:30 a.m. Each weekend day that they come in, in addition to their time and a half, they get two hours placed in their holiday banks. On holidays, the beeper pay is increased and they get their time and a half as well as eight additional hours in their holiday banks for coming in on call.

A: My staff receive call pay at $2.25 per hour, OT when called in regardless of how many hours worked that day or that pay period and a minimum of two hours pay whenever they punch in (even if case were cancelled right after they got here they would still get paid two hours of OT). There are no other incentives.

A: We pay half the RN base rate per hour to be on call. When called in the staff is paid time and half with a guaranteed minimum of four hours regardless of how long, or short, the case(s) take.

A: Nothing, just $2.50 an hour while on call and time and a half when called in.

A: Half their base rate to be on call? 1 _ times per hour with four hour minimum? I want to work for you. Do people fight to get extra call?

Floaters

Q: How do you get your floater to float? Some employees are assigned to be floaters and never give breaks or lunches. How is this possible? These individuals have a knack for avoiding work. When four people are assigned to a room, they should be able to take care of their lunches and breaks. How do you tactfully disagree with a coworker who is a really good friend? These questions plague us daily. It is imperative that we communicate these frustrations with each other in a positive constructive way. Any good ideas of how?

A: This is a management issue. It needs to be addressed with the OR manager. Those staff should not be floaters and be put in a room when they come in.

A: I would suggest that you get the book “Hardwiring Excellence” by Quint Studer. His nine principles of service and operational excellence provide key strategies for managing and motivating staff.

A: Unfortunately, as they say, “what you permit, you promote.” This should be addressed with management.

A: First, how lucky for you to be able to put four people in a room. I wish we had the staff and the ability to do the same. Secondly, a floaters job is to do just that, float… give breaks and lunch and help where needed. Why keep a nurse or tech who refuses to do the job assigned to them? It is very counterproductive to the rest of the staff. However, if that is not possible, do not have these non-productive staff members act as the floater. Put them in a room and let them stay there all day. Have someone else do the float who will float as assigned.

A: How about a form showing accountability? If room 1 is listed with a blank, times of relief given and initials to sign off on as being performed.

A: Are you the manager making the assignment? If so, there shouldn’t be a question. Anyone who refuses an assignment doesn’t belong in surgery.

A: Floaters that do not give breaks and lunches properly should be assigned to do cases and assign the best or reliable nurse/tech to give breaks/lunches. Make assignments either on paper or the board of when breaks and lunches are to be given and make the RN/Tech come to the desk/board to cross off the names.
When it comes to working with a best or good friend…it becomes a slippery slope. You must be diplomatic and carefully explain why something must be done. Stick to professional practice, policy and procedure and AORN guidelines. I worked with a friend in the OR for 20 years as best friends… but we were very different types of managers and we no longer speak to one another. Good luck!