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Support for 10-Hour Shifts in the Clinic Setting

  • 1.  Support for 10-Hour Shifts in the Clinic Setting

    Posted 17 days ago
    Hi!

    We are currently seeking ways to incorporate flexible scheduling in our clinic (hospital-based) for the nurses.

    Our normal business hours are M-F 8a - 4:30p, however some physicians do like to start a bit early (7a or 7:30a) and we often have patients who stay well past 4:30p due to clinic delays or other reasons (acutely ill or receiving bad news, etc).

    We have the largest clinic at our facility. We have over 80 physicians and employ about 33 RNs and 10 MAs. We see anywhere between 200-400 patients daily with the majority being follow ups and 40-60 being consults or new patients.

    2 of our MAs do 10 hour shifts and the remainder do 8s.

    A handful of RNs do what is called a 9/80 work schedule where they work 9 hours 8/10 days, 8 hours 1/10 days and 1 day off every 2 weeks (within the same pay period). About 8 RNs that do 9/80. 1 RN is part-time. The remainder of the nurses work 8 hour shifts with the vast majority of us working 8a - 4:30pm. A handful come in at 7:30a - 4p (less than 5).

    Because of this, we have mandatory late days. We are all assigned a day where we stay until the last patient leaves. There are about 5 closing staff each day of the week and as the census goes down, closing staff leave. 2 RNs must stay until the final patient has left.

    The latest we have stayed in recent months is 6:30p. Rarely we will go past that time.

    There is always something to do in our clinic beyond direct (physical) patient care. We have FMLA, disability forms to fill out. We have EPIC therefore we receive hundreds of messages from patients daily that could be answered in a more timely manner when we have dedicated time for it. There are quality improvement projects that can be worked on during hours before or after clinic opens/closes and it would give more physicians the ability to start their clinics earlier.

    I was thinking of staggering 10-hour shifts for nurses interested in doing so w/ 30 min lunch included):

    7a-5:30p
    7:30a - 6p
    8a - 6:30p

    I think this would increase employee satisfaction by allowing the flexible shift (day off each week) and also allow for the elimination of a closing team, thus giving RNs a more steady and predictable schedule.

    I would appreciate any feedback and constructive criticism.



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    April Thomas RN BSN OCN
    RN
    University of Texas - MD Anderson Cancer Center
    Houston TX
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  • 2.  RE: Support for 10-Hour Shifts in the Clinic Setting

    Posted 16 days ago
    We had to go to 10 hr shifts to accommodate patient load and ultimately went to 12 hr shifts for the same reason. The staff actually love it, they work 3 days a week, the schedulers do 10 hr shifts, we open at 700am and the staff gets there for 630 a to prepare.

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    Chryl Corizzo RN BSN
    Clinical Quality
    St Tammany Parish Hosp
    Mandeville LA
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  • 3.  RE: Support for 10-Hour Shifts in the Clinic Setting

    Posted 16 days ago
    Thank you! That sounds great. How large is your clinic and how many RNs do you have?

    Some of the clinics at our institution do 10s but I am not sure about 12s.


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    April Thomas RN BSN OCN
    RN
    University of Texas - MD Anderson Cancer Center
    Houston TX
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  • 4.  RE: Support for 10-Hour Shifts in the Clinic Setting

    Posted 16 days ago
    We have 2 infusion suites, thr cancer center is 10 hours, the regular infusion which does all bloods, ivig, iron, non cancer stuff went to 12- feel free to call me on my cell 985.264.0964 and I can give you more details!

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    Chryl Corizzo RN BSN
    Clinical Quality
    St Tammany Parish Hosp
    Mandeville LA
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  • 5.  RE: Support for 10-Hour Shifts in the Clinic Setting

    Posted 15 days ago
    Hi April
    Our setup is a bit different (I'm in the Infusion department so we aren't doing follow-up visits or other coordination responsibilities) but we have a mixture of 10 and 8 hour shifts. There are several different start times which are based on our historic scheduled visits, and the start times vary depending on the day of the week as we're much busier on Wednesdays than Tuesdays.

    For perspective, we see about 200 patients per day and are open until 10pm weekdays, 6pm weekends and holidays. Making this change 2 years ago has had a positive effect in assuring we have the right number of RNs to match the scheduled visits. (e.g., we see more patients at 11am than at 7 am or at 9:30 pm).

    We have a self-scheduling system so staff get to pick both their shift start times, days of the week and shift length (provided that it meets their FTE requirement). We currently have just under 80 RNs, although that includes part time and per diem.

    Seth

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    Seth Eisenberg RN ASN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
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