Shift call outs for legit reasons...

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A coworker of mine has spent the last week with his dad in the hospital who has been taken off life support and will soon pass. It has been a slow decline over a week. I have scrambled to help him get his shifts covered (three so far) so he can just be with his dad. Now we have to worry about next week’s shifts as well.

But it got me thinking. In any other field it’s acceptable in a situation like this to take a week or two off to be with the dying family member and deal with the aftermath. But in our line of work taking off even a day can be a huge ordeal, scrambling to find coverage. Much less multiple days. And when people “can’t” or are unwilling to help what can you do?

The ideal (as sick as this sounds) way for a family member to go is during a stretch of days off and then you just have to work on coverage for the day off for the funeral. But how does it work when a family member is dying slowly over the course of a week? Worse, a child? Spouse? Is your supervisor really still supposed to tell you “you’re responsible for finding your own coverage” beyond X Y Z dates? I am the scheduler and it has been a nightmare trying to get coworkers to step up and help. So one day we had to be down a provider. It makes it seem impossible this person could take any more days off and he’s only had a week off. It’s sad that this person has had to think about work during a time like this (luckily I was able to take the reins and get his three shifts covered but still). How do you guys deal with it in your neck of the woods?

I have elderly grandparents I am incredibly close to, they are pretty much like parents. And it’s sad to know that when he finally passed, my entire family will be at their side and I might not be able to be with them in their last moments because some might say that “grandparents dying is not the same as a spouse / child / parent / whatever.” It’s weird to think that if I face a death or any other tragedy I will be on my phone texting my boss about work coverage every day.
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For the most part it isn’t difficult to fill shifts if you have a few prns also some docs don’t mind the extra money.

But I’ll never do call unless the place provided benefits or paid vacation
 
It's like police, EMS, military, or the guy covering the nuclear plant. Somebody has to be there. Either we figure out a way to ensure that with pay, or people get hosed.
 
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ERCAT said:
A coworker of mine has spent the last week with his dad in the hospital who has been taken off life support and will soon pass. It has been a slow decline over a week. I have scrambled to help him get his shifts covered (three so far) so he can just be with his dad. Now we have to worry about next week’s shifts as well.

But it got me thinking. In any other field it’s acceptable in a situation like this to take a week or two off to be with the dying family member and deal with the aftermath. But in our line of work taking off even a day can be a huge ordeal, scrambling to find coverage. Much less multiple days. And when people “can’t” or are unwilling to help what can you do?

The ideal (as sick as this sounds) way for a family member to go is during a stretch of days off and then you just have to work on coverage for the day off for the funeral. But how does it work when a family member is dying slowly over the course of a week? Worse, a child? Spouse? Is your supervisor really still supposed to tell you “you’re responsible for finding your own coverage” beyond X Y Z dates? I am the scheduler and it has been a nightmare trying to get coworkers to step up and help. So one day we had to be down a provider. It makes it seem impossible this person could take any more days off and he’s only had a week off. It’s sad that this person has had to think about work during a time like this (luckily I was able to take the reins and get his three shifts covered but still). How do you guys deal with it in your neck of the woods?

I have elderly grandparents I am incredibly close to, they are pretty much like parents. And it’s sad to know that when he finally passed, my entire family will be at their side and I might not be able to be with them in their last moments because some might say that “grandparents dying is not the same as a spouse / child / parent / whatever.” It’s weird to think that if I face a death or any other tragedy I will be on my phone texting my boss about work coverage every day.
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If I had a close family member dying and my boss told me I couldn't be with them because finding coverage would be a pain, I would resign on the spot.
 
Admin gets a stipend to be admin. They can figure this out. Zero chance of me finding my own coverage ever.

Offer incentive pay and you will fill the shift real quick.
 
When I worked in EM, it was like that for me, too, @ERCAT .

In one alternate EM universe, the ED is full of emergencies only, the emergency doctors must be there at all times, there is a shortage of emergency providers, so that if a department is down one doctor, those patients with emergencies promptly get sicker and die. You're always at a critical state, crisis point, and being down-staffed is always unacceptable. There is no one to fill in, no MD, PA or NP and all the patients must be seen immediately or they'll lose life or limb. There is no way to cover for you or work down a provider. You must be there or unacceptable crisis and loss of life ensues. Period. In this alternate universe, your irreplaceable nature is proven by the fact that neither you nor your group can ever be fired or replaced due to metrics, contract squabbles or other non-patient care matters. In this EM alternate universe, EDs are mostly full of emergencies and an increase in door to doctor times for non-urgent patients was a extinction level event.

In another alternate EM universe, we exist in a first (not third world) country. We have resources. We have plans for these common, every day occurrences and unavoidable life events in other industries. In this other alternate universe, or ED's not only have emergencies and the sick and dying, but are chock full of mostly non-urgent and non-emergent patients. We are staffed eonugh to have the luxury to pretend as if non-sick, non-urgent patients are critical patients and that they must be seen in < 15 minutes or the world will end. In this alternate universe, being down-staffed for a physician family emergency could easily be absorbed while still taking care of all the emergent and non-urgent patients.

Just like we have a plan to cover for other important people, like VPs to cover for President's, copilots to cover for pilots, CFO's to cover for CEOs, and Lieutenant Generals to cover for Generals when they're sick, we could certainly do the same for emergency physicians if we wanted to. In this alternate universe, there could be an easy, compassionate way to allow an EM physician to get to a family member's death bed, funeral, or birth of his child without telling him or her, "Suck it up. Find your coverage. Suit Man Unhappy. Metrics Bad!" if we didn't buy into the mass delusion that, EDs are mostly full of emergencies, we're irreplaceable (only when administration wants us to be) and an increase in door to doctor times for non-urgent patients is a extinction level event because it blunts the rise of Corporate's quarterly bonus.

I guarantee none of your hospital administrators, from the CEO on down, are missing a family member's death-bed visit, funeral or birth, no matter how important and irreplaceable they might think they are to the hospital or it's ability to function efficiently.
 
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We get paid for backup/on call days and get 1.5x pay if we come in. Odds of getting called in are quite low and it solves this problem. We also use a group text/chat for any additional last minute coverage needs. In a case like above, we'd probably open up all the shifts through the scheduling software, then a group text, and if anything still needed coverage, the backup/on call would cover them.
 
Tenk said:
We offer double pay when people call off for the person coming in. Never have a problem covering shifts. Money talks.
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It's great your group has a system that makes it easy to cover shifts when people call out. Where does the extra money to pay double for those shifts, come from?
 
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From ours if a bonus has to be given it comes out of that doctors check
 
Dr.McNinja said:
Seems fair. "Not only did you miss a day's pay, you get penalized for having a family member die".
And people wonder why we commit suicide so often.
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Well that's if you have to have a bonus to get someone to staff the place. Often that doesn't happen and The only other alternative is call which is worse. A pay deduction for a bonus wouldn't be a big deal for me since I have another place where I work for extra shifts and I don't live paycheck to paycheck. Yeah it sucks but it could be worse.
 
I am trying to remember what happened when my little brother died. I remember the 2am phone call and the confusion of what had happened. I remember going in for my 9am shift, but telling them I was on auto-pilot. I was still pretty shell shocked, and there was nothing I could do but sit at home and cry, so I'd rather just see patients. (As long as it was relatively straightforward and no young dying people please.) And the nurses were great and supportive.

But I flew out the next day. I know I had some shifts scheduled, but the group stepped up and basically told me to get on the plane and they'd sort it out later.
The week was a blur. I don't remember how many shifts they covered, but they did. It was all very surreal.

This was before my group got eaten by TeamHealth. I think, knowing the docs that came after, they would have done the same even afterwards. There are decent people, and I'm sorry that ERCAT's group didn't step up, but then again, there are all sorts of circumstances where you're already short staffed and for whatever reason, it's hard.

It sucks regardless.
And I guess I really don't have anything to add as I have no solution, but it still sucks.
 
Dr.McNinja said:
Guess we will agree to disagree.
If we stopped treating us like widgets and more like people, maybe jobs would suck less.
Sure, you've got someone abusing it? Fire them.
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But it's hard to say if someone is "abusing" family emergencies. I had to do a shift for an "emergency" which was going to their kids baseball game that they forgot to schedule.
 
If its a CMG, Im calling in and letting the director, assistant director, regional director, directors at other hospitals, scheduler figure it out. They have big pockets and can load up on bonuses

Its alittle more tricky with a SDG especially if they are understaffed. If most docs are doing 2+ over their desired, they will likely not want to or can not pick up shifts.

We had a pretty large SDG and covering for true emergencies always worked out. Someone died, birth, someone really sick would get everyone to drop their plans to cover if they were in town. We even understood forgetting to put down that you are out of town on vacation and happened to be scheduled. But noone dared put a crappy reason down like their kids Birthday, aniversary, etc.... These "semi" important dates had to be taken care of by the doctor.

Call Never works unless you are paying a hefty stipend. Most docs are scheduled to work 15 dys a month. In a 10 doc hospital group that adds another 3 scheduled days which makes scheduling and everyone's lives miserable.

I would rather run short and extend everyone's hours by 2-3 hours on the rare occasion that no one can cover.
 
Tenk said:
I work for a health care system, so from that.
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Yes. From the pool of money that health care system would otherwise have to pay you. But I get it, in that it doesn't feel like it's coming out of your paycheck to finance this kind of thing when you're a part of a big system. Make no mistake about it though, those running the finances of that system aren't funding perks for the EM physicians out of the pool of money that would otherwise be available to pay themselves. It's likely they take it out of whatever money they budget for the ED, which is going to largely be funded by physician collections for the work you do.
 
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Birdstrike said:
Yes. From the pool of money that health care system would otherwise have to pay you. But I get it, in that it doesn't feel like it's coming out of your paycheck to finance this kind of thing when you're a part of a big system. Make no mistake about it though, those running the finances of that system aren't funding perks for the EM physicians out of the pool of money that would otherwise be available to pay themselves. It's likely they take it out of whatever money they budget for the ED, which is going to largely be funded by physician collections for the work you do.
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SDG ftw. Comes out of partner bonuses. Not from any one person. From my experience, pretty much every shift that someone wants to get out of (not sick calls, just normal stuff) gets covered.
 
Employed. They want to employ us, their FMLA problem when I have an emergency. Director tried to give me crap about it once. Director had to apologize. Now taking time (six weeks) off for surgery. Director behaving.

No one is irreplaceable. My job doesn't want to use locums- their problem, not mine.
 
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