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Toni Talks about PT Today

Holiday Staffing

Published December 6, 2011 4:29 PM by Toni Patt

Christmas time is quickly approaching. With it come the numerous requests for time off during the holidays. More requests will be received than can be granted. My facility takes the approach of letting off as many people as possible. I guess it works. I haven't heard any complaining. Holiday and holiday eves are staffed by volunteers. There are always a few people who want to save paid-time-off for something else.

In order to make this happen, staffing levels are cut. Patients are seen on a priority schedule. As many patients as possible are seen the last day of full staffing. Priority is then given to evaluations, potential discharges and those who complain the loudest. There is an unspoken understanding that not everyone will be seen and those working should do the best they can.

That approach seems to keep the workers happy. I have to wonder about the patients who aren't getting treatment. I know from experience there will be a lot of them. I also know patients who would have benefited from continuous therapy will be seen once, maybe twice over the Christmas holiday weekend. It's great to have a happy staff but what about those patients?

Why is it that as soon as a holiday pops up, concern switches from seeing patients to letting off as many people as possible? Any other time we're struggling to see as many patients as possible. Contract staff is brought in. Individual caseloads increase. Normally we try to see everyone at least every other day if not daily. Over a holiday period, patients are lucky to be seen more than once.

Obviously the holidays aren't a great time to need medical care. Yes, doctors take vacations and cut back on surgeries. So do patients and their families. When I worked outpatient, the day before a holiday was either completely slow or completely crazy. Sure, census will drop but the hospital won't be empty. Even then we'd probably be OK if it weren't for all the admissions. Strokes, heart attacks and motor-vehicle accidents happen no matter time of year it is.

There is no good answer to this. When I've brought it up in the past I've been told it's only for a few days, which is true. For a few days we'll be doing the best we can. I understand it. It's just one of those things I wonder about.



Valid points.  Around the holidays we typically see a drop in census, but we still have days when we are short-staffed.  It's hard to be there and not offer my patients more time, knowing I have many other patients to see before the end of the day- it just doesn't feel right.  

It's also hard being at work, away from my family on those days too.  I've spent more than one evening at work wondering what jokes are being told and what stories I am missing my grandparents tell.  

Lots of things to consider, especially in a hospital setting.  

Lisa Mueller December 6, 2011 10:46 PM

My guess is your facility isn't bringing in per-diems for the holidays because that would be way more expensive than a non-holiday day.

Way back when I worked in an acute care hospital and worked a major holiday, many patients had visitors and were profoundly annoyed that they were expected to partake in rehab on that day. Could they have benefitted from rehab? Of course. Do they have a right to make that choice in during the holiday season? I used to think not, now I'm not so sure. They are still after all adult individuals who should be able to exercise their autonomy to whatever degree possible. But at whose expense? Interesting ethical questions.

Dean Metz December 6, 2011 6:05 PM

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