[Closed] Shift patterns for NHS nurses

Always a bit random. It depends to a great extent how good the person is at doing off duty and what commitments the other staff have but what you describe is not far off the norm

Shift patterns are often a blend of custom and practice and filling the gaps. Its likely that one poor sucker has to do the off duty for the dept, and she is basically filling holes with whoever she can. You can request stuff, but won't always get what you want.

I never requested anything other than birthdays over 30 years; you get used to it and it becomes the way you live.

Depends on the ward and who sets the rotas.

Mine is great:
Week 1 - Tuesday, Wednesday, Saturday and Sunday, 06:50 'till 19.05. 75 minutes break.

Week 2 - Monday, Thursday and Friday.

So, two or three days on with a two or three day break.

However, I've been in the situation your daughter is in and it's awful.
The whole tone of the place will be set by the Modern Matron and the Ward Manager.
If you get good ones, it's all gravy. If not, it's terrible.

Mrs F is an ANP, what you've described is the norm for most trusts/wards.

When my wife was a Hospital based nurse I seem to recall it was 12.5 hour shifts, 3 days a week.

When she first started they had a really well established Band 7 and it was sort-of simple,1 week in 4 was nights. 1 week in 4 was weekends. 1 Week in 4 was early shifts and 1 week in 4 was late shift, maybe not as clean and simple as that, but that's how it seemed to work.

When that Band 7 left and one of the Band 6s got promoted all hell broke loose, she started to take requests from staff "Oh so and so can't do nights because X" "so and so can't do earlies because of Y" etc and it became chaotic, the shift patterns came out later and later and messy. Soon she started to have to remind her Boss that they were supposed to have a clear day between nights and days etc.

I would imagine A&E is one of the hardest to staff, so she might have to accept that sort of thing as long as she's there - that said, do her colleagues 'enjoy' the same thing? IF she has become the Wildcard to plug gaps and she doesn't like that, she'll have to say something, other wise, knowing Nurses, she'll be stuck in that role forever so others who have a 'better relationship' with the Band 7 will get the better shifts.

What you describe is quite normal, and in some/quite a lot of places they deliberately mix people up all the time to avoid regular teams.

Thanks all!
It just seems super chaotic. Our system isnt perfect, but i know my duties 12 months in advance and can easily predict them from a stable pattern.
I also clear break of worktime for rast days.
She hasnt complained to me or anyone else, but the system does seem fuelled by who has the favour of the most senior nurse. I didnt realise this chaos was so wide spread.
Regards
Ian

She can also learn to game the system, get friendly with the person doing the off duty, suggest that she could help lighten the load by doing more set shifts; the whole thing is a matter of filling boxes so if a number of boxes can be filled without thinking...

Or move to theatre and work a more predictable pattern.

One of the things that drove me out of nursing* was having to make up off-duty....

As said above- requests from staff for certain days off, long-term sickness, and a host of other things make it the #1 hated job by those who had to sit with the request book and make it work, so often the more 'flexible' staff members (younger, no family, likes O/T) got the bittier stuff handed to them. Unfair, but when you're presented with someone who you know has personal problems (eg, relationship breakdown**) that mean they'll struggle with certain things then it was a case of just making it work.

That said, when those flexible staff members ever made requests, I made sure they got them.

*Wasn't actually that.
**Or a member of staff who you know would call in sick if rostered for something they couldn't do.

Its in the childrens hospital as she loves the interaction with little kids. So i dont think a move would be on her list at the mo....
As i said, she hasnt complained, but as a shift worker. it seemed chaos for both the staff and the system.
I appreciate your input guys.

Yep normal for mrs b. She can request days off/ shifts which helps to maximise days off or grouping shifts together

You’ve just described nursing they seem stuck on the old ways for rotas. I can tell you what I’m pretty much for the next few years unless they change our pattern.

Not unusual, the only thing I'd have the hump with there is single days off- I get 2 days off in seven and I expect them to be together. Occasionally it cant happen and I accept that but if it was regular I'd say something.
Most issues generally come from one or two entitled buggers who expect to be able to set there own rota through the request book and everyone else gets to pick up the slack but, no matter what, if you do the rota you are on a hiding to nothing- I had one nurse complain that she had to work xmas and new year, when I pointed out she had requested other days off which gave me no other option she complained that I should have 'known not to give her those requests'

so often the more ‘flexible’ staff members (younger, no family, likes O/T) got the bittier stuff handed to them.

This is the answer innit?

If it’s genuinely upsetting for her then she can make a deal but as above, if her colleagues have school pickups, spouses with rotas etc it makes sense for them to be afforded more flexibility.

The Mrs is an ACP. She does the rota for the ACP cohort in A&E.

The only pattern is that there is no real pattern.

is it not computerised in that hospital? all ours are now and that limits requesting but is tricky for the CNs to do.

Fixed patterns are inefficient if you have variable demand. It sounds like they are scheduling to a predicted requirement.

If they are running a “flexible” pattern then best practice would be to offer preferences.

Sadly these systems reward people who participate in the process. I used to work in a place which would allow you to choose whether you wanted longer shifts (gave you a longer run of days off) and a preference of start times.

This works well if the employee is engaged, in fact there were several who could manipulate their shifts very well. Complaints normally came from the poorly briefed or interminably obstinate.

Ex resource scheduler.

It sounds like they are scheduling to a predicted requirement.

Good luck predicting demand in emergency healthcare.

Good luck predicting demand in emergency healthcare.

Err, yes you can and yes I did, not healthcare but other “emergency” demand profiles.

There are trends and patterns everywhere in life. You probably do it yourself. For example in my previous world people would know,Friday night is going to be busy. You know that New Year’s Eve will be busy, but New Year’s Day will be dead.

Summer weekends are busier than cold winter ones. You may not be able to forecast the exact numbers, but with enough data you can forecast within a known range.

When you understand the trends you then realise that having a fixed pattern is inefficient. Staff up to deal with summer weekends and you will have people twiddling their thumbs in the winter. staff to the minimum and everyone burns out.

I don’t expect you to believe me, by the way, no one ever does.

No, I believe you didn’t work in emergency healthcare you demonstrated that well.

Yes there’s a few dates you know may be busier but that’s it. Today a Monday in September has been one of the busiest days in months for example. It’s unpredictable by its very nature.

🙂

Partner is a nurse. From what I’ve seen it depends on the hospital. She used to have somewhat random shifts at her previous job, now in a different hospital they come in chunks of day shifts and chunks of night shifts.

The joke comes when they are x nurses down and she is asked to perform a duty above her pay grade, or those pesky hand overs that always seem to happen late.

First up I'm not NHS. But I've worked shifts in manufacturing for over forty years.

The simplest and fairest system is set shift patterns. 3 on 3 off, 4 on 4 off, alternate days / nights. Or as I do now 2 days, 2 nights, 4 off. Everyone knows where they are for years to come. If you want certain days off you book holiday, someone else then picks up the overtime to cover. There's never been a shortage of people who want the overtime. Very, very rarely do you find a shift short on staff.

The fussy buggers that can't do every third Tuesday when the suns shining gets hoofed off down the road. It builds better teams, keeps work life balance, balanced. Everyone is happier. Except Brenda, but then no one likes Brenda anyway.

I have done off duty. I used a base rota and adapted it. However because of the demands of the service its not possible to have a set rota as you need a minimum number of staff of each grade each day and you need to watch your skill mix. |Its due to holidays, training, skills levels, sickness etc that a fixed rota will not work

some charge nurses are better than others at writing off duty

Because Saturdays and Sundays pay more, along with nights, some people really want to work these shifts. This influences how peoples working weeks are laid out. Add in childcare, add in partners working shifts, add in other commitments and things get complex.

Best option, especially since the pension scheme got played about with, is to do a smaller number of hours as an NHS nurse and a larger number of hours as an agency nurse.

As long as the government keep NHS wages low, people will seek to supplement their income with agency work. This reduces the long term commitment to the NHS and places the onus for pension liabilities onto the individual.
The good times, not that they ever really existed, have gone.

Pretty much how ours work Bigblackshed but we have extra staff each week to cover holidays, training and sickness. Training is suspended over busy periods such as Christmas and holidays limited to a certain amount per week.

Oh for a delete button.

I do know of units including A&E where staffing varied depending on the day and time.

I've just gone back to the NHS after 3 years of agency working. Not sure why.

Like the stability but the fact that I'm working 30% more shifts for less money combined with a crap off duty makes me question decision, next week for me:

M Long day
T Long day
W Day off
T Night
F Day off
S Long day
S Day off

Grim.

Doing my own off duty I'd work 2 or 3 in a row and have a rest in-between.

I've previously done ward rota and there are a number of rules that mean people come out with crap:

A certain percentage has to be on holiday every week.
Sickness.
Budget.
Skill set.
People with fixed rotas.
People with flexible working hours.
Training.
People moaning.
People who can't get along.

You can auto roster with e rostering but it often comes out worse.

I always found the biggest problem was those who had children back in the days when staff were plentiful. They got fixed rotas and it became custom;

Old Janice has been working every Mon, Tues and Weds night for the last 15 years because she has a 17 year old son who is now driving and doing A levels.

Young Savannah, just qualified with no dependents gets the crap like my off duty above.

You try and wrestle Janice's fixed rota off her....

We had 4 members of staff, long in the tooth with kids who were 16+, all on fixed rotas, historic. No flexibility in them, very militant about it. Took 6 months and unions and HR etc to get them off. One retired as she found it too stressful having to work like the rest of us.
As deputy beard manager it was fair to say at that point my off duty was the worst of the lot. My manager would leave at 1pm Fri and be back 1pm Monday. Guess who worked every Fri late and mon morn....

That off duty is against policy and good practice with the days and nights mixed. Do not accept it. It's also too many hours

It takes folk to complain about crap offduty for something to be done. Remember contract law and wtd trump local policy. Over the years I have won numerous cases on this

I’ve just gone back to the NHS after 3 years of agency working. Not sure why.

Were you still getting offered shifts?

The only client we've lost this years thanks to Covid / Shut down was a nursing agency. Both we and they assumed it would be a big year for them, but it went the opposite way, with 99% of electives being cancelled / leave being cancelled and 75%+ reduction in A&E admissions there were almost no agency work about at all.

Those shifts look terrible, Long days, nights and a weekend all in one week, is that usual, or a 'perfect storm' example?

Its is terrible shifts and not usual - and complaining would get them changed. Against policy, breach of contract ( too many hours) possible WTD implications

No agency ( or almost none) in Scots NHS - and hasn't been for 10+ years. We have an NHS bank of staff

Mine can be great but also crap, you can tell who has done them.
I only work nights thankfully because I really didn’t like doing 10 shifts in a row.
My Rota for the next few days goes like this.
From this week Thursday Friday Saturday Sunday in
Next week Monday and Tuesday off Wednesday Thursday Friday Saturday in and Sunday off.
Then the next two weeks Monday till Friday morning in and off Friday Saturday and Sunday.

Use the request system, should have access to online rota system, use it to request days off.

Were you still getting offered shifts?

The only client we’ve lost this years thanks to Covid / Shut down was a nursing agency. Both we and they assumed it would be a big year for them, but it went the opposite way, with 99% of electives being cancelled / leave being cancelled and 75%+ reduction in A&E admissions there were almost no agency work about at all.

Those shifts look terrible, Long days, nights and a weekend all in one week, is that usual, or a ‘perfect storm’ example?

Yes was still getting shifts though the competition was hotting up as we had an influx of staff from down south coming up for the work.

The trust I was doing agency in was the one I used to work in as NHS staff. We all left. Last count they had 130 odd nursing vacancies across two hospitals.

It's nice to know I can fall off my bike and get sick pay etc etc.

The off duty is next week's.
Im used to it. I've worked wards for 13 years. I've never known different, as said, when I was doing managerial mine was worse as I thought of others first. Silly me.

Don't mind 4 shifts in a week. The week after I've only two. Is what it is. I'm also lucky enough that where I currently work nights consist of completing YouTube.

I do hate a night followed by a long day though. That is crap. Long day in to nights is fine by me though.

But yeah, a lot of one in, one off, one in, one off.

I've learnt to use the requests to make sure I get a weekend off every month.

One day, one day I'll escape ward work but for now its easy when I've got a young family to concentrate on.

Olly - there is no need for crap shifts like that. complain and it WILL stop 4 one week and 2 the next especially is easy to stop as is a lack of clear weekends.

people who put up with crap shifts perpetuate the crapness.

.