Nursing dilemma

Re: Nursing dilemma

Mark Hedberg — Fri, 22 Apr 2011 21:08:48 GMT

[quote user="An On MRCVS"]

Maybe I wasn't clear in my reply; the unwritten part was that staff may have input but the decision rests elsewhere. I was then contrasting that with the presumption of the nurses here, that's all.

[/quote]

Oh, that's true enough. Communication's a two way street, after all... :)

Re: Nursing dilemma

An On MRCVS — Fri, 22 Apr 2011 20:24:11 GMT

Maybe I wasn't clear in my reply; the unwritten part was that staff may have input but the decision rests elsewhere. I was then contrasting that with the presumption of the nurses here, that's all.

Re: Nursing dilemma

Mark Hedberg — Fri, 22 Apr 2011 19:20:39 GMT

Er, it wasn't unwritten at all, but you're welcome, i guess.

Re: Nursing dilemma

An On MRCVS — Fri, 22 Apr 2011 12:37:54 GMT

[quote user="Mark Hedberg"]

[quote user="An On MRCVS"]Which brings me back to a question that no-one has answered: do you bosses out there allow your staff to dictate terms? If so, to what degree? [/quote]

Nope, staff don't dictate terms where I work. On the other hand, where I work, the head nurse, practice manager, and practice boss work together so the boss doesn't have to dictate terms.

[/quote]

Thanks - but you have answered the question indirectly with that. The unwritten part of your response is that your staff don't dictate but do have input and are therefore ultimately not the decision makers, which is all fine. The difference is that despite having an open policy of ideas and plans here, the nurses in the case under discussion have "decided" that a locum nurse was coming with no consideration of the costs. All the same, your situation sounds broadly similar to here where opinions are sought, but the decisions made by the practice owners. It was not always thus though, as I mentioned previously. In fact, I would challenge anyone to have a more open policy with the staff than we do here now but the give and take is that if the staff want the input, they need to accept partial responsibilty for outcomes.

Niall was closest in his assessment I think - unfortunately! It is difficult not to be either patronising and/or be perceived as overly financially-centred when discussing finances with the staff, and until they are at the sharp end it is an uphill struggle to make some understand, at least if trying to be subtle about it.

Re: Nursing dilemma

Mary Thomson — Fri, 22 Apr 2011 11:27:38 GMT

[quote user="Clive Ansell"]

No, I was not being serious really.

But, on a serious note. If a small business (veterinary or not) owner advertises a position it is conceivable that they may choose against employing women of child bearing age if there are alternative applicants, knowing the hassle that will be caused by one of a small team being off for 6-12 months on maternity leave.

[/quote]

I think that you are right, there may be an inclination to choose an alternative applicant if available. I certainly seemed to get fewer job offers after I turned 30. I am fortunate enough now to have an employer who knows me well, has taken the longer term view and appreciates my flexibility/willingness to work antisocial hours. I also worked all of my 'keeping in touch' days during both my maternity leaves to cover for holiday/weekend periods when the practice was stuck (working these days does not affect your entitlement to SMP- I think you can work 10 days of your maternity leave as keeping in touch days-see DWP website).

If you look at the bigger picture, women of childbearing age/with families are far more likely to be settled in an area so you, your clients and your other staff have better continuity long term and you don't have the expense of recruiting so regularly. Bit of a generalisation but I would also say that women with children in local schools/nurseries are likely to be active members of the local community and good at promoting the practice- this has certainly been my experience! As mums we have also had to rapidly improve our organisational skills, are good at prioritising and can deal with those clients who behave like toddlers.

Re: Nursing dilemma

Clive Ansell — Fri, 22 Apr 2011 11:05:46 GMT

[quote user="Mark Holmes"][quote user="Laurence Webb"]

[quote user="Clive Ansell"]Would it not just be easier not to employ women of child bearing age? [/quote]

of worms can a open

Rearrange

[/quote] But they are having children younger and younger and older and older. You can never be sure WHEN it's safe!

[/quote]

Stick with men or gays. Oh no don't tell me - they'll be having babies next.

Re: Nursing dilemma

Clive Ansell — Fri, 22 Apr 2011 11:03:32 GMT

No, I was not being serious really.

Re: Nursing dilemma

Mary Thomson — Fri, 22 Apr 2011 10:52:16 GMT

[quote user="Mark Holmes"][quote user="Laurence Webb"]

[quote user="Clive Ansell"]Would it not just be easier not to employ women of child bearing age? [/quote]

of worms can a open

Rearrange

[/quote] But they are having children younger and younger and older and older. You can never be sure WHEN it's safe!

[/quote]

Hmmmmmm. Being a female vet of childbearing age, I really hope you're not serious (-; I work far more evenings/weekends/Saturday mornings now than I used to because those are the times when my husband is at home and I have no childcare costs. Surely there must be VN mums out there with working partners who would take up the slack of some evening/night/weekend working so that they have some income without extra childcare costs. Presumably the wages which would normally pay your permanent nurse would pay someone part time/temporarily/at busy times with the option of a possible job share when the maternity leave nurse returns?

I would try to find a way of meeting the nursing staff half way- you don't want grumpy nurses on your hands, but equally you have to face the economic reality!

Re: Nursing dilemma

Mark Holmes — Fri, 22 Apr 2011 00:14:42 GMT

[quote user="Laurence Webb"]

[quote user="Clive Ansell"]Would it not just be easier not to employ women of child bearing age? [/quote]

of worms can a open

Rearrange

[/quote] But they are having children younger and younger and older and older. You can never be sure WHEN it's safe!

Re: Nursing dilemma

Mark Hedberg — Thu, 21 Apr 2011 23:25:54 GMT

[quote user="An On MRCVS"]

Which brings me back to a question that no-one has answered: do you bosses out there allow your staff to dictate terms? If so, to what degree?

[/quote]

Nope, staff don't dictate terms where I work. On the other hand, where I work, the head nurse, practice manager, and practice boss work together so the boss doesn't have to dictate terms.

Re: Nursing dilemma

Laurence Webb — Thu, 21 Apr 2011 23:19:52 GMT

[quote user="Clive Ansell"]Would it not just be easier not to employ women of child bearing age? [/quote]

of worms can a open

Rearrange

Re: Nursing dilemma

Clive Ansell — Thu, 21 Apr 2011 22:25:08 GMT

The SMP for the pregnant nurse is recovered from HMRC, which still leaves the salary she would have had in the pot. Logistics may be difficult, but It must therefore be possible to employ another nurse, a locum nurse doing fewer hours, a less qualified nurse, or overtime pay to remaining nurses with the given amount of money ??

Would it not just be easier not to employ women of child bearing age?

Re: Nursing dilemma

An On MRCVS — Thu, 21 Apr 2011 22:24:23 GMT

[quote user="Gillian Mostyn"]

Erm... from what I can tell you offered them a choice between a wage rise and a better rota. They chose a better rota. They are now ending up with neither, through no fault of their own. They accepted that locums are no longer feasible but would be assuming that extra hours may only be needed for holidays and sickness leave. They are therefore pretty cheesed off. I have to say I can see why.

I think you either need to give them their pay rise or get another member of staff to cover the maternity leave.

[/quote]

Err, no, they are not necessarily ending up with neither. They are not ending up with a locum is what I have said. I have also said that they could each take a share of the absent nurse's wages, or we could have someone unqualified (probably unqualified anyway) on a six months' contract. They are concerned that someone unqualified will not be up to scratch, which is fair enough. As for "no fault of their own", I didn't realise that it was in fact my fault one of them got pregnant (if you see what I mean!). The issue is the expectation without even any discussion, and despite the original "agreement" when an extra nurse was taken on, that we would fork out for a locum.

Which brings me back to a question that no-one has answered: do you bosses out there allow your staff to dictate terms? If so, to what degree?

Re: Nursing dilemma

Gillian Mostyn — Thu, 21 Apr 2011 21:41:29 GMT

I think you either need to give them their pay rise or get another member of staff to cover the maternity leave.

Re: Nursing dilemma

Helen Wallace — Thu, 21 Apr 2011 21:19:52 GMT

Would taking on a temp receptionist/cleaner/kennel maid help. Would be chaper than a locum and might make life easier. You can try reminding them of the agreement but people do tend to have selective memories.

Re: Nursing dilemma

Claire Fisher — Thu, 21 Apr 2011 20:27:57 GMT

We have a nurse going on maternity leave in May and have taken on an unqualified kennel assistant so the nurses can cover their rota. Our 1st year student is also starting to do more as well.

Re: Nursing dilemma

Niall Taylor — Thu, 21 Apr 2011 12:14:45 GMT

[quote user="An On MRCVS"]have recently increased the number to allow an easier and less stressful rota... When the extra nurse was taken on, locums were ruled out for the foreseeable future as part of the "deal"[/quote]

Oh dear, very naive of you ! Staff have extremely selective memories when it comes to stuff like that and are quite happy to accept the bits of the "deal" they like and conveniently forget about the stuff they don't like. Whether it's performance related pay, bonuses related to profit, extra temporary staff or whatever such is the way of life (until they become employers themselves of course).

Your decision comes down to how good your nurses are - if you have a good team you may want to do something extra to keep things happy. I would certainly say if you are going to do that then do it in the form of a one off bonus to cover the maternity leave period rather than a pay rise which you will then have to increase incrementally at every pay review. How about totting up the amount you will 'save' by reclaiming SMP and distributing it between them? When they each receive their £2.50 maybe that will make them see things differently (wouldn't bank on it though!) .

Why is your nurse only taking 6 months leave anyway when she is entitled to the full 12 months - is that something that might change as she finds she appreciates the joys of motherhood? Also will she want to come back part time, in which case she is presumably going to want to drop the rota duties first. Remember, a member of staff returning from maternity leave can request to go part time but you are not obliged to meet that request - if it would be detrimental to the business you can insist it's on the original terms or not at all.

Definitely a lesson to learn for the future.

Niall

Re: Nursing dilemma

Mark Hedberg — Thu, 21 Apr 2011 07:32:16 GMT

Well, it's nice you pay slightly above the average. Just remember what the average *is*. Not easy to live on a vet nurse salary these days.

Employees work for either financial recompense or job fulfillment. The more you get of one, the less you want if the other. (yes, that's ridiculously oversimplified, but bear with me a moment. ) I don't think they're holding you to ransom. I do think that people who work at a job they love will put up with a lot, including high rotas or high workload. (this forum alone must have lots of examples. )

If you don't get that, you often have people asking for more money. Not necessarily saying you have this issue, but bears a thought.

And we've got 4% inflation and 20% vat now. Their salary no longer buys as much, period.

The correct word here, i feel, is context.

Re: Nursing dilemma

An On MRCVS — Wed, 20 Apr 2011 22:57:02 GMT

Mark H: the nurses were offered a choice of wage rise or extra nurse and opted for the latter but were made aware that this ruled out a locum. Also, they should be very aware of the costs of locums, vets or nurses, the issue has been well-discussed and explained. Also again, this question of mine is posted prior to formal discussion with the nurses of the options and triggered by the comment that they all expect a locum when maternity leave starts. It appears not to have registered that if a nurse locum is ruled out by the expense of an extra full-time nurse that the cost of a six-months nurse locum is even more ruled out. The only realistic options would seem to be a six-months contract for another, probably unqualified, nurse, or them doing the work and sharing the saved wages.

Re. "bluff": it might notbe a bluff of course - I don't even know yet if they would threaten to leave in fact - but the real question is do you let yourself be held to ransom by your staff?

Michael W: The contracts will be for one fewer nurse than we have at present. Also, there is no objection to babies or illness etc, but there is an objection to being unable to see economic reality.

Mark Holmes: I am fully aware of the hidden costs you mention and fortunately we have a relatively low turnover of nursing staff; recent checking shows that we pay slightly higher than the national average for nurses as well and bonuses are already on the table. In addition, locum nurses are no way cost-effective, at least for our practice.

Clive re. SMP: as noted above, locums cost way more than the 103% refund. 200+% is more like my experience. If the money is simply not there in these pressured times, then I return to the question I posed above:

Do you allow yourself to be held to ransom by your staff? I have worked for people who would have just told staff to walk if they had suggested to the bosses how many to employ - are things different now?

Re: Nursing dilemma

Gillian Mostyn — Wed, 20 Apr 2011 21:58:47 GMT

[quote user="Gerry Henry"]Become a training practice and get them for free. [/quote]

eh?

If you are referring to degree nurses (or at least I hope you are), you have to find the time (or a nurse does) to complete the practical aspects of their training, be it portfolio or NPL.

Incidentally, I pay my degree nurse for half her hours worked, assuming the other half of her hours are training/study time. I would hate to have someone work for free and feel they would be very difficult to manage.

Re: Nursing dilemma

Gillian Mostyn — Wed, 20 Apr 2011 21:55:02 GMT

[quote user="Clive Ansell"]Statutory maternity pay (SMP) is recoverable from the government, in the case of small businesses at a rate of 103% (I think, but stand to be corrected). If so what is the issue? [/quote]

The issue is that a nurse locum will cost a lot more than that, and finding someone decent to work for a 6 month contract at 'normal' rates is very difficult.

Re: Nursing dilemma

Gerry Henry — Wed, 20 Apr 2011 11:17:17 GMT

Become a training practice and get them for free.

Re: Nursing dilemma

Clive Ansell — Wed, 20 Apr 2011 09:24:29 GMT

Statutory maternity pay (SMP) is recoverable from the government, in the case of small businesses at a rate of 103% (I think, but stand to be corrected). If so what is the issue?

Re: Nursing dilemma

Mark Hedberg — Wed, 20 Apr 2011 07:11:45 GMT

Also, why did you call it a bluff, anon?

Re: Nursing dilemma

Mark Holmes — Wed, 20 Apr 2011 06:44:09 GMT

I think you have to look at the hidden costs of 1) Stressed poorly motivated staff 2) Recruitment costs 3) The disruption of new staff to the work environment and underperformance whilst settling in 4) Poor staff loyalty. If you have a high staff turnover that becomes expensive. You need to take them seriously as "get on with it" may over time be far more expensive than that locum. How much would you be comfortable/happy/able to pay for the additional staff requested? Give them the option of additional staff or a group bonus based in a disable proportion of that amount. Edit Sizeable proportion..... Damn iPhone