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Letter to the Editor by Al Merchant to The Nursing Shortage: Is This Cycle Different?

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May 3, 2013

Response by Al Merchant to the topic “The Nursing Shortage: Is This Cycle Different?” (January 31, 2001)

Dear Editor:

I am a registered nurse who works as a per-diem nurse in several hospitals. I write in response to the OJIN topic “The Nursing Shortage: Is This Cycle Different?”

I want to create awareness among the healthcare industry (mostly hospitals) about the plight and silent injustice that is being perpetrated on per-diem nurses since the inception of its concept. Per-diem nurses supplement and fill the gaps for hospitals during their acute shortages of nurses, such as on holidays or when the hospital census is high.

Typically, 4-week schedules are drawn up a month or two in advance and per-diem nurses are scheduled according to hospitals' projected needs. However, for per-diem nurses, that schedule is not worth the paper it is written on because they can be canceled by the hospital any time before the commencement of the shift. Per-diem nurses are often canceled as late as 30 minutes before the shift starts or sometimes even after reporting to the unit "because there was a mistake in the schedule" or "our census went down." In reality, a scheduling slot is created for nurses who might have missed a shift during that pay-period.

Per-diem nurses are held accountable for their end of the commitment but the hospitals are not. A schedule is an unwritten contract between a per-diem nurse and a hospital; as such, each party should be responsible to live up to its commitment. There has to be some reasonable compensation for per-diem nurses (like payment for half of the shift) when a hospital's needs have changed at the last minute.

Per-diem nurses have families and bills to pay just like everyone else. They have adjusted their social calendar, assuming that they would be working. Sometimes, per-diem nurse have turned down offers from other hospitals for the same shift, only to be canceled by the first hospital. Upon cancellation, it is then too late for per-diem nurses to be accommodated by other hospitals who had offered that shift because they have already made their own arrangements.

It is not unreasonable to think that there are nurses who may consider working per diem but just do not want to deal with the uncertainty of working on a per diem basis. I believe that there ought to be a law where a schedule is honored like a contract and the offending party is required to reasonably compensate the other party for breach of contract.

Thank you for your time,

Al Merchant, RN
Miramar, FL
ALMERCHANT@aol.com

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