Before our Q & A service goes on holiday hiatus, we’re happy to answer several more of your questions.

Please take heart that we’re still working on many other questions, and we’ll pick up where we left off in the new year.

If you have a question, comment or suggestion, we’re listening and we encourage you to email us what’s on your mind at onevancouver@vch.ca.

Today’s answered questions

Please note that the question regarding the 6-shift rotation represents a compilation of employee questions. When necessary, questions are edited for brevity.

Q. What evaluation has VCH done since eliminating the 9-day fortnight for community employees and what evidence has been reviewed? What were the statistics for sick time before and what are they now for those who went through this change? How many more patients have been seen with this change?

Is VCH willing to reevaluate the current scheduling model and will you consider engaging in a collaborative discussion with community employees about developing rotations that meet service delivery and employee health and wellness needs?

A. We’ll start with client/patient care. When VCH transitioned from the 9-day fortnight schedule to the 37.5-hour work week, our aim was to optimize access to care — and we’ve succeeded. Since implementing the new rotations, VCH Community teams have increased client visits by 8%. By way of comparison, Home Care teams who did not use 9-day fortnight schedules increased client visits by about 1% over the same period. The data show that smoothing schedules has improved access to Community services without increasing the total number of hours worked. In addition, we’ve reduced overtime in Acute and Residential care.

However, our data tell another story, too. Those same Community teams who increased client visits by 8% (some of whom have 6 shifts in a row) saw their sick rate increase by about 2%. For an apple-to-apple comparison, those Home Care teams who did not use 9-day fortnight schedules also saw their sick time increase by about 3%.

Unfortunately, we can’t break this data down to isolate the results for staff on 6-shift rotations due to the complexity of our staffing. Many of our staff work a mix of shifts and manual analysis would be needed to produce a further data cut. With more than 10,000 staff on rotations, this would be a monumental, time-consuming task.

So, are 6-shift rotations responsible for the increase in sick time? We can’t say for certain. Are we willing to reevaluate the current scheduling model? Yes.

VCH Employee Engagement is committed to consulting with staff’s respective unions and VCH leadership to gain a better understanding of the issues. Work has begun to determine how we can eliminate 6-shift rotations while maintaining our improved service levels through other options such as 10-hour shifts, or weekend shifts.

In the meantime, and if you didn’t have an opportunity to attend the last Vancouver All-Staff Forum, may we suggest watching the webcast at your convenience. You can watch the webcast from any location, including home. A presentation on our new “Taking Care of Me” program may interest you and Wayne Balshin, executive director, employee relations, addressed your questions during the Q & A. Wayne’s explanation can be found at the 40-minute mark. Click here for the forum’s webcast.

Q. My question relates to nurse bumping. I understand this is what the Union has come up with, and they feel it is the most fair solution to budget cuts and job losses. However, how is bumping cost-effective for anyone? The cost to the units, all other staff and so on, as bumped nurses set off a huge and disruptive “domino effect” throughout the organization.

Also, in the case of bumping, why is the area PSM not able to say no to the person, if they are not qualified for the area? This means the PSM has no power at all. It makes no sense to me.

A. When displacements occur, nurses have at least two options: apply for a vacancy or exercise bumping rights under their collective agreement. It’s a personal choice but our preference is for nurses to access vacancies. This option is less disruptive, as you point out, and filling vacancies helps address workload issues for a team in need of help.

Regarding your second question, patient services managers do reserve the right to decline a bump where the nurse doesn’t meet the position’s qualifications. In fact, Employee Engagement won’t process any nurse’s request to bump if he or she is not “qualified and capable” to work in the preferred position.

Q. I work in Community and have friends who work in various hospital settings, in various jobs.

I have noticed a real discrepancy between the flexibility that hospital workers have and community workers have with regards to hours at work.

For instance – a friend of mine who worked at a VCH Hospital until recently said that they could take their “last break” at the end of their shift and then leave. However, in Community this is not allowed – staff are expressly forbidden (even if we are fully staffed otherwise) from taking their lunch break at the end of the day to leave early.

As the Timekeeper for my office, I know how important it is to make sure that we have enough staff on site at all times to help clients, deal with emergencies, etc. And, after 27 years with VCH, I know that there are always staff that will try to take advantage. However, a little bit of flexibility from the Employer/HR would certainly help with morale (which is at an all-time low in my opinion) and also show that the Employer/HR really does care about work/life balance.

A. Fitting everything into our busy lives can be difficult, so we understand the temptation to skip lunch and rearrange your day to leave early. However, we don’t support this strategy for anyone in Vancouver. We believe staff should be taking their breaks during the course of their shifts for two important reasons:

1. Your health and safety. Like many temptations in life, skipping lunch, stacking breaks or even rescheduling breaks to leave early isn’t healthy. Breaks at regular intervals are important for your and our patients’/clients’ health and safety.

2. Workload: Health and safety aside, we must also consider the potential for workload issues and the unintended impact of unscheduled absences on the rest of the team and the people we care for.

We realize that this isn’t the answer you were hoping for, and we do hope you don’t interpret this as our not caring about work-life balance — quite the opposite. We do care but we must be practical and honest, too. We hope we can be helpful as well by recommending that you visit our EFAP website, which offers a wide range of services and resources to help you achieve the wellbeing and balance we all seek.

Q. Overtime (OT) costs the organization money and impacts the health/work-life balance of staff (which probably in turn impacts sick time) and patients (a presumed reduction in quality of care due to fatigue).

OT can be avoided in part with a healthy casual pool & effective staffing of that casual pool because casuals, of course, are straight time. In my experience we do not have effective staffing of the casual pool.

For instance: Many casual staff work at multiple sites/Health Authorities. So VCH, in a sense, is ‘competing’ for the services of casual staff. By virtue of being casual there is a degree of uncertainty of when they will be called. This uncertainty is often a discomfort for casual staff because even casual staff enjoy planning their lives. I believe this uncertainty and discomfort can be mitigated by pre-booking in advance.

Sadly, this is not done as a matter of routine. Instead, coverage tends to be booked last minute. So, I am left wondering how much of OT costs are due to last minute call-outs that do not bear straight time casual fruit. I also wonder if these costs would justify employing a designated “pre-booking” staffing staff whose sole responsibility would be to proactively staff units ahead of time by looking for holes and filling them asap.

A. We hear your frustration! And we hope you’ll be pleased to know that solutions are in the works to improve coverage for Tertiary and Acute Mental Health & Addictions (MH&A), the area with the greatest relief needs in Vancouver.

As you note, a reliable casual pool is key, so we’re in the process of creating 20 lines of Experienced Resource Nurses (ERNs) at the DC2 level. The first group will begin orientation in January 2015 to start providing relief for the Vancouver Tertiary and Acute Mental Health & Addictions teams by April 2015.

The ERN Team will supplement the regular casual pool as well as the RNs providing vacation relief. Creating the ERN Team also opens an opportunity for us to redesign how vacancies are called out, streamlining the process across units. To help with this, the Staffing Office is dedicating 1 to 2 clerks to serve the MH&A portfolio.

Regarding vacations and similar pre-booked vacancies, the Staffing Office is working with us to establish a proactive callout process to avoid last-minute callouts and unnecessary overtime. This shift will benefit MH&A to start, but will expand to other Vancouver portfolios in 2015.

To learn more about the ERN Team, visit VCH Connect here. For more on recruitment, refer to this VCH News story.