Communication Challenge # 2
Med-Surg Staff Nurse Faces Dilemma with Meal Breaks
Dear Punched-Out, but Still On,
Thank you for a super example of nursing staff and administration becoming divided about something while an underlying issue may be lost or distorted. While the ‘punch-out’ policy,- may be a good faith effort to address a labor requirement, attempting to control it, as you can attest, seems to be increasing resistance, contributing to a power struggle and creating a new problem.
I can understand your feelings of resentment about being forced to take a break or thinking that you have to lie about not taking one.
I can also hear HR saying, ‘we sent out emails to nurse managers who repeatedly informed staff about the importance of taking meal breaks, and it was the last straw when we got a warning from the department of labor’. I would understand their feelings of frustration too.
In addition to potential liability and labor issues about working while you are punched out, and which an attorney would be better suited to answer, I wonder if there is an opportunity hidden in this conflict. What would happen if you spent some time reflecting on the following questions?
1. How does this policy impact you?
2. What would you need in order to take breaks?
3. What questions could you ask HR that would help you understand their position?
4. What could you do to make breaks more feasible and what limits do you have?
Meanwhile, I would also ask HR and perhaps your Nurse Manager to consider a similar process where some time is spent focusing on these questions:
1. What is the impact on HR or the unit when nurses are not taking breaks regularly?
2. How might HR or the unit support nurses in efforts to increase compliance?
3. What questions might they ask nurses to gain a better understanding of their perspective?
4. What could they do to help; and what limits do they have?
In doing this, both sides show ownership of part of the problem, a willingness to help solve it and a curiosity about each other’s position. This in and of itself is not the solution, but it does contribute to an environment of respect and collaboration. This will allow you and your organization to get at the underlying problem(s) that may include workload, staffing, trust and delegating skills.
Nurses often work long hours in very stressful environments.
I remember working in Med-Surg and frequently not taking a break. In retrospect, I think there were several factors: unrealistic work assignments, an inability to articulate what I needed and a reluctance to include my break as a priority. Finding a way to take a rest or meal break is a healthy goal for you and your organization. Meditating, listening to music, or taking a walk may be alternative ways to take care of yourself for a few minutes during your shift and help prevent ‘burn-out’.
Exploring underlying issues may shed light on a variety of related concerns. If you are willing to be assertive and ask for what you need, I’m betting you and your colleagues can come up with some creative problem-solving ideas.
Progressive healthcare organizations which recognize the value of collaboration and are seeking to improve retention, quality and safety, will listen. Who knows, perhaps you’ll develop a new part-time ‘break-nurse’ position or differential, obtain training on assertiveness or pilot some new scheduling model. Maybe you and your nurse and administration colleagues will come up with something entirely new.
Good luck with this and thanks for submitting your scenario.
Beth
Beth Boynton, RN, MS, is an organizational development consultant and author of Confident Voices: The Nurses’ Guide to Improving Communication & Creating Positive Workplaces. She is an adjunct faculty member with New England College and publishes the free e-newsletter: Confident Voices for Nurses. Please contact her at bbbboynton@earthlink.net with any comments, questions, and/or if you would like to have a situation considered for this column. More about Beth. Buy the book.