Extra Shifts: Good or Bad for Your Career?


Health care staffing is a fluid thing, and managers know they will have to ask their team members to take on extra shifts from time to time. How you react when your name is called could make a difference in your career potential. But there are plenty of caveats along the way. AARC members — managers and staff alike — share their thoughts.

True team players

“When RTs are willing to pick up extra shifts, first and foremost it shows me they are true team players,” said Shawna Creel, RRT, pulmonary manager at Plains Regional Medical Center in Clovis, NM. “It shows they care about the patients and making sure they are taken care of, they care about their co-workers and want to help them in times of need, and they care about where they work. It also shows they have the compassion to be there for others and the drive needed to lead.”

Teri Allen, RRT, RRT-NPS, director of respiratory care services at UC Irvine Health in Orange, CA, believes therapists who take on extra shifts when asked show they are engaged in departmental operations and dedicated to their leadership and their co-workers. “It shows that the mission and vision of your organization are a priority for you.”

For Matt Nolan, MBA, BSRC, RRT, RRT-NPS, RRT-ACCS, a willingness to take on extra shifts demonstrates a higher level of commitment to the department. “I am so grateful to these therapists because I know everyone has a life outside of work,” he said. It doesn’t matter why they chose to work the extra shift; he views their service as not only helping him out with staffing but helping the patients they all serve.

It certainly boosts their career potential in his eyes as well. “I want to always work as hard if not harder for the therapists in the department as they do for me,” said the cardiopulmonary director at Texas Health Harris Methodist Hospital Southwest and Texas Health Clearfork Hospital in Fort Worth, TX. “If you are willing to go an extra inch, I want staff to know I am willing to go a mile in return for them.”

Brian Kessler, MBA, RRT, RRT-NPS, director of respiratory care, neurodiagnostics, and central transport services at Ascension St. Vincent Evansville in Evansville, IN, says staff members who take on extra shifts earn kudos from their manager and fellow staff members alike. He often has staff come by his office to recognize fellow staff who volunteered, wanting to make sure he knows who stepped up and how they helped.

He believes extra shifts can do wonders for new grads too and he encourages them to take advantage of the opportunity. “It can facilitate their continued learning and training after their department orientation is over,” Kessler said.  “Sometimes when they pick up an extra shift, it allows us to assign them as the second RT in the adult critical care area where they can work closely with a more experienced RT, which can help build their confidence and reinforce their clinical, time management, and organizational skills.”

It depends on the individual

However, Creel, Allen, Nolan, and Kessler all admit that there is a limit to how many extra shifts a therapist can take on and still deliver safe and effective care. “RTs should be self-aware and only take on extra shifts when they are physically and mentally able to be completely engaged in their work,” Allen said. “The number of extra shifts an RT can handle is unique to each individual.”

Nolan echoes the latter statement. “The number of extra shifts a therapist can safely handle each week or month is going to vary between each therapist,” he said. “Some therapists will be able to pick up one or two extra shifts a month and some therapists will be able to safely pick up 10 additional shifts a month.” What he wants his staff to know is that it doesn’t matter how many extra shifts they take on — even one is enough to earn his praise.

“That person took time out of their home life and minimal required shifts to go above and beyond to help out in a department staffing need,” Nolan said. “I view the person that picks up one additional shift with the same gratitude as I do someone that picks up five or six shifts.”

Creel advocates for no more than four or five extra shifts a month for any therapist. “While they may be willing to work as much as allowed, it can always wear them out and cause burnout,” she said. “When this happens their mind and body aren’t as clear, and they may not be as said to make the best decisions as they would be able to otherwise.”

Kessler says RTs who volunteer for extra shifts need to make sure they are up to the task physically, mentally, and personally. “When I was a younger, single RT with no children, I would routinely work an extra 12-hour shift practically any week that it was available or needed,” he said. “I would keep a pair of scrubs in my trunk just in case I got called while I was at a friend’s apartment or running errands.”

He knows that doesn’t work as well for the RT who is married with children and has lots of day-to-day responsibilities at home.

Know when to say when

Other managers see pros and cons to extra shifts as well. “If they pick up an extra shift now and then I’m okay with it, but picking up several is not safe for the therapist or the patient,” said Marlyce Campbell, CRT, director of respiratory care at Trego County Lemke Memorial Hospital in Wakeeney, KS. “That’s when a lot of errors are made.”

She believes the location of the extra shift matters too. “I don’t want an RT working extra hours in the ICU or the ER if they have already worked a lot of shifts,” Campbell said. “People like the money, but they are away from family and friends, and worse yet could get sick and then have a hard time even doing the regular shift.”

Sheryle Barrett, MS, RRT, director of cardiopulmonary services at Bethesda Hospital in Boynton Beach, FL, believes therapists who take on extra shifts to help out during staffing shortages do raise their stature in the minds of their managers, but she also emphasizes that the whole process can backfire too.

“You can have someone who is only motivated by the extra money, and when needing to be canceled, have a poor attitude,” she said. “This type of behavior will hurt advancement.”

Therapists who are willing to cover extra shifts are viewed as dependable, especially when those shifts are taken at the last minute to cover sick calls and sudden surges in the patient population, said Jack Fried, MA, RRT, director of respiratory care and neurodiagnostic services at St. Mark’s Hospital in Salt Lake City, UT.

But he too believes there is a limit to how many any single RT can handle. “My experience is that a clinician can handle up to two extra 12 hours shifts for two straight shifts at most,” Fried said.

Susan Wynn, MSM, BSRT, RRT, emphasizes it’s the willingness to help when needed that is the important part when it comes to gaining a manager’s attention. Those who work an extra shift now and then — or even just a few extra hours — with a great attitude are respected and appreciated. “These are the people considered for promotion,” said the director of respiratory care and sleep services at Schneck Medical Center in Seymour, IN. “No manager wants their employees to spread themselves too thin.”

Two different perspectives

What do staff therapists think about the issue of extra shifts? Michael Holbert, RPFT, says picking up an extra shift in times of need can earn praise from managers, but in his career, he has opted to limit the extra shifts he has taken on.

“I was guided by the tactic of working extra shifts whenever I could fairly easily do so without much sacrifice on the family side,” Holbert said. “I think if you work when you can, others on the team will be more understanding when you really have to say no.”

He also believes therapists should be careful about how many extra shifts they work. “Working over six days in a row, getting less than four days off in month, is probably not a good idea,” he said. “I’ve seen people try to do more, and it rarely ended well for patient care, teamwork, or personal life.”

Dan Alamillo, MSRC, RRT, RRT-NPS, RPFT, AE-C, however, sees a lot of upside in working more shifts than usual — when the circumstances are right. Early on in his career he worked full time for a children’s hospital and per diem for an adult hospital and put in 60 hours a week between the two on a regular basis.

Both of his managers were aware of the situation, and for him, it was a great way to gain a wealth of experience in both adult and pediatric care at the same time. “I believe the two jobs helped me to become the respiratory therapist I am today,” Alamillo said. “These vastly varying experiences really cemented, in practical application, those theoretical or observed advanced practices that any seasoned respiratory therapist could encounter on any given shift.”

It did wonders for his financial situation too. Over the 12 years he followed this path he was able to purchase and pay off his home and contribute a sizable amount to his retirement accounts.

He fully admits, however, that his ability to put in those kinds of hours was largely based on the fact that he was single and had no children. “Everyone comes to the table with different circumstances and my path may not be a desirable or practical path for the person standing next to me,” Alamillo said. “It worked out for me because I was unencumbered.”

Finding the right balance

So the bottom line is probably this: extra shifts are a fact of life in respiratory care and therapists who rise to the occasion when asked are sure to earn some brownie points with their managers along with the additional pay. But working more shifts than you can safely handle, either professionally or personally, is never a good idea.

Clearly, it’s a balancing act, and what’s right for one RT might not be right for another.

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