Illustration by the author; all rights reserved

Illustration by the author; all rights reserved

While shopping in a grocery store, I passed a display of craft brew beer that caught my eye. The sign read Hospice Beer! After a double take, I saw on closer inspection that the label actually read: Hop-Slice Beer.

I realized I was badly in need of a summer vacation. Fortunately, I already had one scheduled on the books.

Summer is a traditional time for vacations, but often not for nurses, for multiple reasons.

Paid time off benefits vary from organization to organization.

Some lump vacation hours and sick leave hours into the same bank, while others separate the two so that nurses accrue hours into each per pay period. Paid vacation time accrues slowly when it’s used for paid sick time.

Further, after accepting a new job, nurses may find that as the newbie they accrue vacation and sick leave hours at a rate lower than their colleagues hired earlier; this practice, called tiered employment, exists within many industries outside of health care, whether they’re union or not. The practice can foster division between the newly hired and existing staff within units. Newer hires accrue less benefits for the same amount of work as their peers. The practice is a double-edged sword, however. It also means it’s cheaper for employers to hire new nurses than appease those with seniority.

After twenty-five years working continuously for the same health care system, I found myself in a similar position: a structural reorganization necessitated that I be hired by another organization. After working there for a year, I returned to the first organization as an oncology nurse navigator. The transition resulted in my accruing vacation time at the same rate as a newly hired nurse, despite 25 years of previous service.

I love my work, and I was happy to return to the organization. It was my choice. But it came with a price.

How vacations are scheduled in nursing units varies too.

In some, vacation time requests are required at the beginning of the year, forcing staff to make plans while they cope with holiday plans at home, along with winter illnesses and the accompanying short staffing that occurs with it at work. For many, thinking about a summer vacation in the midst of this melee is daunting, and so they don’t schedule vacation time, leaving it to chance when they finally do request time off.  In this scenario, they risk not getting an adequate vacation at all.

In other units, nurses schedule vacations at will, with the caveat that enough nurses remain to cover staffing needs in a nurse’s absence. During extreme periods of critical staffing needs, units can declare vacations put on hold until further notice, curtailing the best-made plans.

I’m not alone in having extra hurdles to leap when scheduling vacation time, because my husband works in health care too, with the same vacation request challenges. In my experience, many nurses are married to other nurses or health care colleagues, sometimes with conflicting schedules.

I finally accrued enough vacation time to take two consecutive weeks off from work.

We headed south to the coast near San Diego, enjoying fish tacos, and yes, beer (San Diego has a craft brew industry, as does Portland). Interestingly, at poolside we watched a father playing with his young daughter, who was bald in the way of a cancer patient. The child had no obvious venous access device, and swam like a fish, with surprising energy.

Her father stayed in the pool continuously for a couple of hours. You could tell he would stay there with her forever, if that’s what she had wanted.

We never really get away from the job, but that’s another post. I still enjoyed every minute of our vacation, and my oncology nurse–related hallucinations have ceased.