Saying no to extra shifts: selfish or self-preservation?

We all know the feeling.  The phone rings and it’s your boss or manager calling and your heart sinks.  You know what they want.  They want you to work tomorrow, and you dread having to answer the phone.  Your whole body suddenly feels heavy and slumps over in defeat.  You were really looking forward to your day off and don’t really want to pick up another shift.  Should I answer it?  Can I get away with letting it go to voicemail?  Your heart starts racing as you scramble to think of some reasonable excuse to say NO.  I’m sick.  No, I’m not really sick, I'm just tired.  I’ve got a dentist appointment.  No, I don’t want to lie.  By now you’re overcome with feelings of guilt, so you answer the phone, and you end up saying YES anyway.

Why is it so hard to say NO to extra shifts?

As healthcare workers we care.  We care about our patients, and we don’t want them to suffer.  We also care about our co-workers and know what it’s like when it’s short-staffed.  We also care about what other people might think.  My manager may think I’m not a team player.  Others may think I’m selfish.  They may start treating me differently (which is not OK by the way and should be reported).

What happens when you say YES

So we say YES and show up to work the next shift and whatever we had planned for that day sounds really good right now, even if it was just doing laundry and cleaning out the fridge.   Maybe the day seems to drag along as we check the clock to count how many more hours we have left.   We may also feel resentful, coming in on our first day off after having worked several days in a row already.  Because we don’t really want to be here and would rather be somewhere else, we may even be short with our patients and co-workers.  And if we’re tired, we may even make critical mistakes.

Saying YES to extra shifts means saying NO to something else

Is it sleep? Or maybe exercise?  Maybe it's getting caught up on chores or grocery shopping?  Maybe you had something planned with family or a friend.  No matter what you had planned that day, saying YES to an extra shift meant saying NO to a day to rest and recharge.  Saying YES to an extra shift meant saying NO to yourself in some way, to something you really wanted to do.  That’s why it doesn’t feel good.  And that feeling, over time, can contribute to burnout, affecting your own health and wellbeing.

Selfish or Self-preservation

So, is it truly selfish to say NO to extra shifts?    

Is it selfish to want balance and good health?  

As healthcare workers, we often put caring for others before our own needs.  We perpetuate the belief that it’s all part of the job and that being in healthcare means we must be selfless, but we can see now more than ever that it isn’t working.  More and more healthcare professionals have burnt out and quit, contributing to the feeling that we are one of the last ones standing.  

Some of the factors that contribute to burn out are working long hours, lack of sleep, high stress environment and emotional strain from patient care.  While we can’t control the last two factors, the first two are in our control.

We can control how many hours we work to the extent of limiting the number of hours we sign up for and the extra hours we take on.  We can also take our time off to rest, recharge, sleep and find balance.  By taking care of our own health, we avoid burnout, so saying NO to extra shifts can be an act of self-preservation.      

The better we take care of ourselves, the better we’ll be able to take care of our patients.  We’ll be happier, more effective and safer at work.  We can avoid burning out and have longer careers in the healthcare field.

What happens when you say NO

We’ve all worked a shift that was short-staffed, and things worked out.  It may not have been fun or easy, but you figured it out.  We survived, and it’s likely that our patients survived too.  

So if you say NO to a shift, things will work out.  THEY will figure it out.   If things aren’t working out, if your company sees that patient care is suffering due to being short-staffed, then THEY will have to make a change.  

And I think that more and more we’re all realizing that change needs to happen within the entire healthcare system.  We’re recognizing that we need to care for our healthcare workers.  While we may feel bad about contributing to the current situation, we can’t fix it all ourselves.  It’s really not YOUR responsibility.  

Coming to work when you agree to and doing your job is YOUR responsibility.  Everything else is above and beyond.  So, while other people may think you are selfish, you are really doing what’s best for everyone in the long run.  Caring for ourselves may be a new concept for healthcare workers, and you may stand out for a while, but others are beginning to see the positive outcomes. Putting the health of others, no matter how much we care, at the expense of our own health, just isn’t sustainable.

This doesn’t mean you’ll never take an extra shift

Taking an extra shift is a completely personal choice, and up to your discretion no matter what. When feeling conflicted about taking an extra shift, here are some things to consider:

When to say YES

Maybe you’re caught up on self-care and feeling pretty well balanced, or you may be able to reschedule your self-care activities for another day in the not too distant future and that feels fine.  Making sure you are sufficiently rested and recharged to care for others is not only going to make you feel better about being at work, but it’s also crucial for the safety of our patients.  

When to say NO

It doesn’t feel good.  Our emotions don’t lie, they are really trying to tell us that something is up or not quite right - like when we need self-care or when we need to attend to our health, not just our physical health but also our mental, emotional and psychosocial health too.  You may feel bad about going to the lake with friends instead of going to work, but you aren’t playing hooky.  You are doing something that will contribute to better health for yourself and getting recharged for the important work that you do.  

How to say NO to extra shifts

Saying NO is never easy.  Those same feelings of guilt will likely arise even if this article completely resonates with you.  You may not be used to saying NO, so it's good to be prepared, and through the practice of saying NO and seeing how YOU feel, it can get easier over time.

Just say “No”.  You don’t have to make up an excuse or give a reason.  You also don’t have to apologize.  Keeping it short and simple will help with any backpedaling.

You can say something like, “I’d like to help but I am unavailable”.  Stating that you’d like to help acknowledges that you care.

You could also say, “I wish I could help, but I have important things to do that day”.  And when you do those important things, truly value them for what they are.  

If you do end up saying YES when you don't really want to, you can do your best to make it up to yourself and schedule in those self-care activities as soon as possible.    

‍