The phone tree.
Fill takes 30–90 minutes. Manager pieces it together later.
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Charge nurse calls out A nurse on tonight's roster can't make it. The unit lead finds out by text or phone call.
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Manager works the phone tree Calls 5–10 nurses one by one. Most don't pick up. Some say no. Each call is 2–5 minutes.
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Eligibility checked from memory Was she charge-qualified? Did she just work a double? Has she hit overtime? Often discovered after the call.
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Reconciled later The shift is filled, eventually. Hours, premiums, and ratios get squared up at the end of the pay period.