Surgical nurses are skilled at milking the clock by exploiting every staffing loophole known to man. Here are the tricks we RNs play.

Punching the clock
Apparently there's a 7-minute window on either side of clocking-in and clocking-out. You can clock in at 623 and get a jump on the day without being called on the carpet about overtime. Or you can watch that clock until 637, then dress and saunter back to report. You can also hit the dressing room, clock out around 1454 and still get an 8-hour day. That's 14 minutes of free time to your advantage, and some people (you know who you are — and so do your co-workers) do this in every facility that has an OR.

Calling in sick (or dead)
You can make out like a bandit as long as you have the counting skills to avoid counseling or termination over your attendance problem. At most places, if you miss 3 days you need a doctor's note to return to work. Let's say the people you work with make you want to puke, but you're not actually physically ill. You can either make the most of the 2 days you get before you hit the doctor's-note limit, or, if you're on good enough terms with an MD, maybe he'll write you a note. Managers have gotten wise to that last option, though, especially if you're male and the note's from the GYN surgeon. (I saw this once while managing an OR in Little Rock.)

Too many 1-day absences over a given period of time might also get you disciplinary action, so you have to remember the last time you called in. A nurse who worked for me had this down to a science. Her sick days tended to fall around the 1-month anniversary of her last call-in, with a long weekend calculated right in.

Why breaks are better than lunch
A lot of places make you clock out for lunch. You get 30 minutes and that's it. But break is a different story. It's 15 minutes and it depends on the person who's relieving you. If it's a good friend, you can stay gone 20 minutes, sometimes 30, and they won't say a thing. (You'd do the same for them.) But if it's a stickler for time and a tattletale to boot, you'd better be back in 15, as she's written down your time-out and isn't forgiving your leisurely return. Some people just refuse to play the game.

Disappearing acts
Whether you're a large facility with a designated staff to clean and prepare rooms between cases, or a small one where the job falls to the scrub and circulator, there's always someone who's missing in action from the task. It's not certain where these folks go during turnovers, and if you ask them, their stories sound paranormal. Even if alien abductions or out-of-body experiences were involved, though, these no-shows always put extra work on the other team members. Maybe these mysterious disappearances also explain the missing instruments and flat-out mix-ups in that one guaranteed case every day that's pulled wrong.

The tradeoff
We can scream and shout when others' use of staffing's little loopholes slight us, but we also have to keep in mind the times that we've made them work for us. Don't let it ruin your day. Take a deep breath and be thankful you have a job. Maybe, just maybe, everyone — including the most shameless offenders — will get what they deserve.