Every manager wants to do the best by her employees, so saying "no" to time off may be one of the most difficult things you'll have to do. Here are my thoughts on what to do when you cannot grant these requests.

Develop formal procedures
Make sure your employee policies answer the following questions:

• When can requests be submitted? Specify a time frame or dates by which the request must be submitted, and, in general, the earlier the better. It may not be fair to specify a certain time of day that you'll consider requests (in other words, first come, first served). When I worked in a hospital, employees who came in early in the morning of Jan. 2 hustled to file their time-off requests for the year, effectively "blocking off" their desired dates before the staffers scheduled to arrive later that day or the next day could even submit a request.

• To whom are the requests submitted? At my facility, staffers submit requests to their immediate supervisor, who informs the employee verbally and in writing of her decision.
• How soon can the employee expect a decision? Make every effort to respond to the request in a timely fashion. Employees also need to know their recourses if the request is turned down.
• How much time can they request at one time? Set specific rules and limitations. For example, some facilities discourage employees from taking off parts of a workday; others have no problem with this. If you allow requests for more than one week, you might consider a policy that prohibits an employee from taking more than two consecutive weeks off at a time.
• Are there restricted "prime dates"? Develop a policy for granting time off on or around dates that are may create scheduling hassles, including major holidays or professional conferences. If your employees know ahead of time that they may not be able to get those days off, they are far less likely to harbor ill feelings if they end up working these dates.
• How many employees can be off at one time? Use the staff category to determine this. Consider how many of each type of staff are employed and take into account the employees who are cross-trained to fill in for others' work. At my facility, we cannot afford for more than two RNs to be out on the same day.

Try these strategies
1. Specify prime weeks. At my facility, we place limits on the number of employees who can take vacation at certain critical times. During Christmas week, for example, we rotate work according to seniority by each position category. We don't permit full-week vacation requests for this period. We grant single-days off according to the demands of the surgery schedule.

2. Prioritize requests. We let staffers submit several weeks' worth of vacation requests at once. However, we require them to signify which are their most important and/or least flexible requests and give priority to honoring those weeks. We also encourage submitting requests as early in the year as possible.

If it comes down to choosing between two time-off requests, we favor the employee with seniority. However, we at least attempt to rotate time off during the prime weeks. We inform staffers of these "decision-clinching" considerations at the time they are hired.

3. Manage conflicts before they arise. Sometimes employees can work things out amongst themselves. If two or more employees want the same time off, encourage them to meet and see if they resolve things. If this still results in a conflict, use the policies in place (such as seniority) to make the decision. To handle unexpected requests, develop relationships with per diem and contract employees and cross train employees so that you can fill your core staffing requirements. A nursing assistant who is trained for the front desk can allow for a receptionist to be off, when the policy would otherwise make it impossible.

Involve your employees
One final thought: Ask employees for their input regarding your policies for granting time off. Your policies should be open to periodic quality improvement review on the same basis as any other practice in place at the facility. Not only does this maximize long-term employee buy-in for your time-off policies, but it also increases the chances for successful resolution when conflicts arise in the short-term.