On-call

  1. Our dept. has adopted an on-call system due to recent staffing shortages, increased volume and acuity. Does anybody have any magic advice on how to make this more acceptable to the staff? What has worked or not worked for you? This has been a very bitter pill to swallow for our staff.
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  2. 18 Comments

  3. by   CHUBBY
    Unfortunately, haven't really seen one that has worked. Tried voluntary, then assigned on-call (which was even worse). Staff began questioning other staff as to what necessitated the on-call person being called in and it created alot of in-fighting. I believe it was inventually dropped and everyone just works short with back up from inhouse if needed. I know it doesn't help-but you're not alone
  4. by   mdslabod
    Quote from CB
    Our dept. has adopted an on-call system due to recent staffing shortages, increased volume and acuity. Does anybody have any magic advice on how to make this more acceptable to the staff? What has worked or not worked for you? This has been a very bitter pill to swallow for our staff.

    Being "on Call" in the ER does not sound reasonable. The volume and acuity
    flucuate continuously, Only for "call ins", maybe and then at time and a half.
    Set time limits. The call to come to work must be before a certain time (shift change). If no call, the on call person is off the hook for the night.

    Worked for us in the ICU in Michigan.
  5. by   erjulie
    [I]We have call in our ER: two 12 hour night shifts/month, or two 8 hr week-end shifts per month, or one of each. It's mandatory, and we are not called in for "call-ins", only if acuity suddenly sky-rockets. Call ins are handled by either working short, or a volunteer will come in. It's not fun, but it's better than that awful feeling when you're going under for the third time and there's no one to help!
  6. by   Uptoherern
    we are paid some pittance for being "on call". Something like $2 per hour (or less). Then when we are called in, we get paid time and a half. A few weeks ago, I was on call for the first 4 hours of a 12 hour shift. I got called in and did the remaining 8 hours at the time and a half rate. So, basically, I got paid for 12 hours, + the 4 hour on call rate, and I only worked 8 hours. Seems rather silly to me, as it would have been cheaper for them to just have let me come in for the whole 12. Of course, mgmt looks at hours, not $. How ridiculous.
  7. by   Crumbwannabe
    Quote from erdiane
    we are paid some pittance for being "on call". something like $2 per hour (or less). then when we are called in, we get paid time and a half. a few weeks ago, i was on call for the first 4 hours of a 12 hour shift. i got called in and did the remaining 8 hours at the time and a half rate. so, basically, i got paid for 12 hours, + the 4 hour on call rate, and i only worked 8 hours. seems rather silly to me, as it would have been cheaper for them to just have let me come in for the whole 12. of course, mgmt looks at hours, not $. how ridiculous.
    according to federal labor laws (i believe chapter 129), if a person is not on the premises, (such as a fireman) carries a phone, pager, or must call in where they can be reached, must at all times be close enough to respond in a given time, and is otherwise not in control of whatever they wish to do, the employer must pay at least minimum wage to the employee on call.



    in 1947 the portal to portal act (29 u.s.c. 251-262) amended flsa to give clearer definition the term "workday" and to answer questions regarding employers' liability to compensate workers.

    hours worked (29 cfr part 785)
    voluntary late work -29 cfr 785.11 work not requested but suffered or permitted is work time. for example, an employee may voluntarily continue to work at the end of the shift. he may be a piece worker, he may desire to finish an assigned task or he may wish to correct errors, paste work tickets, prepare time reports or other records. the reason is immaterial. the employer knows or has reason to believe that he is continuing to work and the time is working time.

    rest breaks -29 cfr 785.18 rest periods of short duration, running from 5 minutes to about 20 minutes are common in industry. ... they must be counted as hours worked.

    meal breaks -29 cfr 785.19 bona fide meal periods are not worktime. bona fide meal periods do not include coffee breaks or time for snacks. these are rest periods. the employee must be completely relieved from duty for the purposes of eating regular meals. ... the employee is not relieved if he is required to perform any duties, whether active or inactive, while eating.

    lectures/meetings -29 cfr 785.27 attendance at lectures, meetings, training programs and similar activities need not be counted as working time if the following criteria are met: (a) attendance is outside of the employee's regular working hours; (b) attendance is in fact voluntary; (c) the course, lecture or meeting is not directly related to the employee's job; (d) the employee does not perform any productive work during attendance.

    training programs -29 cfr 785.31 the training is directly related to the employee's job if it is designed to make the employee handle his job more effectively as distinguished from training him for another job, or to a new or additional skill.

    changing clothes at work -29 cfr 785.24 and 790.8(c) among the activities included as an integral part of a principal activity are those closely related activities which are indispensable to its performance. if an employee in a chemical plant for example, cannot perform his principal activities without putting on certain clothes, changing clothes on the employer's premises at the beginning and end of the workday would be an integral part of the employee's activity.

    changing clothes off work -29 cfr 785.24 and 790.8(c) on the other hand, if changing clothes is merely a convenience to the employee and not directly related to his primary activities, it would be considered as a 'preliminary' or 'postliminary' activity rather than a principal part of the activity.

    travel time to/from work -29 cfr 785.35 ... travel time at the commencement or cessation of the workday .... need not be counted as worktime unless it is compensable by contract, custom or practice. on the other hand, 29 cfr 785.36 provides, if an employee who has gone home after completing his day's work is subsequently called out at night to travel a substantial distance to perform an emergency job ... all time spent on such travel is work time.

    travel time during work -29 cfr 785.38 time spent by an employee in travel as part of his principal activity, such as travel from job site to job site during the workday, must be counted as hours worked.

    civic work -co. requested -29 cfr 785.44 time spent in work for public or charitable purposes at the employer's request, or under his direction or control, or while the employee is required to be on the premises, is working time.

    medical attention -29 cfr 785.43 time spent by an employee in waiting for and receiving medical attention an the premises or at the direction of the employer during the employee's normal working hours on days when he is working constitutes hours worked.

    on call time -29 cfr 785.17 an employee who is required to remain on call on the employer's premises or so close thereto that he cannot use the time effectively for his own purposes is working while 'on call'. an employee who is not required to remain on the employer's premises but is merely required to leave word at his home or with company officials where he may be reached is not working while on call


    additionally, they are required to pay customary salary, or time and a half from the time they call until you arrive and clock in, because they control your behavior and availability.

    this is the portal to portal law. if you're going to report a violation, i would not mention the law at work...... there are some excellent labor law books out there, but read the ones which are written for the employer to make sure they are protecting themselves. these have the best juicy tidbits. btw federal statutes overrule state or local.

    this may dampen their ardour for call nurses....
    Last edit by Crumbwannabe on Nov 22, '04 : Reason: Error
  8. by   veetach
    >>According to federal labor laws (I believe chapter 129), if a person is not on the premises, (such as a fireman) carries a phone, pager, or must call in where they can be reached, must at all times be close enough to respond in a given time, and is otherwise not in control of whatever they wish to do, the employer must pay at least minimum wage to the employee on call.<<

    this doesnt fly in the commonwealth of PA. We get $2/hr for call time. There must be some loophole around the above law, or our union would not consider our call time pay as acceptable.
  9. by   Crumbwannabe
    Hi
    Maybe your union steward doesn't know or care. It is a federal labor law. If you are not free to use on call time as you please, including staying within a certain perimeter, refraining from having a few beers, et.c., you must be paid at least minimum wage for each hour. And you must be paid regular or overtime wage for commuting time when on call. But not normal day to day commuting.

    Your employer is not going to volunteer to pay this, and will keep you in the dark if possible. Now when I worked in the O/R in N.C. back in the '90s, they avoided the hassle and paid it. BTW, I corrected my mistake in the previous post as to the number/chapter of the law, but se NOLO's publication 'The Employer's Legal Handbook' 6th ed. Ch. 3 pg. 24 for a very clear outline. Full of more little tidbits....
    Last edit by Crumbwannabe on Nov 23, '04
  10. by   needsmore$
    What about lunch? Sometimes (rarely) we do get a break- and once in a while we have a nurse who wants to drive off to Burger King to pick up a sandwich and fries. She feels since this is her "30 min" she should be able to do what she wants with it. Our hospital, and common sense , says that the ED staff has to stay on premises in case of the inevitable disaster that will strike during the meal break. If we are not getting paid for this "30 min break" but we have to stay on premises, shouldn't we get ON CALL pay for that 30 min? Interesting thought....

    Anne
  11. by   Crumbwannabe
    Quote from needsmore$
    What about lunch? Sometimes (rarely) we do get a break- and once in a while we have a nurse who wants to drive off to Burger King to pick up a sandwich and fries. She feels since this is her "30 min" she should be able to do what she wants with it. Our hospital, and common sense , says that the ED staff has to stay on premises in case of the inevitable disaster that will strike during the meal break. If we are not getting paid for this "30 min break" but we have to stay on premises, shouldn't we get ON CALL pay for that 30 min? Interesting thought....

    Anne
    No, you have to be available in case the doc comes back from lunch and wants you.....Honestly, you are entitled to pay unless you are 100% undisturbed with anything work related during those 30 min. (Make it 25 min...they might say you took 31 min. Travel to and from and the lunch line is part of your break.)
    Last edit by Crumbwannabe on Nov 26, '04
  12. by   rjflyn
    The loop hole most places use is the part about what you can and cant do. Every where I have been we are free to do what ever I wanted while on call. They have never restricted that. Now common sense tells me what I should or shouldnt do ie drinking alcohol for example as one poster put it- I have a license, i'm not going to lose it going to work smelling of alcohol.

    As far as call goes the last time I had call we had to self schedule 2- 4hr blocks every 4 weeks. The union contract restricted what we could be called in for- unforseen circumstances- this did not include call offs or short staff situations as these were concidered common occurances. It also helped that the charge nurse also knew that we had an hour response time ie calling in and getting back to the hospital. Hence in a year I think I was called in 3 times, once was at the end of a shift and I stayed over about an hour.

    Rj
    Last edit by rjflyn on Nov 26, '04
  13. by   bergren
    A coworker was disciplined for leaving the premises during the 30 minute unpaid lunch. The next day the US Labor Relations Board phoned the hospital and stated that if not paid, they cannot restrict personnel to premises.
  14. by   PJMommy
    Are you needing to call in people despite having people sign up for extra hours? Just curious as we rarely need to do this. We have the option of signing up for extra shifts and the perks for doing so are good: time and a half for overtime plus an extra amount per hour (say $6-12). The extra amount depends on the hospital census. I work extra a lot because the pay is so nice. If they don't need the extra person, they have the option of being cancelled or placed on-call (for the $2/hr pittance).

    In the rare cases where we need to call in someone and no qualified float person is available, then they really get generous with the perks -- say $20 an hour extra plus your overtime. Someone is always willing to come in for those kind of perks and we've never had to implement a forced call-in.

    Now, with all that said, in the event of a disaster -- you have no choice, you will come in if called.

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