On call Problems

nurseby07 · Feb 21, 2009

That sounds awful. I think that they need to hire an on-call nurse for weekends too. This is what I can't stand, that mandatory on call crap, after you have worked all week. You ALWAYS get called, and if you are covering for the entire team then you can bet that three catheters will fall out in the middle of the night and you'll get 3 phone calls from anxious family members reporting a temp of 98.7. Obviously I have no good advice for you, just a rant.

annaedRN, RN · Feb 21, 2009

We have a FT oncall nurse for week nights. The FT day RNs take turns being oncall weekend nights about every 6-7 weekends(fri and sat) - there are 2 of us and we split the area. We have 2 RNs that work the weekend only and 1 LPN that sees patients and an LPN is oncall for working the day if it's really busy. The way we field phone calls all weekend (8-4) is there is an administrator on call who takes the calls, referrals, and helps trouble shoot ...it makes the weekend/on call a little more tolerable for whatever staff is working. Our census is 120-200 for home health and 40 for the hospice. Most of the overnight calls seem to be hospice though. The calls at evening and night go to the on-call person but that is usually manageable...and if you get really swamped with having to make visits..you can see if the other on call person can help out. Seems to be working well. I can say that if I was expected to do what you do...I would be looking for another job..that's way too much. Some nights may be almost nothing but others are CRAZY...that needs to be recognized.

MIC36FLA · Feb 21, 2009

Thanks for the info. We all need a place to rant, sometimes its just easier to 'speak' with others that have the same problems. I'm hoping that our new branch manager will work out these kinks. She's a RN also. We need a 24 hours on call answering service that can triage the miscellaneous phone calls. I'm on call today and have received more phone calls from employee questions about their schedule than actual patients. Not to say I haven't had a bunch of patient calls today. OH well, eventually it to shall pass...

jnette, ASN, EMT-I · Feb 21, 2009

Hi there ! :)

Ours is set up similar to yours. We rotate as well about every 5 weeks on average. We have one RN and one LPN sharing weekend call from Fri. to Monday. These nurses see all our "must see daily" pts., ie daily wound care and then any non-scheduled visits that come while on call. The primary nurse is the RN who will do any new/unexpected admissions, along with sharing the other scheduled dailies with the LPN. We get $60.00 for week end call, and $28.00 per visit ($5.00 more than non-call weekday visits). Admissions are also $5.00 more, or $65.00 for weekend admissions.

If it looks like the weekend call nurses will have a heavy schedule, our other nurses volunteer to pitch in and several other nurses will take one or two patients in their area where they live.. this really helps the weekend call nurses out a lot.

I now work in the office as well, but I check our weekend visits list on Fridays to see if those on call will need any help. I have a wrist fx. fixator pt who lives 5 miles from me, so I offered to pick her up today and tomorrow. Several other nurses have picked up a pt. or 2 where they live, so this has reduced the number of pts the call nurses will have to see.

We don't get a day off during the week either for pulling call, and it makes for a long week if you had a busy weekend.

Seems like ours isn't much different than yours, right?

We do use an answering service who pages us on the weekends. But they don't screen our calls, just page us or call us and pass on the info.

I would suggest your manager/CEO or agency director.. or Nursing Supervisor for that matter.. send out a directive to each employee stating that on call nurses are NOT be to called/paged on weekends or call nocs. The only time you should be getting called is for patient visits/emergencies/admissions. :nono:

IndianaHH · Mar 7, 2009

The agency I work for hired me to be the "Weekend Option RN" I work every weekend, carried the pager, do pt visits, admissions, discharges, phone triage. etc. My shift is technically 10 hrs. 8-6..on paper. Many times I am charting in the evening until 8 or 9 pm. Not a complaint as the agency is on laptop., I am at home, pj's just pounding away on keyboard. Since I am on call the entire 48 hrs there is no problem to be at home following all pt visits to do the charting.

Last year I was laid off, the Mon-Fri nurses had to pick up the slack. It just about kill them! So following many complaints, lots of begging (from them and myself) I was rehired after 4 months. Initially I had salary .. but the recall changed that to any hourly wage, so if the weekends are slow (NOT!) I also have Mon and Tues to pick up hours.

I can't imagine ever returning to a hospital setting.

IndianaHH

CMH66 · Mar 10, 2009

We have one nurse(me) on call whenever the office is closed(4pm-8am mon-fri and all day/night on sat&sun), paid a daily rate of $20 to carry pager and respond to calls. We have a census of around 160. Some nights I don't get any calls, and some times I will get several a day. We try to advise patients/family on best course of action over the phone(reinforce the dressing, irrigate the blocked catheter, and if the catheter is completely out and they are able to void we wait until the next day to reinsert). On saturday/Sunday we have 2 RNs scheduled to work a 8am-4pm day(they may not have a full day scheduled but they are required to be available 8hrs), they are responsible for any daily visits that need to be done on the weekend plus any additional visits that come up during those hours. Visits that absolutely have to be done after normal hours are done on a volunteer basis based on geographic area--we cover 5 counties so it is a large area--if I get a call and a unplanned visit has to be done, I call the nurse that lives closest to that patient(rarely happens, maybe 1/month). If we have planned evening visits for BID IV antibiotic or PM insulin teaching, etc. we will ask nurses to "volunteer" based on a rotating schedule, usually the nurse living closest to the patient will take the majority of the evening visits needing to be covered. It seems to work for us. I like it because I can use the extra on call pay and I rarely have to go out to do a visit, and the other nurses are willing to go out when asked because they hate being tied to a pager 24/7

Geordi486 · Apr 26, 2009

I am currently as I write this On Call. We work M-F 8-5 with work every 3rd weekend. The week before the weekend we work we have one day off and one day off the week after on a rotating schedule. I have Fridays and Mondays off. We have one night a week on call with 2 nights during the 3rd weekend. RN's take Triage Nurse from 5pm to 8am with .75 cents an hour for being on call with pager. I am not compensated for any calls I field despite some nights being unending and some nights quiet. I do go out for admits and any visits the LPN can't do. The LPN is the nurse that goes out if need be, although they can refuse after 3 visits and they are only given 4 patients the next day along with 2 hours payed respite even if they don't go out. I was originally hired on as salaried but am now payed per visit, it averages out to about the same. I normally stay longer at the office then 5pm it varies from an 8-12 hr day depending on how many admits, recerts, ROC and normal visits I do. Average visit load is 6 and have had up to 9 in a day. We are currently in the works for getting computers which I hope will decrease the time I spend doing paperwork.