Changes to On Call Job Description - page 3

by pixiec11

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Hello, I am a full time, salaried, on call nurse for hospice. We have one on call nurse and one back up nurse that we can use if we are on another call. I like the job, but am nervous about "changes" to my job description. My... Read More


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    Wow. I read every thread and have come to the conclusion that I am working for one of the bad ones. The comments about how we are degraded/demoralized really hit home. This is truly sad. I've been at it for ten years and kept hoping it would get better, but it gets worse every week. I'm happy, though, that some of you have rewarding positions. As of this minute, I am going to find one!
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    Quote from pixiec11
    Oh my... I imagine nurse turnover rate is really high there. I know our day nurses already work 45-50hrs/week just managing their caseload. I am sure if on call was thrown in there many would leave quickly.
    I am a new grad with previous hospice experience at an inpatient unit. I just started at a new company as a full time case manager. I am working 9-10 hour days and will be expected to take call one weekend a month from fri at 5pm until monday at 8am, and also about 2 days per week from 5pm until 8am. Plus we dont have a admissions nurse so we have to do admissions too. I am cringing and wondering what I got myself into. I am exhausted after 10 hour days, even 5 8 hour days would be exhausting in the heat here in nevada.

    I love hospice so much, but I am thinking I might have bit off too much here, the on-call might be more than I can handle. I am bummed because the money is good, but I am so darn exhausted after work all I can do is shower and veg. My quality of life has dropped off.

    If I can hold out for 6 months or so, I am hoping to find a company with a different structure. Darn new grad status!
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    Quote from Geordi486
    And we take call at .75 cents an hour 5pm-8pm nothing extra for actually fielding the calls. If I have to make a visit I get a pay per visit fee.
    75 cents per hour? OMG! I'm an LPN and I take call every other week (weekend included) I get $3.00 per hour for call plus mileage, travel time, and per visit rate for any visits made. Most weeks are pretty quiet because we all take care of our pt needs during the week (meds, supplies, teaching, etc). I may get one or two calls during the week and occasionally a visit has to be made. There's no way I'd be willing to take call for 75 cents.
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    After reading these posts..I'm thinking maybe our call nurses are not being fairly compenstated..here's the deal..7 days on, 7 off - call being M, Tu, Wed, Thur 5p-8a then Fri 5p-Mon 8a. If there is a holiday then call team is on call that 24 hrs. Admissions any time - sometimes several after 5 p.m. Usually 3 nurses on call. census about 200 covering 22 counties - patient must live no more than 50 miles from office but this is pushed sometimes. No extra pay for going out/admissions/deaths, mileage is reimbursed. Hourly rate $17.00/hr.
    Is this a fair rate? Am thinking for the time they put in maybe not.
    Thoughts?
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    My reason for coming to this topic is to get a feel for hours and compensation for on call nurses in home hospice care. I am especially interested in current data to learn how it works in different agencies. There are 2 RNs that share all the on call time. The positions are salaried, The present structure at my site is 2 overnights (5pm to 9am) and Friday 5p through 9a on Monday every other weekend. On paper, to the uninitiated, it looks pretty good. In reality, it is exhausting! The management is willing to listen to suggested alternative hours which is the reason for my search. I am so hoping to be able to come to some kind of schedule which will allow us to give the quality care our agency is known for and will enable us to be safe, rested responsible practitioners while we are on the job. Presently, on weekends we have no scheduled time for sleep. We have on average 75 patients. Case managers work one weekend "shift" every 4-5 weeks which is mostly for admission visits. I agree with my peers who wrote that it is impossible (and not patient/consumer friendly) to do admissions while on call. It is often possible for the nurse to ask administration to take calls while but not always. The leave policy for on call is "pro-rated" as was described by others here. As some of the posters from the early 2005,2007, noted, when they learned what other jobs entailed, they perceived it was maybe not so bad where they work. I think it is essential in 2011 to be sure we are fairly compensated for the hours that we work. be it in the car, patient home, listening to report or waiting for the phone to ring - it is all part of 24/7 care. I love what I do - have been in community nursing for over 30 years, both in home care and hospice. I hope we can support each other to be compensated at a fair, professional level for the essential work that we do. Thanks for reading and please comment if you have the time and inclination.
    KristaKay likes this.
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    I work in a small town in texas and have the unfortunate experience of "bad management" also. We have 2 full time nurses that "do it all" for a patient census ranging from 18-30patients. We have had* 3 nurses at one point but had one position taken away once one of our nurses moved away. I am the senior nurse as far as time spent with the company and even in my 3 years have seen over 5 nurses come and go r/t poor management and poor job description. Lately we have been bought by a larger company and the situation has become even worse. It is directly related to management and I assume it is the same for everyone else who has managers that just "dont get it". We do have a PRN nurse who will pick up 8 days of the call but that still leaves me and the other nurse splitting the rest of the call per month plus full time 8-5 duties including IDT and complete patient care. On-Call pay is $3.00/hr and we are expected to do all visits,admissions, take all call and all crisis care during the weekends and time we are on-call and then return to regular duties on Monday AM to resume the care of our 20+ patients. I wish hospice had a union that would help us take care of these issues because I love my job and feel called to do it but I just dont see it getting any better....and worse quite fast to be sure. oh, the latest "sucker-punch" for us has been that after they got rid of our third nurse they told the other nurse and I that we would be "responsible" for any overtime we accrued and have been hounding us ever since the third nurse left and we have had overtime. These people just dont get how hard 0n-call is and what all it takes - not to mention direct patient care of someone on hospice who is dying and has multiple family issues (family is a patient too in hospice and sometimes we have 4 or more per patient). it is definitely a full time job in itself and I just wish we had other job opportunities in our small town or a union that could set the bar - so to speak. Forgot to mention with previous hospice experience I get $25.75/hr and time&1/2 for overtime. $3.00/hr on call (usually 100+hrs of call every 2 weeks and lately working around 90-100 hrs every 2wks regular)
    Last edit by KristaKay on Oct 12, '11 : Reason: update
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    I think our situations are very simular. I have the unfortunate circumstance of having a terrible manager. I hope things get better for you
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    I quit my job a little over a year ago for exactly the reasons you site in your post. I was with the company 10 years, and the last three were literally *#ll on earth. I kept thinking it would get better and I wanted it to get better.... but it just got worse. They started firing senior nurses and I saw the writing on the wall...I took early retirement before they had a chance to fire me. There were some really talented nurses... as well as our medical director that ended up in the ER with cardiac symptoms, GI symptoms, etc. Not good. All were stress/fatigue related. It took me almost a year to recover physically and emotionally. My heart goes out to you and I hope you find the answer that is right for you. I am now reconsidering retirement and am toying with the idea of working only part time...but I will never again put myself in harms way....
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    Thank you Indianahope, I find myself in your position..hoping and waiting for it to get better but it just gets worse. I think our company has pretty much hit rock bottom as all of our CM have quit with the exception of me. I have my applications out and am praying for another hospice job with a larger company that services our rural Texas area but those jobs are few and far between. This whole situation saddens me to think the people who are dying are being let down for the cost of a few extra people on staff to fix the issue. I just wish the pocket books were deeper for the right reason but my hope has about run out. It's sad to think back on how on-fire I was when I started this job 3 years ago and how far I see the company falling and the staff and patients being let down time after time.


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