New On Call procedure. Need ideas, suggestions - Page 2

Oh hell no. That's my reaction, and I can almost promise that will be the reaction you will get if you implement this without speaking to your nurses first.

At my facility we are all (from the ADON, MDS nurses, unit managers to floor nurses RN and LPN) on call one day per schedule (about a month). I hate it. It's the worst thing about my job.

However, it's still better than being worried every time I come in that I'm going to be forced to stay late. Or waiting at home for a call that I *must* come in early.

Floor nurses don't get paid the big bucks for that type of aggrevation.

I don't think the 4 hour forceful stay is convenient for the nurse on duty, nor the nurse who is coming on duty. You don't want to be in the facility 7 days in a row. I am sure the other nurses aren't going to be pleased with being forced to work overtime. You also may want to check the labor laws on this issue. Your staff morale will go down, and turnover will increase. Thus, this is going to cause the execs to become involved in the issue, as hiring new staff is never inexpensive( especially nursing staff).
The DON & yourself should look into contracting with an agency or possibly hiring a PRN nurse( possibly 2 if budget permits.) in the end, you will save your department money & time.
If the PRN staff is not an option, arranging for a call in list is the best solution. You can arrange for each nurse who has had 2 days off during the week to be on call each week in rotation. Do not exclude yourself and the DON. You don't want to create a separation of hostility in the environment.

Management calls for creative thinking, not convenient to myself thinking. By the way, during the summer months you should expect higher call out rates. It's summer, after all.

PRN staff can't be an option surely if they don't know the area??!!

With situations like this, it's not only the extra time demanded but the uncertainty involved. How do you plan for child care or transportation or school on such short notice? Of course, you can't. And that's the kind of thing that infuriates people who are otherwise loyal and somewhat willing to be flexible.

I suggest hiring a pool nurse or two or having everyone cover a pre-arranged on-call period (so long as it's not too often) that they can plan for ahead of time. If they know that on such-and-such a date that they'll be covering a shift, they'll be able to arrange for their personal needs when they're not under the gun. This is the difference between mild grumbling (taking call) and red-hot rage (get dumped on at the last minute).

If there are some who want extra hours, they could certainly list themselves as more available than others. This can come in handy when there are times of lower census and folks are looking to make up lost time.

I hope that you would also be taking a look at people who are repeat offenders or who seem to cause more than their share of last minute disruption.

Whatever you do, please, don't go with your proposal of mandating one nurse to stay late and another to come in early. Staff members often have others depending on them and may not have workable last minute options available to them or their family members. Surprise mandating is the kind of thing that makes people look for other jobs, even if they're reasonably happy otherwise.

oh geeez when i worked LTC our ADON would pretty much bully us into coming in to cover call offs. if we said no, we knew we'd have a crappy assignment for the next week. She assigned nurses each and every day to what hall(halls) they would work. Needless to say it didn't take too long for me to burn out and leave. :bowingpur

I worked at one small, 'Mom & Pop' type LTC facility that had a very good reputation. As we didn't use agency, it had a really workable solution to overtime. They would automatically pay DOUBLE-TIME if any nurse covered an unexpected shift (one that occcurred with less than 24 hours notice). Automatic DOUBLE-TIME - no questions asked, no authorizations needed, no payroll screwups, no begging, no threats, etc. Just automatic DOUBLE-TIME. It was their way of saying thank you to the staff for helping out in a short-notice pinch.

We would just volunteer to cover the shift. We all felt that it would be just as easy to do the same job for double time as it would be for straight time, and we all liked the little occasional extra $$$. It was never abused. There were certain nurses who especially liked to do the OT, even to be called on their days off, if nec. Some gals even had overnight bags packed in their car trunks with extra clothes, toiletries and some non-persihable snacks. I worked a couple of long ten-day stretches a few times. Yeah, I was tired, but the OT was nice and I felt appreciated and respected to help out. This was explained to me when I interviewed. No surprises.

It worked with that administration. When a new LNHA came in, he abolished it - felt we 'had a racket going on' among the staff. Needless to say, morale went down; staffing became problematic, our state surveys toilet-tanked, private census decreased, etc. Interesting what happens when staff appreciation becomes non-existent!

I wouldn't go for an extra 4 hours on my shift and I would quit if I had to stay extra everytime someone called out sick.

I've VOLUNTEERED a number of times to stay over 4 hours when there was a call in. Being mandated to stay? No way in Hades would I go for it.

Oh I have to stay over today for 4 hours, put my personal life on hold. No problem be glad to. Next day guess what I'm calling in for the whole shift, expect I'd be job hunting. Some nurses enjoy extra time especially when we choose to work it or are asked, but don't tell me I have to due to a call out. You are management find someone , or you stay the 4 hours. This would not work/fly with me.

Sorry posted wrong.