on call rotation

Specialties LTC Directors

Published

My admin wants me to try an on call rotation for the staff nurses to keep the floor covered. I have worked in several types of nursing settings that used this solution, but that was years ago. Do you use this at your facility and how has it worked out. I know if I try to institute this, the nurses will have 10 fits. When I did on call as a staff nurse, we were to be available that day for the staff should there be a call off. If we got called, we were responsible for calling staff to get the shift covered. If we could not get it covered, we had to go in ourselves and work it, be it a nurse or cna who called off.

Up Vote Up Vote ×
Specializes in LTC, Hospice, Case Management.

When the schedule is put out a little "M" sits behind a CNA and a nurses name for every shift. These are the mandated staff. If someone calls off and it can't be covered, these are the staff that is expected to stay and cover it. The little "M" rotates thru everyone. Although no one likes it (and who would) no one really complains either. It is as fair a system as any and at least you have some advance warning you may get stuck. Actually everyone is usually pretty good about trading around their "M's" to suit their own schedules best.

We are having a snow storm here. Both the 3-11 aide and nurse came on duty carrying an extra set of clothes. No one told them to do this, we just all know how it goes.

Up Vote Up Vote ×

We are a small 68 bed facility and rarely have any call-offs. The LNs on the floor manage the call-offs and if they are unable to replace, they call the DNS -me. If I cannot come up with other ideas during the week then it is me - for LN coverage - I don't work as a CNA but I have gone in to assist with feeding, etc. I do have 5 Nursing Managers and we share weekend call from Friday at 1330-Monday at 0530. If we nursing managers can't replace the call-off then we go in and work. The 5 Nursing Managers are the DNS, CMC, SDC, MDS Medicaid RN Coordinator and the Day Shift Supervisor. All 5 of us have every weekend off so it really is not a problem for us to be on call every 5th weekend. Each of us probably works an average of 3-4 shifts per year which is manageable. We do have a small pool of CNAs that work part time and are good at picking up call-off shifts. The nursing managers are not always happy with taking call but I cannot do all of it plus the DNS in Idaho should not be working the floor if the census is 60 or above.

Up Vote Up Vote ×
Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

Just be careful. Make sure you look at the labor laws, I mean if you are requiring someone to be on call and stay near the phone or being available, what are the laws concerning this where you work? They may have the right for some type of reimbursement regarding the on-call status whether or not they are called in to work. I ran into this once and we had to start offering an on-call rate which became a total nightmare....I think it turned out to be $25.00 for being on call for each 8 hour shift. We then had to change it to 12 hour shifts because it was costing us a tidy little sum... If you are not paying them or have some type of contractual agreement as far as being required to take call then they do not have to be available. Salaried persons are exempt from this I think because it is usually in the agreement for a salaried position. Just check. You dont want to end up in some labor fight down the road. Oh yeah, the staff got the 25.00 for being on call plus whatever their rate was when they had to come in to work...then there was overtime...ugh....but sometimes you have to bite the bullett.

Up Vote Up Vote ×
Specializes in LTC, Hospice, Case Management.
Just be careful. Make sure you look at the labor laws, I mean if you are requiring someone to be on call and stay near the phone or being available, what are the laws concerning this where you work? They may have the right for some type of reimbursement regarding the on-call status whether or not they are called in to work. I ran into this once and we had to start offering an on-call rate which became a total nightmare....I think it turned out to be $25.00 for being on call for each 8 hour shift. We then had to change it to 12 hour shifts because it was costing us a tidy little sum... If you are not paying them or have some type of contractual agreement as far as being required to take call then they do not have to be available. Salaried persons are exempt from this I think because it is usually in the agreement for a salaried position. Just check. You dont want to end up in some labor fight down the road. Oh yeah, the staff got the 25.00 for being on call plus whatever their rate was when they had to come in to work...then there was overtime...ugh....but sometimes you have to bite the bullett.

This seems to vary by state labor laws. Back in the day before cell phones were common, I would get stuck on call for a weekend every 4 weeks. I was expected to basically stay home and wait for the land line to ring. I threw a fit and got no where - basically told "part of the job. Take it or leave it". Then I called labor department and was told they were perfectly free to get away with it and it was my decision to take it or leave it.

Some states will be different.

Up Vote Up Vote ×

I have doen call rotation a couple ways. Currently I rotate call with 2 Clinical Coordinators and if a need can not be met the person talking call covers it. I have also worked when all RN managers rotated call and our on call weekend we were required to come in for 4 hours each day. In return for that we took the following Friday off and had a nice little long weekend. I kinda liked that come to think of it :lol2:

Up Vote Up Vote ×

We only do on call rotation with nursing management salaried employees. Labor laws here say that hourly employees have to be compensated for call time even if they don't get called in.

Up Vote Up Vote ×
Specializes in ED/ICU/TELEMETRY/LTC.

We have DON, CSC, SDC, NM, all salaried taking call. We also allow (read, beg, plead, cajole) to sign up for call. We only get $25 bucks a day. The PRN nurses are very good about taking call. I only have two days call for the nest 5 weeks.

Up Vote Up Vote ×
Specializes in Gerontology, Med surg, Home Health.

We have an on call rotation. 4 nurse managers, the 2 admissions nurses, 2 MDS nurses, SDC, and 3-11 supervisor. So they are on call once every 10 weeks. They are all salaried but get paid extra to be on call. It's usually helping to find someone to come in if there's been a callout. If they can't find anyone, they go in and then take another day off. Usually I get all the clinically oriented calls whether it's 9 am or 3am so I am not on the on call rotation.

Up Vote Up Vote ×
Specializes in geriatrics.

I am always willing to pick up a shift now and then. We do not use on call, and most facilities that I know of don't either. I would be looking for another job if on call was mandatory. No thank you. The only time we can be mandated is in an emergency.

Up Vote Up Vote ×
Specializes in Geriatrics, WCC.

we do not use an on-call rotation. I have RN suprvisors in the building around the clock. If they have a question, they call me. I get maybe 5 calls a month. If they can not reach me, they call the NHA.

Up Vote Up Vote ×
Specializes in Gerontology, Med surg, Home Health.

Our consultant (read queen of all) has decided we don't need managers or supervisors since "what do they do?". Really?!!? Apparently it's been more than a while since she actually spent time on a nursing unit.

Up Vote Up Vote ×
+ Add a Comment