MDS Coordinators on call question - page 2

]Good Morning! Got a question for ya'll MDS people out there.. ]Do you all have to take staffing call? ]Week at a time,just weekends? ]Do you find it to be nerve racking and horrible? ]Just... Read More

  1. by   chaotick
    I'm an MDS coordinator in 80 bed facility/10-25 Medicare A (rehab) and lots of finicky families to keep happy. I have been required to be 'on call' in a rotation every x-th weekend with various other facility RN's since about 1 year after I started working there.

    Currently weekends are alternated between myself, assistant MDS coordinator (also an RN - she gets a lot of other duties dumped on her (Restorative Nursing, Dining room duty, and (eyeroll!) doing pedicures with the Activity Director on Tuesday afternoons) (our owner/administrator thought it would be a good way to do regular foot assessments... sigh) because she's not 'the main MDS coordinator'), the evening shift treatment nurse (an RN imported from overseas for a 2 year contract in exchange for Green Card - i.e. indentured servant), night shift RN (ditto to treatment nurse - she took over my old position which had been unfilled after I got 'promoted'), and the SDS nurse (education and training) nurse (older than dirt RN and cranky as cranky can be...) -- so every 5th weekend.

    It's been as little as every other weekend (when cranky SDS put her foot down... and we had yet to import the current crop of indentured servants) which got REALLY old - I almost missed my younger daughter's high school graduation but one of the floor LPN's took pity on me and covered a Friday night 2nd shift callout so I could go...
    ...
    DON and ADON (also RN's) cover weekday evening/night call - somehow only the ADON ever has to actually come in and cover for a callout...

    I think the DON would probably see things a whole lot differently if she had to work a night shift and then do her regular job, too (we technically get 'comp time' - DON, ADON, SDS, and I are salaried... the other 3 are paid hourly... since all but the two foreign nurses have 'flexible' job specs - even if we do take 'a day off' - the work is not done for us while we are home 'relaxing' - so we have to somehow make up for lost time anyway.)

    On call pay is $75 a night (if the weekend covers end of month/beginning of next - we're paid twice monthly - they split it up on two separate paychecks!!!) If we don't take comp time we get a flat $150 for each shift we have to work... but we're constantly told how tight their budget is and so we are encouraged to do the comp time thing... which ends up being not at all - unless I'm physically exhausted because... as I said ... I have to do the work anyway even if I'm off...

    I also have to cover for CNA call-offs if we drop below 'minimum staffing' level. I haven't worked the floor since I took over as MDS coordinator and it's been even longer since I had to regularly do CNA duties... so I end up giving almost criminally substandard care if I do have to fill in... I had to work 8 pm to 8 am plus the other weekend... on short notice (i.e. no sleep) due to a couple of unexpected injuries combined with (chronic) lack of 'spare staff'. We are not allowed to call agency (at times I've considered offering to pay for them out of my 'on call pay'... I know, I know... I wouldn't - but it's tempting given the stubborn as a mule-like attitude of the owner/administrator... the joy of being a family owned facility). I worry I'm going to make a bad med/care error as a result - and so I marched into the DON's office last Monday and said I was getting too old to take call and wanted off the rotation until staffing levels improved. She laughed and said a) Tough - it's part of an 'administrator's' job description to share 'on call' and b) if I knew of a way to improve staffing levels I was welcome to let her know... I like her a lot and she's one of the main reasons I put up with the crazy owner instead of looking for another job.

    Oh well. I wouldn't want her job for all the money in the world... (the owner/administrator is even harder on her) and it IS only one weekend out of 5 (and - yeah - I do sometimes luck out and don't even get a phone call - for example at 10 pm on a Sat. night saying they have a broken call light cord, no replacement where there's supposed to be a spare - and what do they do...)(the head of housekeeping/maintenance - theoretically also on call at all times... somehow always manages to have a non-working cell-phone number... and I live 5 minutes away and they know I'll come...)( A) cut the switch off the end of the cord - plug into the socket in an 'empty' bed (to silence automatic "hey someone pulled the call light out of the wall" emergency signal) - and use the functional cord to replace the broken one... B) leave somewhat obnoxious 'work order' for head of housekeeping/maintenance to repair cut cord on Monday since they somehow can't be bothered to have a working phone number on record... and C) Cross fingers that I don't get written up (again) for being a smart-ass and not following the 'chain of command')
    Last edit by chaotick on Mar 5, '08
  2. by   nratchet
    You poor thing. I hate taking call but atleast I'm not expected to do all that even if I'm not paid for it. I think I'd be looking for a new job.







  3. by   JanM82
    At my facility I have recently been approached about being on call for the weekends along with the DON and two other nurses on the MDS team. My concern with this is I have worked there 6 years without orienting to the floor and I don't feel comfortable and am very "rusty" with floor nursing. I did recently attempt a couple of shifts and was very slow. It was awful, honestly. I hate to do a poor job at anything. Now I know that I would get faster if I worked more often on the floor, but quite honestly, that isn't what I want to do. I've been told I can take comp time if I work the weekend but we all know our schedules don't often allow for that. One more thing...we won't get paid for the "on call" time unless we actually have to go in to work. I do feel for the DON who often gets called in to cover call ins but I wish that they would enforce attendence policies that are already in place so that the call ins decrease. We'll see what happens. We haven't actually set up an on call schedule YET. :uhoh21:
  4. by   noc4senuf
    I , as a DON, am on-call M-TH each week and every 7th weekend. No one can afford the time off during the week when we do have to come in to cover a shift. We are ALL busy with our own jobs. I average 2-3 shifts per year where I need to come in. That is not asking much. Yes, I am extremely slow and rusty when I work the floor. But, it is something we who do take call need to suck it up and take care of our residents.
  5. by   JanM82
    For me it's not just a matter of "sucking it up" when it comes to working the floor. I believe when you're passing medications late and running around like a chicken with your head cut off because you don't know where everything is that it isn't really the best solution in caring for our residents. I don't believe that it really is safe for the residents. They deserve better. I would be working once every fourth week because there was one nurse who called in almost every weekend. I'm not opposed to working hard and taking good care of our residents. My problem is that we don't enforce current attendence policies thereby cutting down on call ins and then we ask staff who aren't trained to work the floor to jump in. I'm not opposed to working hard, I've come in and worked as an aid without complaint. Now that's hard work! I just don't want to risk resident safety and my license.
    Just my thoughts. Maybe I'm the only one.
  6. by   noc4senuf
    Jan, completely understand what you are saying. I enforce the attendance policies to the hilt and there are always those that are going to call-in. That is why there are multiple people I let go each year due to attendance alone. What I also enforce is.... if you call in on your weekend to work, you will be making it up on your next weekend off. That usually curbs it right there. But, we just dealt with a run of the gastric flu at the beginning of Feb that affected staff and residents, and then at the end of Feb we had the respiratory flu in-house. Of course don't for get when I have a staff person that is also an immigrant and they come at the last minute and want a two month leave to go "back home" and have already paid thousands of dollars for their whole family's plane tickets.

    It's always something, that's why even though I am rusty on the floor, getting the meds somewhat late is better than not having me at all and they work extremely short. Didn't mean to offend you.
  7. by   JanM82
    No offense taken really! Just trying to explain how I feel about being on the floor and not really properly trained.
    Our DON was not enforcing policies, there were no consequences for this particular nurse who called in three out of 4 weekends. Plus this nurse works every Saturday because she has requested every Sunday off and has found someone to split the weekends with her. So every weekend was a problem.
    I know that staffing is always a problem, especially in SNFs so I do feel for the DON. I'm really torn about the whole thing. I am the type of person who hates to say "no" to anyone and I want to be supportive, that's why I have tried to staff. But it was just so stressful for me that I'm not sure I am willing to do it again. I actually prefer to resign.
    We shall see what happens.
  8. by   edhcinc
    Some facilities/corporations have "pulled" the MDS/PPS coordinator out of the nursing department. This role reports directly to the administrator, and would be "on-call" for administrative coverage on a rotating basis.

    We all know that the PPS coordinator who works a Sunday evening/night double shift the first weekend of the month will never be able to complete his/her assessments accurately on Monday morning for the monthly billing deadline!!
  9. by   JanM82
    Actually I do report directly to the administrator. But we are a small facility and I think an RN is an RN is an RN if you know what I mean. We're all fair game.
  10. by   Tarong50
    I have weekend call every 4-6 weeks. Not too bad, can usually get more work done on weekend without all the upper crust around.

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