NPs ever have to take call? - page 2

Hi! I'm considering becoming an NP and was wondering if it's customary for NPs to be on call. I've tried looking all over the internet and can't find a definitive answer. Thanks so much!... Read More

  1. Visit  BostonFNP profile page
    0
    I have first call every 6th weekend. It really isn't too bad. Nerve wracking at times though
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  3. Visit  BCgradnurse profile page
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    I'm on call one week out of 5. It's phone consultation only, and I usually only get 3-4 calls per week.
  4. Visit  AtomicWoman profile page
    0
    It would be a lot more nerve wracking for me if I couldn't access the EMR from home. At least I can see what meds the person is on, what problems they have etc.
  5. Visit  traumaRUs profile page
    0
    Yes indeed the EMR at home is a lifesaver.
  6. Visit  leahvonleah profile page
    0
    Our primary clinic is looking to transition NP/PA to start taking call but also to incorporate specialty clinics to cover call;
    I am in endocrine so the thought would be to cover patient AND hospital/ER call (DKA patients) 1 week/month.
    My issue is compensation. When asked if there would be additional compensation for taking call, of course they looked at me like I was asking for something unusual.
    When I was hired, the job consisted of M-F 9-5. I know health care is dynamic and ever-changing but what is everyone's experience with this??
  7. Visit  AtomicWoman profile page
    0
    Don't. Get. Me. Started. At every single job I interviewed for, I was expected to take call "as part of the job". And it didn't matter if the pay was salary or hourly! Mind you, I do not cover hospital call, as our practice is a primary care office without a hospital practice. I told my husband that in my next job, I will either (a) not take call, or (b) be compensated for call, or (c) be paid so much I won't mind taking call! I don't know where this trend started, but it's beyond annoying. Sure the physicians take call, too, but they make a lot more money.
  8. Visit  PsychiatricNP profile page
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    I work in psychiatry and the call issue always seems to come up. I am curious how others have negotiated this? Because I am not salaried anywhere that I work, I am always compensated additionally for call. At Facility A, I am paid a set rate ($200) per week of call and then paid an additional amount ($25) for each call that I take. At Facility B, I am paid a lump sum ($400) for the weekend to take call, no matter the volume of calls, it is the same pay. At Facility C, I am paid one lump sum ($2500) for a 14 day period of call (24/7 for 14 days). I am currently in negotiations with another inpatient facility and they are looking for Monday-Thursday night time phone call and I am not sure how to negotiate this or what would be fair compensation for all involved. None of these call arrangements require that I go in and see a patient. Does anyone have any experience or thoughts on how to negotiate the weeknight call?
  9. Visit  leahvonleah profile page
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    I don't even know where to start with negotiations. I'm just concerned if we don't start setting a precedent- it will be expected as part of our duty. Sure , physicians don't get paid to take call, but their compensation historically has been in alignment with the "off hours" duties associated with their profession. I foresee more call expectations as our roles evolve.
    I've been in my role 8+ years and more and more I'm hearing about call.
    Tha ks for the input so far!
  10. Visit  AtomicWoman profile page
    0
    My NP colleagues and I joke that we sure would like to know who started this whole "call is part of your job" thing! Somewhere along the line, some NP(s) agreed to do it.
  11. Visit  AtomicWoman profile page
    0
    Quote from PsychiatricNP
    I work in psychiatry and the call issue always seems to come up. I am curious how others have negotiated this? Because I am not salaried anywhere that I work, I am always compensated additionally for call. At Facility A, I am paid a set rate ($200) per week of call and then paid an additional amount ($25) for each call that I take. At Facility B, I am paid a lump sum ($400) for the weekend to take call, no matter the volume of calls, it is the same pay. At Facility C, I am paid one lump sum ($2500) for a 14 day period of call (24/7 for 14 days). I am currently in negotiations with another inpatient facility and they are looking for Monday-Thursday night time phone call and I am not sure how to negotiate this or what would be fair compensation for all involved. None of these call arrangements require that I go in and see a patient. Does anyone have any experience or thoughts on how to negotiate the weeknight call?
    I am envious that you get compensated. Good for you!
  12. Visit  unplannedRN profile page
    0
    I'm just a prospective NP student, but happened across this.

    I think that unless you are a salaried employee or co-owner of the business (clinic or whatever), or an independent contractor, then you are by definition a non-exempt hourly employee. In that case, USDL law says you HAVE to be compensated in money, or 1:1 extra time off work for taking call--unless you don't get any calls. If you do, and you've already worked 40 hours for the week, or will have by the end of the pay period, then you are in OT and must be paid accordingly. (Typically, holidays pay more, but I don't know if that part is the law--don't think so.)

    Just being available is a gray area with which I'm less familiar. (When I've had call as a nurse, we got a flat-but-low rate for being available, then the full OT rate for any actual hours worked, in 15-minute increments. We kept careful records.) Salaried employees can be paid, but it's negotiable, not the law, that they earn money for after-hours work.
  13. Visit  unplannedRN profile page
    0
    I have to add that NPs should really take a firm line on this, once they decide what type and pattern of compensation seems fair. I have read posts on MD discussion boards where they complain that NPs make a little less, but have no call and no OT, and much lower liability, so what in the heck did they go to MD school for. (Etc.)

    I'm not kidding.

    And maybe that was the way it used to be, almost, back when NPs needed a co-signature for a Tylenol and an MD almost in eyesight at all times. They really weren't ABLE to take call or do much alone. (...as for the "little less money"...well.)

    Those days are long gone, of course. But as APNs become more and more a big and recognized presence in healthcare, that protection from work overload is changing. I've seen NPs making 5am rounds in ICU in hospitals where they don't have hospitalists and the attendings should be there instead. They've told me this is common, and that they are expected to pull a full day back in the office, too.

    As MDs get squeezed harder and harder and rely on NPs more and more, they will naturally be inclined to download as much of the drudgery as possible, without downloading extra money, and real autonomy--not just as 1:1 " just between you and me in our clinic" arrangements, but making it official, by offering APNs support in the legislature, etc.

    This must be prevented. MDs and other providers should be collaborating on how to manage the workload and use healthcare funds wisely, etc....not abusing one another. Please, practicing NPs--learn your rights and stick up for them, for yourselves and for those coming behind you.

    This I know from long experience: It is ever so much harder to take back your power and rights after you've given them away, than it is to get them in the first place. So if you let anything slip by now, be prepared to fight much harder and longer to restore the balance later.

    As an older nurse, I've been a fighter for respect and recognition for nurses for a long time, so some of the freedoms you have now are due to nurses like me. And yet, ironically, if I get to be an NP, I'll be benefiting from the work of those in front of me at that level--like you!
  14. Visit  AtomicWoman profile page
    0
    Quote from unplannedRN
    I'm just a prospective NP student, but happened across this.

    I think that unless you are a salaried employee or co-owner of the business (clinic or whatever), or an independent contractor, then you are by definition a non-exempt hourly employee. In that case, USDL law says you HAVE to be compensated in money, or 1:1 extra time off work for taking call--unless you don't get any calls. If you do, and you've already worked 40 hours for the week, or will have by the end of the pay period, then you are in OT and must be paid accordingly. (Typically, holidays pay more, but I don't know if that part is the law--don't think so.)

    Just being available is a gray area with which I'm less familiar. (When I've had call as a nurse, we got a flat-but-low rate for being available, then the full OT rate for any actual hours worked, in 15-minute increments. We kept careful records.) Salaried employees can be paid, but it's negotiable, not the law, that they earn money for after-hours work.
    Many NPs are salaried, some are hourly. I don't think being either salaried or hourly will "fix" the problem of call being an expectation. You'll likely run into this problem when you get into practice in the future and you can decide how to handle it. As for me, I am getting my magical 2 years of experience as an NP that more advanced positions want. So for now, I take call and laugh and vent with the other NPs in the practice.


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