NPs ever have to take call?

Specialties NP

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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!

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!

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. :)

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.)

Not sure what geographical area those MDs are from, but around here NPs start in the low 90s and MDs start at a minimum of $150-160,000, depending on the employer and the specialty. That's a pretty big difference in salary. And as you can see, we certainly take call. And we certainly work lots of hours. Probably makes the docs feel better to grumble.

That is my point precisely. The other endos in clinic salary is significantly more than what I am making. I know the newest is at base of $160k + bonus. I'm at mid90s no bonus- now with a proposed 50% call- which would be one week on, one week off

No thank you!

But, as previous posters have said, it is going to become more commonplace with more NP & PAs - we need to figure out a way to negotiate better salaries to be in alignment with our professional expectations.

I am a veteran NP w 8 yrs experience- the administration is not looking at that- just how they can better serve the patients and themselves!

As a clarification of above - I'm here to serve the patients as well but feel our salary should be commensurate with the responsibility and level of care we provide

My patients always ask- "why didn't you become a md" my response was because I enjoy what I do and I can go home at night and enjoy my "off" time the way I choose.

Now that will be changing....

Administration is quite busy comparing cost/expense but I don't want to see it get to a point where our roles are being taken advantage of- that is when our role will suffer.

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