Call/Post Call Situation - Need Your Advice!

[heather2084, BSN]

I had a situation arise at work where I had been on call Sunday and worked 11 hours. This is a day of call I signed up extra for, as we have lots of holes in our call schedule. I was already scheduled to be on call on Monday to which I worked from 0630 until nearly 0100 the next day. In my facility, they allow us to have the post call day off, unless we are needed to work. Usually we are told the day before if we are needed the next day or not.

I was not told that I was needed the next day (Tuesday), however my name was placed on the board. Being that I worked nearly 30 hours in two days, and was to get only 4 hours max of sleep before having to be back at work, I left a note saying that I needed the day off, especially since I was not told I was needed the next day. The biggest concern for her was that another nurse in a manager type position had to be pulled to do a case, and that a 0730 start was delayed somewhat.

I then woke up today with a phone call from an unhappy supervisor asking why I did not come into work. She did get the note, but did not seem to care that I would be coming to work with little to no sleep.

I do not see how I can be forced to put my license on the line or compromise patient safety, or how my management could condone that.

And frankly, I'm not sure I want to work for an institution that would want their nurses working in that condition.

I'm curious as to what other OR nurses on here feel about this situation.

[canoehead, BSN, RN]

Sounds like a sick call to me...and you have sick days as benefits. If you approach it that way she doesn't have a leg to stand on.

[buck70]

First, I do not agree with the post calling your situation a "sick call." That is not what sick days are for, and behavior like that is what forces some facilities to make staff use 2 personal days before they can use a sick day.

Second, sounds like there was a communication problem. Maybe it would not have played out like it did if you could have communicated with your manager the possibility of working all night and, then having to work the next day. With your staffing, it sounds like you gambled taking two nights in a row, and lost. I probably would have had a contingency plan for working a lot SUN and MON, and being able to be off TUE..................

Third, sounds like you guys are short handed..................Feel your pain, though. Learn from this, and see managements' side, and just know "call is a crap shoot!"

Hang in there.

[shodobe]

Well buck70, with only 7 posts I assume you have very few years as a OR nurse? Looks like you will become an excellent middle management drone. I agree with you in only one aspect, yes you do take chances with taking on extra call and could really get screwed and pay for it. I take call almost every night and have done this for a very long time and have come back to work even after working 20 straight hours. I think is ridiculous for a supervisor to EXPECT a overwork and overtired individual to come back for shift work. I think both sides could be a fault because #1, the facility allows someone to be off unless they are notified they are needed. The nurse in question assumed they would be off because they were not told they were needed. On the other hand, the nurse maybe should have called and spoke to her supervisor. Who really cares if a supervisor has to put in some real work for a change and get their hands dirty doing real OR nursing care. I would have called off if necessary, but where I work we have understanding managers who wouldn't want you there. It has never been an issue of, you took the call so you have to pay for it! Stupid way of thinking. Be safe.

[GadgetRN71, ASN, RN]

Our OR manager allows you the day off if you get called back in the middle of the night and you work days..she's usually very good about sending you home early if you have a family or personal issue, or if you are ill. Hospitals have to realize that having someone work while exhausted is asking for a BAD error to happen...plus, it's bad for morale.

I'm also not feeling much sympathy for the manager that actually had to do a case.Cry me a river! I run the board on my shift and I also circulate rooms.

[humblecirculator]

This sounds like a bad situation to be in. It was valiant of you to sign up for that extra call, but like a few others have mentioned, it is sort of a crap shoot. You take a risk of sorts when you sign up for extra call. From your post, it also sounds like there was a break down in the lines of communication. As a responsible member of the surgical team, both you and the supervisor need to relay information to one another

and make sure that you both understand what the other is saying.

I do agree that it is extremely unsafe to work with a severe lack of sleep and I think that is it unfortunate that this supervisor did not seem to think or care about that.

Perhaps in the future, if you are thinking about signing up for that extra call and you will be on call for 2 or more days, you should have a conversation with your supervisor regarding the post call.

Good luck!!

[buck70]

Well, shodobe, with your many years of experience, I shouldn't have to mention what comes to mind when someone "assumes." I've experienced my fair share of **** poor management, in my humble 15 years, working in the OR; however, I never used "calling in sick" as a form of retaliation. My prior post was, mainly, set off by the posting that mentioned the nurse should have called in sick. I was simply trying to make a point, that communication could have been better, and that leaving a note, stating you need the day off, is poor form.

[buck70]

Also, heather admitted to only 1.5 years experience, and I was simply trying to set a good example. However poor the communication was, her name being on the board, and her being assigned a room, was telling her, possibly in a passive way, that she was expected to work. I'm not saying this is okay. I'm very aware that working while fatigued is compromising patient safety. I'm also, in no way, taking up for the manager that had to "work."

[shodobe]

Good answer. Good communication will always save your butt when things get dicy. When you take extra call, ALWAYS expect the worse because usually that is what will happen. I take sometimes 6-7 days in a row of call, including weekends, but we have a soft call and usually never work alot. However, there have been times over the years where someone, including myself, will end up with the "call from hell!" and regret taking so much. This is far and few and most call nights are very quiet. larger hospitals are the worse and will get pummeled over and over again. This is why you see alot of notes asking for someone to "please take some of my call"! Most people will learn and not volunteer to take extra call. Live and learn.