Call schedule

[americanTrain]

I'm interested in how other LTCF's handle their on call rotations and who participates.

As DON, do you ever take on call for a week in the rotation with other staff for call offs

and make calls to find employees to work that needed shift?

[sls73]

There are good and lazy MDS nurses. I have one now that is only working 24 to 32 of her schedule 40 hrs per week(of her own admittance) and questions why I am asking her to cut her hours. We are a small facility with only 7 on medicare caseload. The ICP team complete their own sections and input them into the computer. They do their own care plans and even assist in the CAAs. She has it made, so while I understand what you all are saying. It drives me crazy that she is sitting in offices chatting and doing nothing while I am working 50+ hours a week. Sorry just venting.

[noc4senuf]

Since we closed my last facility in Dec., I am now at a different one. I no longer have a call rotation as there is not one. I have a Supervisor in the house on every shift. If they need the day off, they trade with another supervisor or call the scheduler to help them. Once in a while they will call mewith a question.

[NurseGuyBri]

Our Administrator is on call to the DON only, 24/7. The DON is on call to respond to the rotating call people each weekend. I know it sounds funny, but it works great. We have 3 on call people - 2 Unit managers and myself, the ADON. We rotate every third weekend. If I cannot handle an issue, I call DON. DON can then call Admin. It's a phone tree to bother only those necessary. Of course, when we have computer problems, they call me directly even when I'm not on call. I guess that's what I get for growing up in the digital age. It is not up to the person on call to find coverage, we just give assistance and help with issues. If we drop below required staffing, however, you better believe we will be calling people in, and if we find no one, we do come in of course.

[NurseGuyBri]

In addition, we do not have someone "on call" to come in during the week for staffing, only for answering questions. That is the DON. During the week if there are scheduling issues, it is the scheduler (a designated Nurse Aide who also does restorative assistance) that will find coverage. If no coverage is found, the Supervisors are to find coverage. We also have 2 LPN PRN staff members and 4 CNA PRN staff to come in as needed (and they get more hours than our regular staff, lol). Not funny..

[Do_Good]

.......

[CapeCodMermaid, RN]

Those nurses on call get $125 extra for the weekend. If they get called in, they get paid their hourly rate.

[TTCubit]

I do not/would not take call during the week; what if state happens to pop in &you've had to pull a night shift the night before??? Just saying....

[NurseGuyBri]

If they do pop in and I've had to pull a night shift the night before, I'd come in anyway, even if I weren't on call. The on call is for shift coverage and executive decisions - to cover the floor. When state comes, we all come in regardless, so being "on call" doesnt affect how we react to state.

[kbarnhillrn]

our DON is never on call to work the floor, but she's there for backup just in case there are two call outs, or whatever else may happen. the call schedule rotates between me (SDC), QI Coordinator, Unit Manager, ADON and 2 treatment nurses. it only puts us on call every 6th weekend, and usually 1 day a week unless it's our week that we're on call that week... it works out well i think! we only call the DON if we can not handle the issue!

[blackjackA10]

There is a nice on-line tool available to manage oncall schedules called miOnCall. You can check it out at https://mioncall.com/

[PammyRN,CEN]

Well I am still on call 24/7 M -F for staffing. There is a weekend on call rotation in place so that helps. I am also in the on call Holiday rotation. I have been doing this for about a year and I am tired. I usually have 2 MDS nurse but am down 1 and have been for 3 months. Big load generally 25-35 Medicare. It is crazy right now. I think when our MDS coordinator comes back it will be able to implement an on call rotation for staffing. I am implementing something. Any suggestions?

[pixie120]

As the DON in a 134 bed facility, I am the only one who takes call. The only time another nurse manager takes call is if I am on vacation. All nurses/CNAs/CMAs must find there own replacement and notify the facility. If they are unable to find their own replacement then they call me. If they are calling off for a shift and I am in the building I will help them find coverage.

I have been in the same facility for 5 years and have worked the floor a total 4 times and never a whole shift. Usually if another nurse cannot cover, a manager will work because this was the agreement that was made with the manangers when I agreed to be the only person to take call.

This may not work in every facility but it works for us. The nurses feel they have more control of their time off because they can switch shifts easily as long as they watch their overtime.

It was difficult at first because the nursing staff felt they should be able to just call off and it would be someone else's problem. We have now been doing it this way for almost 4 years. The nurses take more ownership for their shifts and residents knowing who likes to work which spot and how to cover positions.

Example: I had a nurse whose Grandfather passed away recently and she needed off a week for his funeral. She covered every shift and texted me to tell me who was covering which days including the two shifts she had picked up for another nurse whose grandmother had passed away.

I have to say that Assisted Living works very, very well this way...I tried to implement this at LTC as DNS, got shot down HARD by my Administrator, he claims there is a state law that says I cannot do this...lol. THere isn't it, and since he shot it down, of course, we had the continued bad behaviors... and he was, of course, recently asked to resign... gee, I wonder why? My motto is, if its good for the residents, it's good for the staff and you are so right, if staff are given that opportunity, they make multiple changes without overtime, and fell much more impowered, and the residents get safe nursing, no agency and no struggling manager who has never worked that cart before... I also tell all the nurses I dont' hire the managers to pass pills, so....... funny how it works SO well in Assisted Living, and the med techs are REALLY much more responsible and accountable in part because they have been given a lot of hands on training and guidance, and are NOT nurses, so they don't put on the resistive front that, unfortunately, so many nurses seem to do. It is getting harder and harder to find responsible nurses who don't try to pass the buck and then just pass meds (and ifthey could do that without med errors, I would be happpy, however they do a bang up job of messing up the meds as well, failure to look at PT/INR prior to administrering Coumadin (honestly), failure to notify MD of triplicate therapies like Lovenox, Heparin and COumadin, all given on THEIR shift, BY them..but it must be the RCM's fault.... the list goes on and on. med techs are headed for LTC, so I say, watch out nurses with a fat paycheck and no discernible skill, you WILL be outsourced and it WILL be hard for you to continue to keep your job...and the med techs WILL get paid less..and do a better job....Any suggestions from seasoned nurses on how to motivate bad staff?