Call Scheduled for Medical Unit Nurses?

[Nik.S.RN]

We have made the decision on our combined unit (med/surg, tele, icu) to have a nurse on call every day, for 24hrs. I believe in a 6 week schedule it works out so that the nurses are only on call 2 times in the 6 weeks. We are on 12 hour shifts. Does any one else out there have RNs on call for medical departments? Of course they wouldn't be scheduled to work the day after their call shift, in case they had to work the shift.

We often have ebbs & flows of low census and high census days. Nurses are put on call on low census days, and in that case the "on call" person would only be on call for the next 12 hr period, or called off completely if low census for the 24hrs. We have some teamwork issues, and often the same 3-4 nurses, the "reliable ones", will fill in the gaps. We are hoping to avoid burn out, promote teamwork and reliability, and create a sense of accountability to each other. How did you work it out, what has worked and not worked for you? Thoughts?

[SoldierNurse22, BSN, RN]

We have nurses on call 2-4 times (12 hours shifts) in a 2-week period. It's horrendous. Is there no way to incorporate per diem or PRN nurses into the staffing mix? Do you have a float pool?

Would the nurse on call be expected to work the entire 24 hours? Would the shifts be rotating? I cannot imagine that I'd enjoy being on call all day and all night, especially if I were called in to work on the opposite shift. I'd suggest putting people on call for 12s based on the shift they are currently working (night shift on night call, day shift on day call) OR to pull up the old low census roster and see who was sent home last and call them in.

Scheduled on call is very limiting. Try to keep it to a minimum. In my experience, on call doesn't tend to improve unit cohesiveness...only breed contempt.

[brillohead, ADN, RN]

I agree about only being on call for your normal shift (days or nights).

A 24-hour on-call sounds horribly problematic, particularly for those who have transportation or childcare issues that they have to schedule around.

[wanderlustnurse88, RN]

We do an 8 hour on call shift 1-2 times in a 6 week schedule.

Since it's not the summer, this is how we are staffed.

ER on days has 2 RNs 07-19, 1 RN 11-23, 1 RPN 09-17 for a 8 bed ER (2 trauma rooms, 1 isolation room, 3 stretchers, 2 exam rooms).

ER on nights has 1 RN 19-07, plus the one RN till 23.

Acute care on days has 1RN and 2 RPNs for 14 beds. On nights there is 1RN and 1 RPN.

The on-call shift is 23-07 to cover in the ER if needed or go out on a transfer. We just started this on-call oration and I've been on four times and haven't been called in.