Call in systems

It probably won't help much in your facility, but the way it works at my hospital if someone calls in...

1. See if census allows the person to be off with no replacement

2. go to float pool

3. Pull from another floor that is over

4. Call nurses offering OT that work the floor

5. Call float pool offering OT

6. Work short or the unit manager has to come in. If the unit manager is already there she works the floor instead of doing her duties. (rarely happens, but it has been done)

I no longer work on the floor but in a small department that provides coverage for our patients 7 days a week. If someone calls in sick through the week (like I did last week for the whole week after I had my wisdom teeth out), everyone just pulls together and gets the patient care done. If it's the weekend, usually whoever is scheduled knows they are probably not going to be able to work and someone steps up and works the weekend or they split it up. A couple of years ago, one of my coworkers had been out for several days and her weekend was coming up. We lined up who was going to work when on Thursday and four of us arranged to each work a half day Saturday or Sunday. Fortunately, she was able to come back to work Friday and work her weekend.

Is there a way you could split up the call? i.e. Betsy (day shift) is on call Monday 3-7, so if someone on evenings calls in she stays over. Sarah (night shift) is on call Monday 7-11 so if someone on evenings calls in she relieves Betsy four hours early. I don't know how many people you have working there and how popular that would be, but everywhere I've ever worked there's always someone who'd like a little OT.

You need more staff if one call in causes this amount of dislocation. A paid on call program may be helpful, plus staff that are willing to help when call in occur. At least call iins that are legitimate and not just because....

Nursing unlike inventory, can't be just in time. Call ins are a cost of doing business and need to be budgeted for and planned for. Having 1 person having 24/7 responsibility is not good business practice nor is it a long term viable plan.

You need more staff if one call in causes this amount of dislocation. A paid on call program may be helpful, plus staff that are willing to help when call in occur. At least call iins that are legitimate and not just because....

Nursing unlike inventory, can't be just in time. Call ins are a cost of doing business and need to be budgeted for and planned for. Having 1 person having 24/7 responsibility is not good business practice nor is it a long term viable plan.

OP stated she works in a SNF. This is standard procedure in SNFs. Acutally, most SNFs don't even have that much. Usually its call everyone in the facility to see if someone will stay over, or if someone will come in. And sometimes they just work short as no one will come in, and no management will work the floor.

when i worked at a SNF years ago, if we called in sick, we would have to find our own replacement! Not very practical at all.

At one hospital I worked at, we would sign up for a 4 hours slotted time at least 2x per month; this would NOT be in addition to the 12 hour that was just worked, it was on a day that we would normally have off (management frowned upon working over 12 hours in a shift). So once in a while, we may get called in if someone had called off, but it was only for a short shift. Everyone seemed happy with it.

I understood the OP was talking about a SNF, Bad business practice is still bad business without regard to the type of business. Just because most SNF do this, or it is accepted practice, doesn't make it right. (I have been involved with plenty of SNF).

Thanks for taking the time to reply guys, keep the suggestions coming. I agree it is bad practice to have a singe person on call 24-7. And not just b/c that person happens to be me, lol. I am really feeling the stress, even though I generally have a good staff that don't call in. I have multiple hats to wear, as I don't have an SDC, ADON, supervisors, etc. I have an MDS nurse, and that is it. BTW, we currently have 101 resident, 55 skilled and the rest are rest home LOC,