Can hospitals require you to do "extra" on-call shifts?

Can hospitals require you to do "extra" on-call shifts? We've been asked to start doing a "Back Up" call weekend in addition to the "1st Call" weekend we already do. That means twice as many on-call weekends. Some of the younger nurses are threatening to quit because they don't want to do the extra call. 

[toomuchbaloney]

Overtime Mom said:

Thanks everyone. We have become a regional hub for out lying smaller hospitals and are getting acute GI Bleed and ERCP transfers. Sometimes more than one nurse can handle, therefore the backup call "just in case".  We only take call every 12th weekend now so one extra back up call would not be so bad. I think the young nurses are overreacting but I have concern more for the patients and my coworkers with these sicker patients than whining over one weekend of backup call needed to support the team. 

You have to choose your battles.  Sometimes we make trades for work that we enjoy. 

[klone, MSN, RN]

Been there,done that said:

Imagine if you will, a place where administration has  on call agencies to fill those needs. Overworked staff would not need to come in every weekend.  Maybe they could have a life, while the big wigs are out on the boat.

That would not happen, as agency cost  is more than flogging the nurses on staff.

There are some communities where that would literally be impossible. I was the manager of an OB unit at a hospital in a community of 15,000 people. Nearest city with a larger population than that was 90 minutes away. Every nurse in the community already worked there. Where would we find these magical agency nurses?

Right now I'm a manager in a large urban hospital that has community clinics all over the metro area, and we are implementing just what you are describing. Our HR director calls it "like Uber for nurses"

[subee, MSN, CRNA]

Overtime Mom said:

Thanks everyone. We have become a regional hub for out lying smaller hospitals and are getting acute GI Bleed and ERCP transfers. Sometimes more than one nurse can handle, therefore the backup call "just in case".  We only take call every 12th weekend now so one extra back up call would not be so bad. I think the young nurses are overreacting but I have concern more for the patients and my coworkers with these sicker patients than whining over one weekend of backup call needed to support the team. 

These GI cases are technically challenging and not suitable for nurses who don't have extensive experience (they're unaware of MD's quirks, timing, etc.)  Yes, these nurses are whining and I'm sure they are not expected to do it for free.  If they don't want to do it, find an immigrant who will.

[JKL33]

subee said:

[...]these nurses are whining and I'm sure they are not expected to do it for free. 

Being OC  (especially 2nd call/"just in case") without getting called in is for sure something darn near akin to doing it for free....

I have a philosophical problem with being told I will sell my time for pennies on the dollar and have avoided it as much as humanly possible by the positions I've accepted. The times/places I have been more understanding of it is the small places exactly as Klone is mentioning--but then, those places roll differently and aren't too-big-for-their-britches fake not-for-profits with billions in revenue who live each day just to swallow up another community hospital but supposedly can't afford to pay people a real wage to be on stand-by for cases that bring in the monies...

 

[subee, MSN, CRNA]

JKL33 said:

Being OC  (especially 2nd call/"just in case") without getting called in is for sure something darn near akin to doing it for free....

I have a philosophical problem with being told I will sell my time for pennies on the dollar and have avoided it as much as humanly possible by the positions I've accepted. The times/places I have been more understanding of it is the small places exactly as Klone is mentioning--but then, those places roll differently and aren't too-big-for-their-britches fake not-for-profits with billions in revenue who live each day just to swallow up another community hospital but supposedly can't afford to pay people a real wage to be on stand-by for cases that bring in the monies...

 

If you are on back-up call and you are never called in,  do you expect to be paid your regular hourly rate?  My group gave it a fun twist - double or nothing.  First call was in-house.  You are paid full rate.  But what do you expect to be paid for finally cleaning your house on 2nd call?:)  Of course, I have no idea what the OP is being paid for 2nd call and I don't believe money was the issue; it was actually being on 2nd call that was offensive to the nurses.  No one mentioned anything about pay.  Most people get addicted to the extra money quickly.

[JKL33]

subee said:

But what do you expect to be paid for finally cleaning your house on 2nd call?:) 

Ha; I almost commented about that very thing initially--that being allowed to clean my house and do laundry isn't the problem, it's the overall idea. Sometimes I just get my panties in a twist about certain things ? and this is one. I generally think it is a double standard that workers are all supposed to care about the concerns of businesses but are apparently not supposed to have needs and expectations of similar importance. I'm running my life and my household and that takes time and money and resources, too. So is every other worker out there.

For example: (by the way, not trying to be argumentative, here--just having convo)--Say that the employer's line is that they "have to" be able to provide a service on short notice, and they "have to" do it while staying within the budget that they have determined they WANT to have. Fine. But I also "have to" sell my time for a fair price so that I can pay my bills, help put food on the table and shelter over our heads, help with college expenses for my children. I see zero reason why their needs and their preferred budget are more important than mine.

At the time/place where I had a position that involved call, the going rate was approximately 1/10 of my usual hourly wage. If called in, guaranteed 4 hrs only at 1.5x usual hourly wage. So it was possible to monkey around at the employer's beck and call all day and not make my usual daily wage even if called in.

Even worse (if I consider my work the business that I do to get money): Getting put on call when you're scheduled to work. I really did put my foot down about that. I had two jobs at the time so when they tried to put me on call and I told them "I don't do that, if you don't need my services today I'll work for my full wage at my other place of employment." This story goes back 10 years or so, but at that time I got away with it. They had their cake by calling me off but they did not also get to eat it by having me sit home twiddling my thumbs in case they changed their mind.  It's just a big fat no with me because of the idea of both having the cake and eating it, at my expense.

I get that there are a lot of other factors, but that's just me. The time/services that we (individual workers) sell are all most of us have to support the business of our lives and households. I really do not care more about someone else's business than my own. ??‍♀️

[JKL33]

subee said:

it was actually being on 2nd call that was offensive to the nurses.

Also--yes, agree.

For the record, despite my philosophical problems discussed above, I think if I enjoyed a job generally, the employer was good to work for and the wages were fair, I probably wouldn't get too upset about a change in call like the one in the OP. The problem comes in when people are very stressed in a high demand workplace, the employer isn't great to work for, and then they pull an "oh by the way, we're changing what you signed up for because of all our very important business needs."  That's when people get upset.

And admittedly sometimes people get upset just because they easily get upset. ?

[Lovethenurse2b25, ASN, BSN, CNA, LPN, RN]

I would look into your facilities policy. My current hospital but us on call all the time. To be honest is quite annoying. They cut us short nurses to save money. On call pay is $4 hr. Since being per diem I haven't worked in almost 5 months for this exact reason being on call.

[subee, MSN, CRNA]

toomuchbaloney said:

You have to choose your battles.  Sometimes we make trades for work that we enjoy. 

People never complain when they get that extra money in their paycheck:)  but will complain about having to do the work.

[Leader25, ASN, BSN, RN]

They can make you do anything [ like floating you like furniture ]if you have no union organisation.Some states have outlawed mandatory OT but who knows what goes on everywhere else worldwide,you can quit or do it

[klone, MSN, RN]

They sure can!

[subee, MSN, CRNA]

klone said:

Some specialties need that call that is totally unnecessary in other specialties. Generally, those with unpredictable censuses really need to have call shifts in order to function safely and remain in the black. L&D and OR are two I can think of.

GI labs also