Changes to On Call Job Description

[pixiec11]

Hello,

I am a full time, salaried, on call nurse for hospice. We have one on call nurse and one back up nurse that we can use if we are on another call. I like the job, but am nervous about "changes" to my job description. My hospice census is typically in the 80's, 3 counties-(about an hour and a half in each direction).

CURRENTLY-

I work about 110 hours/2weeks on call and about 10 hours/2weeks for IDG meetings. (Also, (4) 8hr holidays/year, 1 staff meeting/month, and multiple in-services during daytime hours.) On call hours are 3 nights one week and 2 nights the next plus ever other weekend. Nights are 15.5 hrs and weekends are 48hrs.

I do not do admissions. We have a back up nurse that does evening/weekend admissions, and in patient visits.

Paid time off is 4 to 1 for week nights and 2 to 1 for weekends. Meaning if we want a 16hr week night off, we use 4 hrs pto and if we want 24hours off on the weekend it would be 12 hrs pto.

PROPOSED-

Apparently, the management team feels like we could be doing more, such as weekend/evening admissions. And, that the pto should be revised so that we do not get as much time off.

MY QUESTIONS-

1. How many on call nurses are expected to go to IDG's during daytime hours?

2. Do other on call nurses do admissions in addition to being on call?

3. How is your pto set up?

4. Is fundraising mandatory on your evaluations?

5. Do other nurses/management feel like on call nurses are working less than regular staff because they aren't running every minute of their 110 hrs on call?

MY FEELINGS-

On call nurses should not have to go to IDG's or into the office during daytime hrs, except for inservices or staff meetings. (I'm tired during the day and need that time to sleep)

Fundraising should not be on your evaluation.

On call nurse should not do admissions. (Who's going to take calls if I am doing an admission?)

PTO time should not be changed after working there for 2 years for only the on call nurses. (Seems like being hired under false pretenses to me?)

Although, I may not be "working" every hour that I am on call, I am still technically working. I can not make dinner plans, etc as I must be "available" at all times during those 110hrs. (Even if I only "work" 20 hrs/week, I was still required to be available at all times.)

Unfortunately, I don't think I can do any more that I already do. When I worked 3-12hr shifts on med/surg plus overtime, I was less tired than I am now. I feel they should not require us to go to IDG, as it is too much. They feel they should add more work to our schedule. I have a feeling my time is short at this job, which is sad because I really love what I do and my coworkers are awesome.

Any advice? Am I just whiny and really have it good compared to others on call nurses? How should I state my unhappiness about changes to PTO and extra work being added?

Currently my 2 week schedule is- (doesn't leave much time for sleep or anything else for that matter)

Sun-430pm-8am

Mon- off

Tues- 430pm-8am

Wed- 9am-12pm- IDG, then on call 430pm-8am

Thurs- 9am-12pm- IDG, then off

Fri-430pm- (til Sunday 430pm)

Sat-work 24hrs

Sun-work til 430pm

Mon-off

Tues-off

Wed-9-12pm- IDG, then on call 430pm-8am

Thurs-430pm-8am

Fri-off

Sat-off

Thanks for any input,

P

[peer support]

My reason for coming to this topic is to get a feel for hours and compensation for on call nurses in home hospice care. I am especially interested in current data to learn how it works in different agencies. There are 2 RNs that share all the on call time. The positions are salaried, The present structure at my site is 2 overnights (5pm to 9am) and Friday 5p through 9a on Monday every other weekend. On paper, to the uninitiated, it looks pretty good. In reality, it is exhausting! The management is willing to listen to suggested alternative hours which is the reason for my search. I am so hoping to be able to come to some kind of schedule which will allow us to give the quality care our agency is known for and will enable us to be safe, rested responsible practitioners while we are on the job. Presently, on weekends we have no scheduled time for sleep. We have on average 75 patients. Case managers work one weekend "shift" every 4-5 weeks which is mostly for admission visits. I agree with my peers who wrote that it is impossible (and not patient/consumer friendly) to do admissions while on call. It is often possible for the nurse to ask administration to take calls while but not always. The leave policy for on call is "pro-rated" as was described by others here. As some of the posters from the early 2005,2007, noted, when they learned what other jobs entailed, they perceived it was maybe not so bad where they work. I think it is essential in 2011 to be sure we are fairly compensated for the hours that we work. be it in the car, patient home, listening to report or waiting for the phone to ring - it is all part of 24/7 care. I love what I do - have been in community nursing for over 30 years, both in home care and hospice. I hope we can support each other to be compensated at a fair, professional level for the essential work that we do. Thanks for reading and please comment if you have the time and inclination.

[KristaKay]

I work in a small town in texas and have the unfortunate experience of "bad management" also. We have 2 full time nurses that "do it all" for a patient census ranging from 18-30patients. We have had* 3 nurses at one point but had one position taken away once one of our nurses moved away. I am the senior nurse as far as time spent with the company and even in my 3 years have seen over 5 nurses come and go r/t poor management and poor job description. Lately we have been bought by a larger company and the situation has become even worse. It is directly related to management and I assume it is the same for everyone else who has managers that just "dont get it". We do have a PRN nurse who will pick up 8 days of the call but that still leaves me and the other nurse splitting the rest of the call per month plus full time 8-5 duties including IDT and complete patient care. On-Call pay is $3.00/hr and we are expected to do all visits,admissions, take all call and all crisis care during the weekends and time we are on-call and then return to regular duties on Monday AM to resume the care of our 20+ patients. I wish hospice had a union that would help us take care of these issues because I love my job and feel called to do it but I just dont see it getting any better....and worse quite fast to be sure. oh, the latest "sucker-punch" for us has been that after they got rid of our third nurse they told the other nurse and I that we would be "responsible" for any overtime we accrued and have been hounding us ever since the third nurse left and we have had overtime. These people just dont get how hard 0n-call is and what all it takes - not to mention direct patient care of someone on hospice who is dying and has multiple family issues (family is a patient too in hospice and sometimes we have 4 or more per patient). it is definitely a full time job in itself and I just wish we had other job opportunities in our small town or a union that could set the bar - so to speak. Forgot to mention with previous hospice experience I get $25.75/hr and time&1/2 for overtime. $3.00/hr on call (usually 100+hrs of call every 2 weeks and lately working around 90-100 hrs every 2wks regular)

[KristaKay]

I think our situations are very simular. I have the unfortunate circumstance of having a terrible manager. I hope things get better for you

[indianahope]

I quit my job a little over a year ago for exactly the reasons you site in your post. I was with the company 10 years, and the last three were literally *#ll on earth. I kept thinking it would get better and I wanted it to get better.... but it just got worse. They started firing senior nurses and I saw the writing on the wall...I took early retirement before they had a chance to fire me. There were some really talented nurses... as well as our medical director that ended up in the ER with cardiac symptoms, GI symptoms, etc. Not good. All were stress/fatigue related. It took me almost a year to recover physically and emotionally. My heart goes out to you and I hope you find the answer that is right for you. I am now reconsidering retirement and am toying with the idea of working only part time...but I will never again put myself in harms way....

[KristaKay]

Thank you Indianahope, I find myself in your position..hoping and waiting for it to get better but it just gets worse. I think our company has pretty much hit rock bottom as all of our CM have quit with the exception of me. I have my applications out and am praying for another hospice job with a larger company that services our rural Texas area but those jobs are few and far between. This whole situation saddens me to think the people who are dying are being let down for the cost of a few extra people on staff to fix the issue. I just wish the pocket books were deeper for the right reason but my hope has about run out. It's sad to think back on how on-fire I was when I started this job 3 years ago and how far I see the company falling and the staff and patients being let down time after time.