Considering an on call position

westieluv · Apr 19, 2016

I have been an on call hospice nurse, and here is what my concerns would be:

Salary. I have learned the hard way that many times, though not always, salaried RN positions are designed to squeeze the maximum amount of work out of a nurse with the minimum investment. Suppose part of their plan is to give you an admission to do every evening right off the bat (hospice admissions take at least 2-3 hours to complete) and several on Saturday and Sunday? By the time you do all of those admissions and still squeeze in emergency visits, you will be working a LOT of hours. Will your salary compensate you fairly by the time you break it down to an hourly rate?

Mileage. Anyone who travels in their job needs to be paid mileage, and it should be the going rate (there is some government reference that they are supposed to use to determine how many cents/mile). This should not be included in your salary unless your salary is unbelievably generous even after breaking it down into an hourly rate.

How big of a territory will you have to cover? I found this one out the hard way. I really enjoyed being an on call hospice nurse, but it turns out that on the night shift, which I worked, we had to cover a HUGE seven county region. I would be on my way to one visit and get a call to make a visit in a city 2 hours from where I was headed, meaning that it would require me to take the time to make the first visit then the drive time to the second visit. Patients were waiting way, way too long for visits and they were not happy. This was not my fault, but boy, was I the one who got to hear about it when I finally got there!

I was once hired by a hospice company for a nice sounding salary. I was told in the interview that I would do visits one week then the other week I would be able to stay home during the day and be on call overnight, alternating this way with every other weekend off. Once I was hired, it became do all the visits one week, be available for visits and/or admissions every day the other week, and be on call every night of that week as well. Basically, every other week I was expected to be available 24/7. I'm not saying your company would try anything this underhanded, but I would definitely want to know if a.) I would be expected to do admissions on a regular/daily basis and b.) how many hours, on average, the other nurses in this position (assuming there are others) work for this salary. I have really learned the hard way that unless you ask questions like this before you are hired, you can really get burned.

Otherwise, I liked on call hospice nursing. Everyday was different and the patients and families were so appreciative, something that you don't often get in acute inpatient care.

SaraLTayRN · Apr 19, 2016

Thank you so much for your reply. Those are definitely sound like concerns I should be mindful of. I am a hard worker, but I also very much believe in having work-life balance. I am making a list of everything that I need to know and consider before I accept a position.

kymom24 · Apr 20, 2016

I am a oncall nurse as well. Started in Dec.. 2015. This position works well for me being I am a mother of 4. It allows me to pick up my kids after school, attend appointments, field trips, ect. My schedule is every other Sunday, 24hrs and 2--3 days a during the week. 5p-8a. Before I started, I asked alot of questions to the other oncall nurses that work at my company. By the time I applied, I was certain that I wanted the position.

Coming from home health, I really enjoyed working with families in the home. But I was doing way to.much work outside of work hours. Now, I have time for my family. I am mostly done with my work after my shift. I say mostly done, because if I have an admission or busy night, I get sleepy and go to bed.

I would recommend, asking alot of questions. Ask why the position is available, what happened to the other person. What's the turn over rate. Again Mileage, and if it's salary or per visit. I've seen companies that have oncall staff but pay them per visit. I would not do that. I have a salary which was more than my full time position in home health and I feel work less. I would say. The weekends are usually busy. I would ask about triage on the weekends. It will be very hard to triage your own calls on the weekend and do visits. Also find out about the service area you'll be covering. And last ask about backup. If your in a jam, stuck at a visit for hrs, who can you call for help? Me personally, I would rather have the few days off a week and work every week cause 7 days can be draining on your body. But I know people who do week on/week off and like the 26 weeks off a year. They says it's lime they're on vacation every other week. Just weigh the odds and pros against what the needs of your family are. I wish you the best of luck in your decision. I hope you update us on what you decide.

SaraLTayRN · Apr 21, 2016

Thank you for the great info. I also have young kids and I think that this position would allow me to be around for them as much as humanly possible while still being a working mom. Right now I work three 12 hour shifts a week, two of which are day shift and one that is night shift.

I agree about the salary. I have to have a salary position because I have to have a certain income every month in order to contribute to supporting my family. I could never go to a job that is pay per visit because it would be way too stressful not knowing what my income would be from paycheck to paycheck. They did tell me on the phone that it is salary, but I will know more tomorrow. I also will definitely ask about triage, I wouldn't have thought about. Thanks again!!!

QTBabyNurse, BSN, RN · May 9, 2016

Thank you for the great info. I also have young kids and I think that this position would allow me to be around for them as much as humanly possible while still being a working mom. Right now I work three 12 hour shifts a week, two of which are day shift and one that is night shift.
I agree about the salary. I have to have a salary position because I have to have a certain income every month in order to contribute to supporting my family. I could never go to a job that is pay per visit because it would be way too stressful not knowing what my income would be from paycheck to paycheck. They did tell me on the phone that it is salary, but I will know more tomorrow. I also will definitely ask about triage, I wouldn't have thought about. Thanks again!!!

Just curious.....What did you decide to do?

SaraLTayRN · May 10, 2016

Crazy story ...

The interview went great. I was given the unofficial offer and began all of the paperwork, etc. Then a week later I receive a bland email from the Administrator sent at 0100 in the morning saying I was not selected. I was shocked because none of it made sense. I called my HR contact, no answer so I left a message. I also sent an email to my HR contact, very polite, just explaining my disappointment and I did say how shocked I was since we were clearly on the path to employment. I have never gotten any kind of response from them.

I honestly believe I was blacklisted so to speak. My mom is the Executive Director for another competing hospice in the same area. All of the management staff for the hospice I applied to knows my mom and sees her as a competitor. It was right after they found out who my mom is (someone who used to work at my mom's hospice recognized me) that I got that email.

As of right now I cannot work for my mom's company per their policy. Who is going to hire their competitor's daughter? So I feel like I have no hope with any other companies. I should have known this would happen, but I guess I forgot how well known my mom is in this area. I truly had no ill intentions to share information. My mom wants me to be a hospice nurse and she is full of integrity, we already discussed that we would not talk about work other than the generic.

The only light right now is that my mom

is trying to get her company to make an exception and hire me. She is so far up in the company that I will have many bosses in between her and I. So far it is looking like it might happen except that there is currently no on call opening.

QTBabyNurse, BSN, RN · May 10, 2016

Crazy story ...
The interview went great. I was given the unofficial offer and began all of the paperwork, etc. Then a week later I receive a bland email from the Administrator sent at 0100 in the morning saying I was not selected. I was shocked because none of it made sense. I called my HR contact, no answer so I left a message. I also sent an email to my HR contact, very polite, just explaining my disappointment and I did say how shocked I was since we were clearly on the path to employment. I have never gotten any kind of response from them.
I honestly believe I was blacklisted so to speak. My mom is the Executive Director for another competing hospice in the same area. All of the management staff for the hospice I applied to knows my mom and sees her as a competitor. It was right after they found out who my mom is (someone who used to work at my mom's hospice recognized me) that I got that email.
As of right now I cannot work for my mom's company per their policy. Who is going to hire their competitor's daughter? So I feel like I have no hope with any other companies. I should have known this would happen, but I guess I forgot how well known my mom is in this area. I truly had no ill intentions to share information. My mom wants me to be a hospice nurse and she is full of integrity, we already discussed that we would not talk about work other than the generic.
The only light right now is that my mom
is trying to get her company to make an exception and hire me. She is so far up in the company that I will have many bosses in between her and I. So far it is looking like it might happen except that there is currently no on call opening.

Sorry that happened to you! Best of luck in the future...keep us posted!