how does your facility cover call?

I don't remember the details, but I worked in an out patient surgery center that was part of the hospitals regular in-patient OR. We also had a GI clinic.

The OR nurses and techs hated it but they were on call for OR and GI emergencies after hours.

Do you get called in that often? I don't remember having very many after hours GI emergencies. Just occasional urgent cases on Saturday or Sunday.

Getting a sedation nurse was sometimes an issue. Do nurses do your sedation or does anesthesia?

Cross train your main theatre nurses to do scopes. You can't run a 24hr service with 6 nurses. Do you have a cath lab? Can you all be cross trained in emergent procedures? Guessing if you have a cath lab service it is just as small.

Chart your activity....if you are being called in every night then that is the case for more staff, or are all of the calls truly urgent or could they be left until the morning and done first before the first elective case? Have your HOU involved in this review....is it one doc who is always calling cases overnight? Is it a post CABG pt on DAPT with a varix that needs surgery but can't have for another 4 months because of the drug eluding stent he can't come off his DAPT? Get this guy a management plan with the ED, gastro doc's, ward, cardiac doc's, ICU etc.

The OR has been helping us cover call but now they are fighting against it because they just had 5 nurses quit. They are more burned out than we are. They hate covering our call which I do understand. They get called in a lot more than we do and have to stay a lot longer doing back to back cases.

Unfortunately we don't have a cath lab.

We are tracking our call-in cases for the next 3 months and then taking a look at what we can do.

Does anyone work in a small hospital that doesn't have 24 hour GI call coverage? Even if we stopped call at 11pm and resumed at say, 5 or 6, that would help us a lot because at least we could SLEEP! And our "emergency" add ons during the day typically wait several hours to follow our outpatients anyway. I like the idea of a slot to add in an emergency before our first outpatient.

I appreciate all input!

We had very limited after hours GI coverage for several years. From not having a dedicated GI doctor, to the OR nurses complaining about being called in, to not having a moderate sedation nurse on call.

I don't remember how it all worked out, luck, the kindness of some nurses who would come in. But again, we did not have that many GI emergencies, especially at night. Maybe once in a while we'd do a non-emergency GI case on a Saturday or Sunday.

It wasn't the greatest way to run a small community hospital . I'll never forget a critical GI bleeder of course on the night shift. A young male, it was an ulcer, not esophageal varices, (not that that makes a difference). But that was a one time situation! He had to be transported to the bigger hospital across town.

I feel badly for you and am glad I am out of that type of nursing. The GI call mess didn't make me leave, we moved and the ambulatory surgery clinic I got a job in does not do after hour emergencies.