Home Health Agencies and On-call nursing

[chitownRNgrace]

I am a new RN (almost one year working) and I work for a home health agency. In the few months that I have worked at this agency, there have been many changes and many are controversial. Recently, our administrator was replaced by the office manager who is very unprofessional and she promptly did away with on-call nursing. There was a dispute over what the definition of on-call nursing was and when the DON told her it was to have someone taking calls until 9:00pm each day or on the weekends when the office is closed, the admin said she did not want to have the nurses being paid "just for that" and completely did away with on-call nursing altogether. Now, if someone calls after hours it just goes to an answering service and I'm not sure how they deal with it in the office. My questions:

A) What is on-call nursing supposed to entail for an HHA (medicare certified)? Is it supposed to be all through the night and is the RN expected to go to the pts home if needed?

B) Is there any law or resource stating that HHA's have to have a nurse on call?

THANK YOU!

[realnursealso/LPN, LPN]

As an LPN doing home health shifts for many, many years, an RN has to be avalible 24/7, in case a nurse or aide has a medical question, while providing care. I live in New York State, but I can't imagine it being any different elsewhere. Your Office manager/boss, better make sure she's not braking any regulations.

[Hospice Nurse LPN, BSN, RN]

I don't know about home health, but in hospice we alternate call Mon-Thursday from 4:30 pm to 8:30 am. We have one nurse who takes call Q w/e from 4:30 pm Friday to 8:30 am Monday. Yea, sometimes we get paid for doing absolutely nothing, but then other times we work our tail off. At any rate, a nurse is ALWAYS available.

[caliotter3]

I think this person is getting their wires crossed. In all the years of hh nursing and with all the agencies I have worked with, there has been an on-call nurse at night. I can't see it being any other way. As a matter of fact, I have seen the agencies advertise the fact that they have an RN on-call.

[merlee]

I have been a Home Health Nurse (RN) in 3 states, and have been on-call in all three. Yes, there needs to an RN available 24/7 for questions and sometimes to go out to pt's homes.

I have changed foley caths, attended to IV situations, replaced wound vacs and other stuff all after hours.

If your agency handles any of these, then there needs to be someone on-call.

And there needs to be reasonable on-call pay, and written policies for how someone gets paid if you go out on a call, or spend more than 5 min on the phone to resolve an issue that can't wait 'til morning.

Best wishes!

[jenjenrn1217]

Yes, you have to have a nurse on call 24/7.

[cathrn64]

I'm guessing by your screen name that you are in Chicago. I am in the suburbs. Yes, we have a nurse available 24hrs a day 7 days a week. We also rotate weekends to see pt's during the day that need to be seen. (SOC's, IV's, wound care etc)