Hospice full time on call

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I have been doing full time on call for about 1 year. I really like my job and get alot of fulfillment out of it. Today during my evaluation, I was told my supervisor has been trying to justify a full time position vs actual hours worked. I would like input as to if I am being justly compensated for my position.

Here are the details:

Census-70-80, over 3 counties, approx 30 mile radius, some visits are 10 miles away up to about 65 miles away

Hours- 4:30pm-8am x 5 nights= 77.5hrs plus weekend Fri430p-sun430p= 48 hrs, which equals 125.5 hrs oncall every 2 weeks.

IDG meetings- 3 meetings every 2 weeks, 4hrs each= 12hrs in the office every 2 weeks.

Typical night on call- Weeknights can range from a couple calls with no visits up to several hours of running. Weeknights usually 0-2 visits and a couple calls. Weekends usually crazy lots of calls, maybe a couple deaths and a couple s/s management visits. Probably 20 hrs or so, of weekend calls/visits/charting.

I always have a backup nurse in case I have to make two visits at once and I don't do admissions.

I am salaried at 24.50/hr x 37.5hrs/wk, which comes out to about $12-13/hr for being on call, regardless of the actual number of hours worked, sometimes I feel like I work non stop, others I feel guilty not being busy. No extra pay for nights/weekends/holidays/per visit, etc. as this is a salaried position. I do work between 8-24hrs extra for holidays also.

Mileage is 0.585 cents per mile, decreasing to 0.55 cent in Jan 2009.

I am blessed to be able to take time off almost whenever I want, due to per diems that are willing to cover for me.

I am also blessed that I have great case managers that anticipate their pt's needs and supervisors that are very considerate of their nurses.

So, my question is- Am I justified in making a full time salary? Should I be doing more, if so, what?

When I work doing med/surg, I don't have to justify my hours. Some nights I am busy from the time I step on the floor, other times I am reading a magazine praying someone will put on their call light.

Thanks for any input,

Lisa

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Specializes in hospice.

here is what people do not understand about being on call. The moment your call time starts, you are working. You cannot make plans to do anything and you are tied to either a beeper or a phone. I am full-time weekend on call. We have 250+ pts. There are 4 full time on call and 1CM backup. We also have a triage nurse to take all of the calls, so we know when we are called, we are going somewhere. All I think about when I start call is that I have to sleep every moment I am not working because I don't know what is coming. It is pretty slow right now so I'm only working 9-12 hours a day. There have been times when I have worked 17-20 hours straight. I am also salaried at around 27.00 and it is divided into 63 hour work week, which comes out to around 17.00 an hour. I've have been doing this for 3 years now and it works for me but we have been through MANY on call nurses. It is not an easy job. You have no life. tonight I got home about 6pm and went straight to bed because who knows when I'll be called out next. Of course now I am up at 1am, my family is asleep. If I am not called out, I have to get up in a couple of hours and go to the office and turn in my paperwork. Remind your boss what you have to give up to do your job. On-call is one of the hardest jobs to fill and there is a lot of turnover, that should tell you something. Several times in the 3 yrs, there has been only me and maybe one other person. The case managers have to take more call at that point. Thats when they start quiting. If they think that you are not worth the full time position now, they will know when they start losing case managers because of the On-call. In our employee survey, the worst part of the job was being on call. good luck and don't feel guilty about having down time, it won't last long!

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Specializes in Cardiovasc-thoracic/Hospice.

You are definitely justified in receiving full time compensation. You are on call regardless of the hours worked. I receive a comparable wage to yours and get paid for 80hr/2wks plus same for mileage, 8p-8a, 7 days on 7 days off, although I am not required to sit in on IDT's as I am not a case manager, but extended hours coverage. You are dealing with pt's that are not particularly known to you and must depend on the accurate documentation by your coworkers to provide appropriate care after hours. You also may not be up to date on family dynamics issues. Don't sell yourself short, you are worth every cent and then some. You are providing a service that most do not want to do.

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I agree with the above... they should cut out the requirement to be at IDT's. 1 person per 70 is definitely justifiable at full time, especially on the weekend. We have a census of about 200 and have three people covering call. On the weekends we also have a phone triage nurse because the call volume is so high. And although you can't be paid extra for holidays since you are salaried, they should give you some sort of compensation, like an extra day off somewhere else.

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YES you are worth a full time salary. As someone else said, the case managers would have to cover the call, and I know I would consider quitting if I had to do call every other week (been there, HATE it.) The sad thing about call is that it appears to be a cushy, easy job. And at times maybe it is, but most of the time you have no ability to have a life since you are tied to a cell or pager for 24 hours a day. And if you have an 80 hour week, you're only being compensated for a 40 hour week on salary. That's a lot to give up for a job. If it were that easy of a job, it wouldn't be that hard of a job to fill......something for those managers to think about.

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I am PCC (patient care coordinator) for a hospice, 1 county with current census of 17. I am on call every night with the exception of maybe 2 nights out of 7, with no compensation unless I have to go out. I am on call every third to fourth weekend. I get $50.00 for the weekend plus time and mileage if I have to go out. I believe you should get paid for your time on call. I recently found out that I am making less as pcc than other companies pay staff nurses. and that their call compensation is much better as well.

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Thanks so much for all of your input!! The funniest thing happened today after IDG... my supervisor asked if I posted the original message here, lol. Of course, I told her I did. We all got a little chuckle out of it.

I guess the reason for my original post was because myself and the other full time on call nurse were being asked to make daily phone calls to the patients that were seen the night before to assess if their needs were met. This is one of our Quapi projects. In doing this, it quickly became clear, that it seemed nearly impossible to try and figure out who to call each day, d/t deaths, duplicate calls, revokations, etc. It was very time consuming and being on call it is difficult to find time to research and make these calls. Management felt on call had the extra time and this would help "justify" our hours. However, on call felt our calls are too inconsistent to make the time for this every evening.

Today, we did find a solution. Myself and the other oncall nurse will make all these calls on Wednesdays after IDG, instead of daily. That way we will know who has passed and we can just give each other our list of calls that need to be made.

Thank goodness my original post was politically correct, haha. Now that I know I am being spied on, I will have to make sure I let everyone know how great my bosses really are.:flowersfo

~Lisa

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