I usually work 13-27 hours during the week (by choice) and I do call friday 5p-monday 8a. I have been doing this for about 3 years. I did full time case management for 4years. When I first started doing on call we had about 175 pts and I was the 3rd. full time on call nurse. It was not too bad. I might get called out once on friday, see 4-5- pts sat and sun. I actually worked 20-32 hours, but I got plenty of sleep. Only on occasion we had a bad weekend. many on call nurses came and went and at times I was the only full time on call. the case managers did back up and we usually had a total of 5-6 nurses on call. fast forward. our census is 300+, we had 4 on call nursess, one just quit and they may not replace her. they cut the total nurses to 4, sometimes 3 on sunday. On friday, I usually see up to 3 pts and out until 3-4am. only to have a full days worth of pt, and then back out all night. I'm working at times 17 hours out of 24, and two weeks ago, out of 24h, I worked 22 with 1 1/2 hour nap. The management didn't feel we were seeing enough pt's, so along with the crisis care visits, the prn visits, the actual On call visits, they decided to add the 1st RN visits, AND if anyone said "fall" even when they actually didn't fall, the cg sat them down on the floor, or the slid off the chair and there are no injuries. If a COPD pt call about anything we have to go. If a nursing home calls, we have to go. If anyone calls twice for any reason, we have to go. What happens is while we are out on these NON-EMERGENT" calls, someone calls in that really needs us and they have to wait. We have tried to talk to management and they just dont care. They don't understand that it's not the amount of calls we go on, it's time in which we have to go. I can see 7-8pt during the day and be fine, but when you have to go during the night, it reeks havoc on you, no matter if you get a few hours sleep during the day, you just cannot catch up. Last weekend I drove 367miles. 11hours worth of driving in a 24 hour time span. Truck drivers cannot drive that much. Aren't there some sort of safety laws in place? The day I worked 22 hours, the triage nurse was trying to explain to the administrator on call that if I am working all day, that I cannot be expected to be out all night, her response was "she has too" the triage nurse said "no, she doesn't, if she says she us unsafe, I cannot send her" do you think that made a difference, hell no, I was out all night also. We are all about to quit, i have 2 small kids that need a mother. Anyway, sorry so long, but I just had to get it out.