Hospice On Call Compensation Structure

[indianahope]

What about this scenario? You are being paid let's say $2.00 hour for carryng the beeper. You are paged and take a phone call and then do charting but you do not go out. Are you compensated anything above the beeper pay ($2.00 hr.) for the amount of time you spend on the phone and charting the phone call? Our management tells us that phone calls and charting are "part of call" that the time we spend on phone calls/charting is covered within the $2.00/hr. My thinking (may be flawed!) is that I am being paid $2.00/hr to wear a pager and must be ready and available to work during a certain time frame. Period. If I am doing hospice-related work as a result of being paged, that is now work. This is a new policy and my coworkers and I are unhappy. As you all know, some calls are relatively quiet, but some are buggers and the time tied up in phone calls/charting can add up. And it starts to feel like we are working for $2.00/hour. We are all RN's..most of us have been with the organization over 5 years. I think I can speak for the others...we all love what we do but we don't much like this policy.

[aimeee, BSN, RN]

You should be paid your regular rate for the time you spend on the phone and for the documentation. It can really add up. The $2.00 an hour is compensation for being available and curbing your life for the time you are oncall. Our hospice has a census of 135 and we have a nurse who is dedicated to triaging calls on the weekends. Saturday is the busier day and it is not unusual to barely have time to take a bathroom break or eat a meal during the daytime hours! Our triage nurse gets a certain number of "guaranteed" hours but may get extra if she actually logs more hours of work.

[indianahope]

Thanks, Aimee. I will go back to administration and request reconsideration of this policy.....all they can do is say no.

[Al Stephens]

here at our hospice, I work Mondays, Tuesdays, from 5pm until 8 am, and every other weekend from 5pm on friday until 8 am on monday, for regular salary. I also get 25 for any visit I do before or after my regular hours, and 50 for extra admits. I also get mileage. Any other time i put in, as in filling in for the other on call staff if they are off, is overtime, and I get of course holdiay pay for monday holidays. (yes, I get all the monday holidays). I do ok, and have been at this for over 6 years now, but, as in all Life, it is time to move on..I am moving to another, bigger city, and a bigger hospice, I hope. I like the work.....and the feeling of truely helping.

[sharlyb]

We have two full time on call nurses. Each works two weeknights from 4PM-8AM the next morning and every other weekend from 8 am Sat. to 8 am Mon. That makes for a 56 hour week for the on call nurse. Case managers take turns covering on call for Friday nights, the only night not covered by the on call nurses. They get paid beeper time of $5.25/hour. They also get mileage paid minus travel distance equal to what it would take to drive to the office and home again. If they go out to see someone they get paid $45 per visit. If they do an admission they get paid $75 for the admission in addition to beeper time. Our census is 42.

[JSCOOBY]

We get $1.00/hr. for "beeper call." The RN case managers are salaried and get $75.00 for a new admission (takes about 4 to 4-1/2 hours), $60.00 for an unscheduled visit or task, and $45.00 for a death. Our crisis care LVN's get $1.00/hr for beeper call and then will draw their hourly salary if the are called to begin a crisis care case are do a unscheduled problem or task visit.

[a21chdchic]

I'm salaried, week night call is $10/hour, w/e call is $12/hr. Get $25 for an afterhours admission and mileage, that's it. Katillac - I'll bet your Hospice is 'not for profit'?

Ana

[Percy60]

I work in a non profit with a census of 260. We get $2/hr for back-up call once every 16 days (430p-8a weekdays or 24 hour on sat/sun). Our visit rate is $55 but if it's over 2 hours, additional comp is negotiated with manager. Admissions is $120 for eval and clinical. Mileage is door to door. We have a full time weekday 3-11 nurse and another nurse who works Sat & Sun 8a-8p. The back-up nurse is the only one on call after 11p M-F and 8p S-S. We usually only get called out once or twice during the week but anything goes on the weekends. Our biggest problem is when our PM nurse or weekend nurse is off (PTO, illness). Then they make the full timers cover. Since both nurses get approximate 3-4 weeks(each) per year...this adds up. Our agency, as others, operates 24/7 yet we have less staff on the weekends. Do we have less patients? No. Do we have more problems? Yes. Patients are discharged from hospital on Th & Fr with increased needs & anxiety over the weekend which leads to lots of weekend visits. We usually have a mess on Monday morning.

I think nurses should not underestimate their value. You should not be going out in the middle of the night, or spending time on an admission(3-4 hr) or paperwork for less than the average hourly pay in your area with your level of expertise. What other profession would do this? Oh, well, sorry for the rant. Anyway, after reading the other oncall compensations/schedules...I'm going to count my blessings.

[CaringRN1234]

At my agency we get $100 per weekday (5pm-830am) and $150 per weekend day (830am-830am). If we go out we get our regular mileage from door to door. If we do an after hours admission (which we rarely do) we get an additional $75 for that. One weekend I had to do 7 hrs of continuous care by myself. My administrator allowed me to take a day off during the week.

We only have 2 nurses (myself and one other). We don't have to go out very often on call because we try to be proactive with pts meds & such. Plus our hospice is small with a census of aprx 24 right now.

[indianahope]

We have no on-call team but take turns. Weekdays on-call starts at 4:30pm to 8am. Sat or Sun call is 8-8 for 24 hours. We usually get 4 days through the week and 1 weekend day in a 6 week schedule plus we all have rotating assigned holidays to cover. We are paid $2.00/hr. to carry beeper and it is the same for any call day regardless of weekend/holiday/etc. We do phone triage and get no compensation for phone time/charting of these calls. They say it is part of being "on-call and is covered under the $2/hr beeper pay. If we go out we get D-D mileage and time and a half our hourly rate regardless if it is an admission, death, or skilled nurse visit..... It is interesting to read about the various on-call compensation structures.

[heart4hospice]

Our hospice recently decided to have a call nurse to help cut cost. I am currently trying this position. The position is salary. I take call 110 hours every 2 weeks and actually work 2 days a pay.

I feel like management expects me to actually work close to 80 hours in addition to being on call because I get paid for 80 hours. My average hours per pay that I have worked is approx. 48 hours plus being on call 110 hours. I wanted to take a vacation day for a saturday, and Human Resources expected me to take 3 days (24 hours) of vacation because I was "on call" for 24 hours. Should this be pro rated some how?

Does anyone else get paid 80 hours for being a call nurse? What is the approx. amt. of hours do you work? If call is slow, are you expected to go into the office and work or make home visits? Our average daily census averagess 25-32...we cover a 5 county area so alot of time is lost on the road. Any information would be appreciated.

[a21chdchic]

I just quit working for hospice as a case manager. I loved the work, learned a great deal, and did very well working so autonamously.

HOWEVER.......In addition to working a 40 hour week, we were required to take call, and for the last 4 months, it has been once a week. Add another 24 hours on top of the 40 hours. But, this wasn't your ordinary call.......we very frequently had 'bad days' where you arrive in office on Sat am 0730, so you can organize your day, get supplies, admission and death documents that will needed - to be handy, get the paperwork for the 'scheduled' admissions, and referrals. This takes a good 45 minues. The straw that broke the camels back is the sat I didn't get home until 2300 the same night, worked straight through without having the time to stop and eat due to the constant calls, visits, deaths, etc. And then you add all of the documentation on to that. That was one of many 95+ hours weeks. SH**, that's is twice the work of a regular work day! For $12 an hour? The perk of that Saturday is I got an extra $25 for doing an admission, which by the way, both the patient and family were spanish speakers only! Go figure that one? My spanish is not even minimal. How great was that assessment? Then, after getting to bed, I'm back up at 0500 for another death (3) in that 24 hour period. And more calls. And we are reequired to go in at 0800, replicate, and give report to the oncoming nurse who did not show up. I had to call her at 0815, which was very common. And THEN there's documentation! So, we commonly were working 7 days a week.And then, the director has the nerve to insult me by coming up to me to tell me, that I get that admission bonus for the day? I just looked at her and turned away. And believe me, that was the nicest and most respectful thing I could say, do, or think. I suggested the office nurses help with taking call until they could get more nurses, to lighten our load, but, that wasn't an 'option'.

That friggin $25 bonus for a 4-5 hour admission? $25 an hour isn't even an hourly wage. All it did for any of us was rub us the wrong way, to say the very least.

Hey guys, I'm going back to the hospital, so I can at least be paid for every hour worked, for an additional $5/hour, not counting shift and w/e differentials, and do self scheduling.