Hospice On Call Compensation Structure

[Katillac]

I am a hospice and palliative care nurse who takes scheduled call quite a bit (every other weekend, and every Monday night). I'm curious about how on call pay is structured in other organizations. Here's how ours works: We get paid by the hour to "carry the beeper" weekend nights from 1630 until 0830, and a little more for the weekend 24 hour periods from 0830 Saturday until 0830 Monday. We get mileage door to door for visits. No extra money for admissions, Friday nights, holidays or middle of the night visits.

Many healthcare organizations get a base rate for call and then a different hourly rate for visits. Are there hospices out there in allnurses land who operate that way? No need for specific dollar amounts, I'm just curious how others are set up.

Thanks!

Kat

[happy2008]

WE GET 5 DOLLARS AN HOUR TO CARRY THE PAGER FROM 5PM-7:30AM DUING THE WEEK. WHICH IS ABOUT EVERY 9 DAYS. WEEKENDS START ON SAT AT 7:30 AM THRU TO 7:30AM MONDAY, WHEN WE GO OUT WE GET PAID MILLEAGE AND TIME AND HALF PER HOUR OUT. wE DO ADMISSIONS AND ANSWER THE PAGER.

[SpringTXRN]

Case Mgr census now is about 13-15...less than a yr ago I had 26 for months on end.

We now do call 2 weekend days and 2 week nights a month...with only one LVN who rolls

We get $2 hr to carry the pager and if we roll mileage driveway to driveway and straight time if we roll..weekend or weeknight is the same pay. We have one on call LVN weeknight, Admit RN from 3-11. Weekend is stacked better. And perfect example on callin when you are not on call.

I had 2 nights back to back, the triage nrs tried making it 3 nights but seeing as I wasnt on call the first nite I didnt answer my phone. 2nd night they killed me..worked all day Wed, out all night, then worked Thurs, then on call Thurs night. Think all companies need to have on call staff and leave the case mgrs alone. I mean if I wanted to work nights I would go back to the hospital and make alot more money on 11-7

[rnboysmom]

I don't know that I agree with "leaving case managers alone." I don't think that it needs to be extensive, but there is something to be said for all case managers to have to do some on-call through the month. I have worked for companies that have employed an on-call nursing staff at some time or another and most have phased them out. Case managers that have on call responsibility become aware of the faults of other case managers and this does not tend to go "unchecked" amoung peers. Many companies that have nurses case managing an extreme caseload (as the 26 in your case) (BTW, I worked for a company that had me case managing 24 at one time). What happens with these extreme caseloads is that you can't possibly manage that many terminally ill patients, the ball gets dropped during the day, and the on-call staff pays dearly for the company decision to overload their case managers. Sooner than later, the case management gets exhausted and starts quitting in droves thus effectively forcing the company to start asking questions. The sharing of on-call responsibility along with some good PRN weekend or weeknight help seems to be a good combination. Case managers on our staff "aggressively anticipate" the need for any medications or education that may need to be in the home to allow the patient's family to effectively care for them at home--thus effectively lowering the time a nurse is in the field after hours:nurse:.

[OncallRN]

I'm a salaried on call nurse I'm on call for 52 hr a wk and am paid and benefitted at a 40hr a week salary.

we all have day staff during the weekend. and rarely have a scheduled evening visit, usually a crisis which hit at very end of day.

I have a back up nurse ( who is case manager/ staff RN)- rotate so the usually work 1-2 shift a month, and rarely are called.

non salary 1st call get $9 / hr for carrying pager and 60 per visit

back up gets $4/ hr and 60 if they have to go out.

our over all census is about 220

but from post here I'd say our CM do a great job and I dont' get that many calls. mainly deaths and pain crisis

[rockchalk_jayhawk]

I have always been told that our call policy is very generous. I have never really researched it much, I just felt it was average.

I take call about 10 days per month, including every third weekend. We are paid $15 per day (8am -8am) Monday thru Thursday and $30 per day (8am-8am) Friday, Saturday and Sunday. During the week, if we get called out anytime after regular business hours (anything after 4:30 p.m.) it is all considered call back which we are reimbersed at time and a half. Any mileage during call back is paid at $0.42 per mile.

[SpringTXRN]

I have always been told that our call policy is very generous. I have never really researched it much, I just felt it was average.

I take call about 10 days per month, including every third weekend. We are paid $15 per day (8am -8am) Monday thru Thursday and $30 per day (8am-8am) Friday, Saturday and Sunday. During the week, if we get called out anytime after regular business hours (anything after 4:30 p.m.) it is all considered call back which we are reimbersed at time and a half. Any mileage during call back is paid at $0.42 per mile.

We get $2 hr to carry pager and paid hourly wage if we go out...mileage is only $0.37 per mile..not much considering gas here is $3.25 and up

[oncallforhospice]

]Wow, you guys make me realize how lucky we are at my hospice. All of the RNs are on salary and the regular case managers take 830a-5p call every 6th weekend or so for ONE weekend day. We have two full time on call eve-night nurses (5p-8:30a), including myself, and the two of us take turns with primary and secondary, trying not to bother the secondary if possible so it's like a night off. We are to work as a team and work it out between us anyway we want as long as it's in the best interest of the patient. Not to mention that there are nights when I get NO calls or just a few and I don't have to leave the house. Sometimes they send me to do admissions, but we also have a full time admissions nurse from 1p-9p. I'm not sure what the hourly beeper pay for that weekend day is, though, but I know there is one.

[DelanaRN, MSN, APRN, NP]

I am an LPN in RN school. I am considered by the company I work for to be "Full Time" although I do not work in the office at all, except to turn in paperwork, or copy new charts for my personal records. I am on call Monday and Tuesday night from 430 in the afternoon until the following morning at 830. I take call all weekend, every weekend from 430 on Friday afternoon until Monday morning at 830. I get paid a flat salary whether I go out, get any calls, don't get any calls, etc. If I do have to go out I get 50 cents a mile, but no extra pay for deaths, etc.

This past weekend I had about 8-10 calls. I went on about 6 visits. I inserted a foley, dug out fecal impaction, and stayed with a patient for about 6 hours while they died. Of course, I had to get orders for caths, dulcolax supp, preparation h, verbal DNR's, etc. I have only been at this job for a month, and it was by far the busiest weekend I have had. In the past there were weekends I only got 2-3 calls and didn't have to go out at all. I work for a small branch of a hospice company and we currently only have 8-10 patients.

After reading what you all make, I'm feeling pretty fortunate.

[jeannepaul, BSN]

I work at a large for profit hospice. I am one of 4 full time on call weekend RNs. It is a 62h period and they pay a salary equal to a 40h week. We get mileage door to door. The case managers take the 5th on call spot on Friday and Sat. We only have us 4 working on Sun. It usually works out well for us when we are all working, but there have been several times I have ended up working 18+ hours straight. (we only had 2 on call nurses at that time)

We also have a full-time on call nurse mon-thurs with 2 CMs as backups. We also have a triage nurse, so that makes it alot better.

The case managers are paid hourly so everything over 40 is time and a half. They also get paid around 2.00 beeper. Their time starts the moment they get the call to the moment they get home so they get paid their hourly rate for drive time.

The only drawback for us on call nurses is when we take time off. We have to take hour for hour, so if we want to take the whole weekend off, it's 62 hours of PTO. They just recently started giving us more PTO per pay period than they used to.

[LaRN]

why is it that hospice is the only branch of healthcare that can get away with making nurses work for free or hardly nothing. try asking a hospital or nursing home nurse to donate her hours !

[Whispera, MSN, RN]

where I worked, I got $1.25 per hour to be on call (and got called lots!) and my regular rate of pay if I had to go to the patient...

[youngheartoldhead]

Agencies that don't properly compensate their nurses for doing on call visits (or don't pay them at all!) encourage poor care. When a nurse has a busy on call, with visits and numerous phone calls that can potentially fill up her whole day or night, she becomes frustrated and downright angry, she may choose to not make a visit when doing one may be a better choice, skimp on a visit, or simply make poor judgement calls. (unacceptable but understandable). Patients and families almost ALWAYS assume and treat a nurse as though she is getting paid for the job she is doing, and ALWAYS expect her to do it right. If she doesn't, they will usually let management know about it and in turn, management will come down on this nurse with the same force whether she was working for free or at double time and a half. So you see, getting paid fairly is a necessary part of what it takes to be a good, effective and safe nurse, you owe it to your patients, the agency owes it to THEIR patients, and they owe it to you to PAY YOU FOR THE WORK YOU DO.