How does your agency do call

[Kindra Nelson R.N.]

I have worked for the same home health agency for 14 years. We have always done call one way. We have a RN and Lpn on together for a week at a time. The RN does the SOC, PH and triages. The LPN does regular visits on the weekend and will help with triage during the week. Our RN's are on every 4 weeks, the LPN's evvery 3 weeks. We now have an odd number of nurses and we are being forced to change the way we do our call.All of us have worked for this agency for many years. We are looking for ideas on how other agencies do their call. All the ideas we have came up with don't sound appealing. Would love to hear yours.

[jnette, ASN, EMT-I]

Here's how we do ours:

Weekdays from 4:30 pm to 7:30 am we rotate a different nurse each day. (LPN or RN, doesn't matter) As we usually do not do sign-ups after 4:30 pm, this works out fine for all. We also have a back-up RN from our office staff pool who takes back up call from Mon-Thurs for those same hours. This RN would be called only if there were a real need.. such as a RARE after hours SOC, or if the primary on call nurse for that night was being swamped with calls.. also very rare. In other words, the back up "office RN" is very rarely needed, but is available just in case.

Of course if the primary nurse on scheduled call for that noc happens to be an RN, and a rare after hours SOC were to come in, she would do the SOC as she is already on call as primary.

WEEKEND call begins 4:30 Fri. pm through 7:30 Monday a.m. We rotate weekend call nurses as well. One primary and one back up . Both these nurses are from the "daily road nurse" pool, no office staff are used on weekends. Both nurses share the workload.. both do the daily wound care visits, and what ever other daily visits are needed. The primary nurse carries the pager and is responsible for answering all pages day and night. Should she get swamped, she calls her back up to help out. Ie, the back up nurse could help out by taking another 1-2 of the scheduled daily visits, freeing up the primary nurse to do a SOC or whatever the other calls might be that she needs to see about.

Both nurses work together, doing what needs to be done. The following w/e 2 other nurses will do w/e call. We rotate them and it usually ends up that each nurse will have w/e call about every 5-6 weeks.

The weekday pm call schedule works out to approx. one night every 10-12 days.

This works really well for all of us... we have a great team of nurses and we all work together well. A close knit bunch who work hand in hand. Never have had any problems, complaints, or cop outs. We also have several nurses who will often take 1-2 pts. each near their home on weekends to help out the w/e call nurses if they want a few extra dollars that week.. or simply because we're swamped and they want to lend a hand. If 2-3 nurses help out this way on busy weekends, it really makes a difference for the other two who have scheduled call that weekend.

Also.. the 2 nurses who are coming up for w/e call... they do not have to do any daily "pm call" that week leading up to their weekend call.

Hope that helps. :)

[annaedRN, RN]

we have a FT on-call nurse that does sun, mon, tues & thurs. from 430p-8a. we have 2 RNs on call wed night and then on weekend nights (fri/sat) -these are on a rotating basis so it boils down to about every 6 weeks - one RN is for hospice and one is for home health. we also take turns being back up call on the nights that our FT oncall nurse works - that is just for the scheduled visits/soc/roc, etc that have to be done or if the FT nurse gets really swamped ( she rarely ever calls us).

we usually have call about 3 times a month - either a weekend and one other day or just 3 random days. not too bad. we have regular weekend nurses so call is always just for overnight.