How does on call work?

Editorial Team / Moderator · Apr 27, 2018

That does seem like a lot of call time. Some places pay extra for your time if you do get called in, and then that adds up once you are in overtime as well. I would definitely ask because honestly it sounds like a dealbreaker if you never get a day off! 8-10 hours per month, no problem. But 8-10 shifts?! Our ED actually has a call schedule, but it's not that frequent at all.

JKL33 · Apr 27, 2018

So you would work (16) 10-hr shifts per month.

And you would have an additional part-time job being OC for pennies on the dollar.

Yes that is 2-3 shifts a week, in addition to the 4 you are working per week. And remember, day shifts are likely covered in person, so you're talking nights and weekends for OC. You get home, you get called back in; go in, do the case, go back home, get up and come back for your next shift. Or it's the weekend and you can't do anything significant because you're on call. I am against very much on-call time, at least the way it is commonly paid right now.

If you live a good 30 minutes away, you won't be able to do anything (like get involved in a messy project at home or do something out and about in your neighborhood, like grocery shopping) when you're on-call other than sit there ready to bolt out the door. Otherwise it will take you too long to respond, and they will not take kindly to that *at all.*

You need more information to make your decision, such as:

- An accounting of how often OC is typically called in; this should be an accurate representation over the past 6 mos. or so - not simply what might've happened last week.

- Are they increasing or decreasing offered services, such that whatever has recently happened in the past with OC is expected to change? If so, how?

- What your specific OC schedule would be (recognizing that they could say it's no nights but all weekends, which would essentially mean every single one of your weekend days. I kind of doubt they would do that, but you need to know.)

- Exactly how OC is paid. What's the base rate and what's the call-in bonus (if there isn't one, or if it isn't significant, forget it).

- What their expectations are for your ability to respond in a timely manner

- Orientation process!!

KelRN215, BSN, RN · Apr 27, 2018

I am going to imagine that on-call involves taking call for overnights and weekends/to respond to emergency cases. So if you are on-call one week, you work your 4 10 hr days and then after 5-6pm (whatever hour your shift ends), you're on call until the next morning. If there's an emergency case in the ER at the end of your shift, you have to stay to work it. If you get home at 7pm and an emergency case has shown up during your commute home, you have to turn back around and go in.

I, personally, would not take a position that involved this kind of on-call because I value work-life balance. The 2 positions I've held where I had on-call responsibilities were case manager type positions. The first one involved dealing with primarily staffing issues on the weekends and occasionally accepting referrals that came in over the weekend. My current job, the last weekend I was on-call, I got 1 call the whole weekend- at 5pm on Sunday with a question about ear drops. I'm not ever expected to go out on call, so I can take call from anywhere I get a cell phone signal.

Editorial Team / Admin · Apr 27, 2018

Amount of call will vary based on the facility. Back when I was on a cardiac surgery team, I would be on call for an average of 2 16 hour shifts per week plus every 4th weekend 3:30pm Friday until 7am Monday. The work-life balance wasn't great, the $2 per hour wasn't competitive, and I spent a lot of time finishing up scheduled cases (not too much time getting called back in for emergencies) and the paychecks were nice (until my hours got cut- then I ran for a new job).

TruvyNurse · Apr 27, 2018

I personally wouldn't take the job. It sounds like too much of a time commitment. Maybe if you had no life whatsoever but you'd pretty much be either working or on call!

jarielle22 · Apr 28, 2018

They do pay time and a half after two hours of being called in and they pay $3.75 to just be on stand by. But still, idk, I accepted the job, but technically do not fully have it until I finish my hire papers and health assessment and drug screen. I am not sure what to do because yeah 8-10 shifts is a lot for on call! Ugh idk what to do. I wonder if I should rethink and tell the manager it may not work. Day shift is great, but I have a kiddo and my hubby, 8-10 shifts on call a month is rough especially as I read all these reponses!

jarielle22 · Apr 28, 2018

Thanks so much for your response! Yeah, I mean when would I really have a good amount of time off you know? The pay would be nice, yes, but I was not expecting 8-10 on call shifts a month! Especially since those would be on nights probably or right after my shift which stinks. I accepted the job, but its not officially mine until I finish the hire paperwork/ drug screen/ health assessment. I am not sure what to do now, I feel bad because I know they are counting on me to work for them, but now I am rethinking everything with this on call. If there was not so much of that I would do it.

jarielle22 · Apr 28, 2018

Ugh, you are smart! I accepted, but the job is not actually mine until I do the hire papers, health assessment, and drug screen. I have a kiddo and my hubby, going days was major and I was happy but with all of this on-call I am not sure. I wonder if I should retract my acceptance of the job before I do all of the hiring papers and drug screen.

jarielle22 · Apr 28, 2018

Yeah, see? That is rough! If they has maybe like 3-4 on call shifts a month that would be do-able, heck even like 5!, but 8-10? I accepted the job but its not totally mine until I pass the drug screen/hiring papers/health assessment. I wonder if I should apply elsewhere or ride this out and try it and see what happens.

jarielle22 · Apr 28, 2018

I totally value the life and work balance which is why I wanted to go to days, but all of this on-call? I just do not know anymore. I did accept the position, but the job is not entirely mine until, I finish the hiring paperwork/drug screen/health assessment. I feel so bad if I retract my acceptance, but ugh, its tugging at me if I really have like no days off really. I do live 30 minutes away as it is, and I am afraid that they need me there right in 30 minutes you know? I am so torn now.

guest940422 · Apr 28, 2018

How big is your hospital? Are you a stroke center? Is it rad call or IR call?

My hospital is pretty big and in a medium-large city. So I don't take call without the mentality that I'm getting called in. We are also a stroke center so we have two kinds of call:

Radiology call (CT, MRI, US) that only lasts until 11 pm on the given day and then you can turn the pager off. Rad call is more likely to be called in because it's just the nurse and the tech so its cheaper to call them in, but youre off the hook by bedtime.

IR call is 24 hours and includes stroke cases, if you get a stroke call you have to be in the procedural suite within 30 min. time is brain. This call gets called in less often because they have to bring in an rn, two techs, anesthesiologist, radiologist, and respiratory. So unless someone can't survive till morning or has a PE or a stroke they aren't calling in this team.

Either way we get $3/hr to hold the pager and double time for walking in the door when we are called in. The on call person during the week also has to stay late so people not on call can leave if their cases are going past their normal clock out time. So if you're on call on a tuesday, and you typically get off work at 5, but your unit closes at 6:30, and there is an embolisation running over till 7... even though call doesn't start till 7 you have to stay to relieve the nurse who clocks out at 6.

All this being said, we take a weekend every other month and 3 or 4 days a month of call I take more because I like the overtime. My unit's call is very demanding and I would never take that much call on my unit. But I have worked places where you may only get called in once out of every 10 or so call shifts. I've also seen units put nurses on call on their days off in case the unit has a heavy schedule or someone calls in. So that might account for some of the extra call time you are being told about.

A good gauge is to look at the turnover on your unit. If people are really taking that much call, and actually getting called in that much, they probably aren't sticking around long. If everyone on the unit has been there for over 10 years and positions are never open, then they probably never get called in.