Ideas for on-call nurse system

MrChicagoRN, RN · Aug 9, 2011

I was wanting to get some ideas for how other long term facilities or hospitals handle open shifts from nurses either calling in sick, vacation, and open shifts. My facility currently has us being on call 24/7 for four days every other month while still working our normal shifts. We have lost so many good nurses and can't keep the ones we hire becasue of this. Nurses calling in sick is the biggest problem. There are two of us and we are on call for the whole facility of seven units. Needless to say, we get called in a lot and work doubles sometimes. Please help!

A number of variables feed into our staffing.

1. We have an internal "agency" of dedicated nurses who can provide staffing to any unit. If the unit is overstaffed, they are offered up to float to other units.

2. A web based program allows the unit to post anticipated needs, and any staff can sign to take the shifts. If they aren't needed, they will be cancelled first.

3. We have a formal attendance that penalizes frivolous or excessive absenteeism.

4. We have our own unit-specific registry RN, they must sign up for at least one shift per schedule, and will be asked to help if the need presents itself.

Do they comply with state labor law? For example, they pay OT for extra hours, follow state law regarding mandatory OT, and schedule you For example, Illinois bans mandatory RN overtime, and no employee can be required to work 7 or more days without a day of rest.

Does your institution provide on-call pay? It may have to, depending on the state & circumstances.

I hope this helps

xtxrn, ASN, RN · Aug 9, 2011

One place I worked asked for people to sign up for on call shifts, for call-ins- then the charge nurse working who got the call-in would call the nurse on the list (and there was a back up in case the first one had something come up). Those who wanted OT got it. And, the management RN didn't have to go in. The staffing coordinator had the list up during the week for the next week... it worked out well. I never had to work the floor with that system when I was on call. I might have to go in for other things but not staffing.

jbluehorseh · Aug 9, 2011

The administration needs to have a better plan, the way they are doing it now sounds costly. They could use registry, and travel nurses and volunteer sign up let alone hire more nurses. There is also the risk of nurses being too tired to work. This also infringes on the nurses privet life. this is where union could step and prevent that, whether one is for or against union, the end result is patient safety. “Overtime in general may be bad for patients, whether it’s mandatory or not. While much has been written about the effects of mandatory overtime on the risk of committing errors, little information has been available on error risk in the context of voluntary overtime” (Kennedy, (2004). Those long, long hours. The American Journal Of Nursing, 104(10), 19. Retrieved from EBSCOhost.) this maybe a uphill battle but in the new era of evidence based nurse present them with the evidence.

jenann1220 · Aug 10, 2011

Thanks for the ideas so far. I live in Indiana so there is no laws to safeguard us from working too much besides the law to not work more than 16 hours straight. Also, the reason we started on call two years ago is because our annual cost for using agency nurses was around $100,000.