L&D On Call

SmilingBluEyes · Sep 14, 2003

Originally posted by CIVICgalz
Hi, looking for input from otherr L&D units as to how they run on-call/stand-by. Our hospital is trying to institute it, but it's causing much grief! If it runs well on your unit would appreciate knowing:

*do f/t and p/t do call?
*do you do 12 hour shifts?
*is unit covered by call 24/7 or just weekends/nights?
*what is premium pay for call?
*what are your nurses paid when called back in for busy unit but NOT the designated on call person?

And anything else you can think of.

Thanks! CIVICgalz in Ontario, Canada

Hope this helps:

*Yes, where I work, we ALL must sign up for ONE call shift per schedule...... whether we are full-time/part-time/perdiem. This IS mandatory for all nursing staff.

*yes we ALL do 12-hour shifts; 7-7.

*Our unit is covered by call on the busiest days, Mon-Thurs, (when most of the inductions, csections and GYN surgical cases are done). This is for both days and night shift---- and weekends, as-needed, but only as-needed. Weekend call IS NOT mandatory.

*Premium pay for being ON CALL is $3.00 an hour and time and 1/2 if we are called in---minimum 4 hours once we are called in.

*All nurses are paid time and 1/2 for call-ins', whether specially on-call for the shift, or just coming in to help out when a asked.

*We are a Level-II unit, doing about about 70-75 deliveries a month, as well as post-op gynecological surgery patients.

RMH · Sep 14, 2003

I work in a very rural, small hospital. We do about 100/year. We pay on-call whenever there isn't an OB nurse in house, or when we know there is someone in prodromal labor. We pay 3.00/hour and it is voluntary but would like all to help. When called in it is 1 1/2 times and no you don't have to be specifically on call. If you are called and come in it is call back pay..good Luck. It took years for us to get paid to be on call. RMH

NurseyNursey · Sep 14, 2003

I also work in a small, rural hospital. We do about 300 deliveries a year. We have no "extra" staff on call but do have call when there are no patients or even a pp couplet (the second person on will take call).

We get $2/hour for call. We only get regular pay when called back in.

On the occasion when the unit is closed, we have all learned the hard way not to come in until the patient actually shows up.

L&D_RN_OH · Sep 15, 2003

Originally posted by CIVICgalz
*do f/t and p/t do call?
*do you do 12 hour shifts?
*is unit covered by call 24/7 or just weekends/nights?
*what is premium pay for call?
*what are your nurses paid when called back in for busy unit but NOT the designated on call person?

Everybody signs up for call on our unit, ft, pt, and pool. How mnay open shifts determines how many on call shifts you are required to sign up for each schedule. Some 6 week schedules, it's 20 hours, some it's only 12. We have 4 nurses on at a time or 3 with someone on call. We generally cover 12 hours for mandatory on call, but on call for call outs can be split up by whoever is willing to take it. We are paid $5/hour for being on call, and regular pay once called in (OT if you are over already).

Offering premium pay is up to the manager. It is usually offered after we have called everybody and no one is able to take call.

Caseyrnbsn · Sep 15, 2003

We take on call time at our level II facility. We schedule 4/4/4. Our call time consists of 3p - 7a coverage. We are required to take 8-12 hours per pay period (every 2 weeks). We cover 7 days a week. We do not cover daylight shift becasue it is easier to get people into work on daylight hours than off shift hours. Full time and part time take call time. Pay is time and a half if called in then if called in between the hours of 11p and 5a it is double time and a half. We get $2.50/hr just to be on call.

We are a LDRP setup and also we do our own C/sections and Post-partum tubals. That is why we schedule 4/4/4 also we run a Level II nursery.

I hope this helps.

CIVICgalz · Sep 17, 2003

Thanks for all the responses. We do 1300 deliveries per year, level 2 hospital, and staff 3 per shift and no on call. They are trying to institute call but looking for models. A few other questions if you'll all humour me:

* Do F/T do call on weekends? If so how does that work with an every-other-weekend f/t schedule? An example of how F/T would do call typically would be appreciated --- ie, after last shift - what is maximum number of hours that could potentially be worked?

*Do L&D units you work for utilize the GRASP (workload assessment) utilization tool? Our manager claims 80% utilization is ideal. We don't know how that can be achieved in L&D where you have to staff for a certain level of "what if". We spend a lot of time "inputting" into GRASP to justify our existences, but for the most part think we're cutting our own throats. In our establishment ER for example, does not have to do GRASP - but is still a variable workload.

THANK YOU!!

nrsnan_1 · Sep 17, 2003

A little twist from my end....In all the places I have worked, the mandatory call system had the most negative effect on staff morale. One of the primary problems was call-ins because people knew there was a backup. I convinced the head nurse to try going without mandatory call. If someone called in sick or if patient census required additional help, we started calling around, asking people to come in and help out, for either all or part of the shift. Believe it or not, it has worked out. Whenever possible, if the census is low, I cut people out early. It is amazing how happy someone can be just to get off work an hour or two early. The facility I work at now does about 50 births a month and on a good day has two RNs on the labor deck. There was no additional pay for being on call and time and 1/2 after 80 hours per pay. Not much incentive there at all. Previous facilities paid $1-2 for being on call but straight pay when called in unless accrued hours greater than 80.

FERTMYRTOBRN · Sep 17, 2003

Ours is a rural facility that averages 150- 200 births a year....we're working on increasing that number with our waterbirth program!

We only have a 12 hour on call person on either Sat or Sun. THe rest of the week, we have to call around to find additional help. This pays time and 1/2. We usually have no problems finding someone. We only have 8 nurses in our dept. that are OB, but we do pull LPN's, CNA's, NI from the Med-surg floor to help with postpartum and nursery staffing when census is high!

OUr unit usually has only 1 OBRN per shift and if there are no pts then we either help out on Med/Surg or stay at home on call for $3 and hour.

I personally would always like an on call person scheduled as I have had situations when I have been jumping through hoops to do an emergent section and don't have the time to call around to find help to take care of my pospartum moms and babes! UGH!

Our rural hospital is in a financial crunch at the moment due to summer low census, so we have all had to tighten our schedule belts!

Good luck and if you have any good staffing ideas...pass it on!!

Paulette

imenid37 · Sep 17, 2003

We do ~600 deliveries per year. We also admit gyn's and do our own PACU, but not our own OR. We schedule 6 or7 on weekdays, 4 or 5 on evenings, nights, or weekend days. If the lower # is scheduled we have a person on call. (example-4 on for nights, we'd have a person on call. If 5 are scheduled to work, we'd have no on call unless we were very busy). On call pay is $2.00/hr. and time and 1/2 if called in for minimum 2 hrs. To cover on call for staffing, it is voluntary. For the PACU, we must sign up for 28 hours in 8 weeks in 4 hour slots w/ same rate of pay.