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Need Your Help: Revamping ON-CALL System

Specializes in LTC, PCU, Med/Surg, Hospice, OBGYN.

We are a small Hospice non-for-profit organization with 130-140 pts and with 2 teams (a 3rd is going to start d/t increase in census) with 11 - 13 pt case loads for each full-time RN. Right now we have a full-time on-call nurse Mon - Thu starting at 5pm until 9am next day. We also have a weekend on-call nurse Fri - Sun 5pm until 9am each weekend day along with 2 Full-time nurses during the week that alternate every other weekend to assist the on-call weekend nurse. The regular full-time salary nurses who work Mon - Fri also take back-up on-call during the week & weekend in case the primary on-call nurses are busy with a visit or admissions. We raffle our nights and weekend shifts to work, it averages about 2 nights a month 5pm - 9am + 1 weekend shift of 9am to next day 9am. Issues are that we only get $1.00/hr for on-call even if you get phone calls. If you do a visit as a back-up nurse you get $30 vs if you are the primary on-call nurse you get $60 for that visit. There are many other issues that I'm not going to bother you with but my boss wants me to find out how other agencies do their on-call system and how they compensate their employees for it. Can you help by answering the following questions?

1) Are you profit or non-profit?

2) What is your pt case load? What is your census?

3) Do you have an on-call staff?

4) If you take call, how are you paid? By visit, per hour, salary?

5) How much do they pay you for your visit? Is it more for death visit?

6) Do you get paid if it is just phone calls?

7) How many on-call shifts do you have to do a week/month? How many weekends?

8) How many nurses do you have on-call on a given night or weekend?

9) How is your on-call scheduled? Does your supervisor schedule you? Do you self-schedule?

Again any info is appreciated even if it isn't in one of the above questions. We are getting frustrated and burning out and don't want to stop being Hospice nurses but want our on-call system at least looked at to see what can be done.

Thank you!:heartbeat

1) Are you profit or non-profit? for profit

2) What is your pt case load? What is your census? 220

3) Do you have an on-call staff?yes

4) If you take call, how are you paid? By visit, per hour, salary? over time striagt hourly pay.

5) How much do they pay you for your visit? Is it more for death visit? not paid per visit..

6) Do you get paid if it is just phone calls? Not done at our agency

7) How many on-call shifts do you have to do a week/month? How many weekends? None, our triage team does this on thier own.

We are lucky. We don't take call after hours. We have our own team that does this. But our office is in horrible shape in other areas.. Hence my resignation given. i'd rather take call and work for an ethical agency.

8) How many nurses do you have on-call on a given night or weekend?

9) How is your on-call scheduled? Does your supervisor schedule you? Do you self-schedule?

Again any info is appreciated even if it isn't in one of the above questions. We are getting frustrated and burning out and don't want to stop being Hospice nurses but want our on-call system at least looked at to see what can be done.

NC29mom, ASN, LPN, RN

Specializes in Hospice, Geriatrics, Wounds. Has 10 years experience.

for profit

10-13/RN case manager

NO, we have 1 PRN nurse that picks up some of the on-call

If I take on-call, I get paid $75 for weeknight and $150 for weekend, AND if I

go out on a call, my hourly rate starts, which is usually overtime b/c

I am full-time already

not paid by the visit

yes, my on-call time starts when I answer a phone call (say for instance, Mr

Joe calls on-call. The answering service will call me and I will call Mr.

Joe back. My time started when the answering service contacted me.

Even if I don't go out on a call, I still get paid for dealing with it over

the phone)

I work as much on-call as I can because it's EXTRA money, and good money

at that. This month I scheduled for 9 weekdays and 2 weekend (a sat and

sun not in same weekend). However; next month, I only got 3 total days

of on-call b/c my DON (who also takes call) took most of the days b/c

she is newly single and needs the money.

Our census is 34 (I think), but we are with another office and i'm not sure

what their census is. We have 3 full-time RN's for our 34 and 1 PRN

who really just takes call b/c she has a fulltime job elsewhere. We have

one nurse scheduled to take call and then a back-up nurse (who gets paid

$50 and then hourly rate if you have to go out). Normally one nurse

is enough.

Our DON fills out what she wants to take on the on-call calendar first - THEN

WE can fill in the rest. SOme months she takes a lot of call, others she

doesn't. She is newly divorced with kids, so she's been taking a lot of

call lately.

1) Are you profit or non-profit? For Profit

2) What is your pt case load? What is your census? Census 60. Caseload 10-14 per RN

3) Do you have an on-call staff?Yes, two full time RNs. They work 7 on/7 off. Starting Monday at 1630 and ending the following Monday morning at 0800. The case managers rotate through back-up call, so about every 6 weeks they are on back-up for 7 days.

4) If you take call, how are you paid? By visit, per hour, salary? Full time on-call are salaried. Back-up case managers get paid their hourly rate starting at the time a call comes in.

5) How much do they pay you for your visit? Is it more for death visit? See above.

6) Do you get paid if it is just phone calls? Yes. $1/hour to carry the pager.

7) How many on-call shifts do you have to do a week/month? How many weekends?

See #3. We also have a holiday rotation where everyone (including full time on-call RNs) are included.

8) How many nurses do you have on-call on a given night or weekend? One primary, one back-up and one administrator (who covers multiple offices)

9) How is your on-call scheduled? Does your supervisor schedule you? Do you self-schedule? Supervisor schedules.

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