NPs and Being On-Call

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 Hello all!

I've been a nurse for about 3 years now and have been considering going back to school to be a nurse practitioner or finish some sort of MSN degree. I am still deciding on what specialty I would be interested in. Part of what is making me so indecisive is being on-call. It can be hard to separate work and personal life in this field, but I'm really hoping for that in the settings I consider. I've not been having luck online with people explaining the amount of on-call time (if any) they need to do in their specialties. The closest thing I have found so far is being a nurse educator. My current bedside work can be rough at times, but I know when I clock out, I can say no to coming in or even thinking about work until my next scheduled day (besides training of course). 

Sorry! I know this is a bit of a ramble, but any ideas would be appreciated!

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Specializes in Psychiatry.

It's really variable. Outpatient often has no call, especially for certain fields like dermatology. Inpatient often has call. Psych is a mixed bag, sometimes I feel like we are always "on call" for true emergencies, but most offices also have crisis line numbers to call after hours.

If you don't want to do call it should be easy to find a job without it.

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Specializes in mental health / psychiatic nursing.

It can be highly variable which is part of the challenge. I'm in psych and where I work (inpatient) the NPs don't take call at all, so no overnights or weekends. Which is really nice and can help keep a good work/home balance (there is always someone else responsible for my patients when I'm not there which makes it easier to "let go" and keep work at work.).

However in other psych settings - such as the inpatient setting I did my clinical rotations in - NPs not only take call, but may even be contracted specifically for call-shifts (aka all nights or all weekends) only.  (Though there was also option for regular day-shift NPs to take voluntary call for OT pay if they wanted it). 

Depending on outpatient calls may be directed to a crisis line or dedicated "After hours" number, and there is never call, or you may be "on-call" all the time, and be expected to take emergency calls. 

I wouldn't let fear of taking call hold you back from exploring different specialties and going for an APRN role. I think the only one that might be challenging is Midwife, but even then there are places where call is not mandatory. 

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Agreed with the above.  I used to have call a few times a month.  I would dread those days because I am the type where I need my sleep!  My current position does not take call, nephrology.  I am half outpatient clinic and half dialysis, whereas the doctors consult in the hospital and cover a lot of ICU patients.  Not being acute-trained, taking call for consult from inpatient happily limits my potential for call.  You will find in NP world so much different from RN that there are no clear lines, it is truly more a professional experience in which I bring up because you may be disappointed if you are looking for reality of 9-5 hours.  It is more about outcomes, which sometimes you can't just say oh, done.  Especially the first few years, you need to put in time to learn to function in the provider role independently, school is just the beginning. 

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Specializes in allergy and asthma, urgent care.

I work in an outpatient specialty and am on-call 1 week a month.  It's by phone only; I never have to go in.  Most weeks I don't get called at all.  It really doesn't impact my life at all.

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Specializes in NICU.

I work in-patient in a NICU and don't do any call time as far as being at home- we are 100% in house and get paid 1:1 hours even if we are lucky to get a few hours of sleep in the call room. 

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How is on-call work managed for aprns  - is it via collaborative agreements or protocols that it is delineated? Does the physician need to provide back-up for you if you take call?

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I work in outpatient psych and I am on call for a week every few months. In the off hours I may get a call from a patient who needs an urgent refill, is having a med side effect or is wondering if they should go to the ED. I have a work laptop at home and dealing with the page usually takes ten minutes or less. Every once in a while I get woken up to return a page but it's not often. It can be kind of a stressful at times but it doesn't make me want to leave the job because I really like my work. 

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On 10/11/2022 at 8:34 AM, Heather Richmond said:

How is on-call work managed for aprns  - is it via collaborative agreements or protocols that it is delineated? Does the physician need to provide back-up for you if you take call?

Highly variable. I don’t have MD back up.

Being a NP isn’t a 9-5 job or clock in/out like a RN. If you are already having reservations about a on call situation which might not even happen, you may need to rethink things.

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Specializes in Surgery.

I work in inpatient surgery and it varies. In my particular hospital there is no requirement to pick up call per se, but I end up taking 1-2 Saturdays a month, 7a-7pm. This could require doing nothing if there are no active patients or consults to having multiple consults, inpatients to see and cases to first assist it, it highly varies. 

I try and be within 30 minutes of the hospital, but again there is not requirement.

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