Nurses "on-call" related to low census; Am I rightfully angry?

[inthesky]

I work on a small 15 bed behavioral heath unit at a local hospital. Even though the economy took a dump, our census has not really been affected. More and more people come in depressed with nervous breakdowns due to financial pressures, job and home losses, and marriages crumbling in those stressors. What has changed is our staffing policy when the census does have a dip. When the census dips to 11, a nurse has to leave or be put on the dreaded 'on-call'. For example, let's say that I get a phone call at 1230 to put me on-call for my 1500-2330 shift. I have to be ready to come into work whenever I am called. This means that I cannot do anything with my day, not knowing. The stress of not working is more than if I were at work. Usually that patient #12 does come in because well.. it is rather ridiculous to be able to predict the census for the entire afternoon and night at 1230. When I do make my way in (I live 30 minutes away), the single charge nurse looks ready to cry with the stress of admitting patients, dealing with the doc, and giving patients their meds. Even our on-call docs don't have to come in! I make new grad pay and get a measly $4 an hour for on-call. One day, I was really pulled around. I was called at 1300 and told I was on call before a 1500 shift. I was called at 1445 to come in . I was lazing around in my PJs reading a good book. It took me a rushed 45 minutes to get there and I was very angry in my car. My day turned around when I arrived to the lovely day nurse waiting for me and people happy to see me. It was just dumb, but being at work was a relief from the on-call stress :icon_roll. It is much worse for the day charge nurses when their AM med nurse is called in. How one charge nurse is supposed to pass meds and PRNs (psych patients get a lot of PRNs) for 10 patients, transcribe all new orders, deal with the docs, put out unit 'fires', be harassed at the desk for things like patient belongings and laundry issues, and admit patient #11 is beyond me. This is one of the reasons which I have not fought to renew my charge nurse status after previous issues at work which have faded for the most part. A 20 year experienced extremely capable nurse told me that she locked herself in the med room and almost cried. It made me feel so bad.

This on-call policy strikes me as wrong and unfair. I'm sure that employees (who keep their jobs) in every job field around the world are being abused in one way or another and I'm lucky to have a decent job. However, that doesn't make this right. Anyone else have to be put 'on-call'?

[lpnflorida]

I use to love being on call. I would give my cell number then go about my business, keeping a uniform and shoes in the car. I always made sure I was not more than 20 min away from work. We knew on the 3-11 shift if we weren't called in by 9 pm they would not call us in as then they would have to pay us for 4 hours even though we could still go home at 11 pm..

[JKidzMom]

This is becoming a huge problem in my area. We are NOT paid to be on call, yet we have to sit at home (by the phone) and wait for a call to come in. I live 45 minutes away and have 4 kids. One night the charge nurse "forgot" to call me off and I took the kids to the babysitter and drove all the way in to find my unit wasn't even open. I was so upset. And because I work nights, I am on call all night long, which means if I get called in at 3am, I have to wake my kids up and take them over to the babysitters in the middle of the night. The other problem (working in ICU) is that the census or night can change in a second. I strongly believe that ICU and ER should not have to send home staff when an emergency can occur at any time. (However, I have heard over and over again, "we can't staff for what-ifs!") I have gone to administration over and over again. They just don't care. It is really sad that the nursing profession is treated like this. I have NO vacation time because when the census is low, I am told to stay home. I am a full time employee and I don't think I have worked a 40 week in over a year. I am currently looking for another job....hopefully, it won't be the same thing. I think we deserve to be treated better then this.

[Be_Moore]

I've been getting put on call a lot lately as well, so I feel your pain. But I get $4 per hour and time-and-a-half if I do get called in, so I guess it makes up for it. To date, not been called in, however. Just keep in mind that while you may only make $4 hourly to be on call, at least you are getting paid for not working. And instead of stressing about getting called in...these days I just sleep in. To hell with them, I'll get there when I get there.

[inthesky]

Boo to that "HR" policy of having to call every few hours and not being paid for it! Thanks for putting some things in perspective. Psych is rough to skeleton crew as our 'codes' are violent patients going off. Sometimes we can make special calls to the manager to allow the second nurse if we suspect a patient could get violent. The unit only had 8 patients during the most catastrophic shift I have ever had (I was activated from on-call for this one). There were only 11 patients during one of the busiest, most demanding, frustrating days I have ever had just a few weeks ago. There might as well have been 20. Nobody even called the manager about census. I told the charge nurse that I wouldn't leave her. As I'm sure that it is not uncommon that one ICU patient can be more work than 3 combined.

Last time I was on-call for the AM, I just went back to sleep with the phone next to my head because what is one non-morning person going to do when awoken at 5am? *plunk back to sleep*

[Freedom42]

If my employer required me to be "on call," I would expect to be paid at least the minimum wage of $6.55 an hour. If you're not paid when on call, ask yourself: Does the doctor go home without pay when the census is low? I don't think so. It takes a lot more than the idea of lounging around in my pajamas to get me to accept the idea of a pay cut.

This practice ought to be challenged. If I were in an "on call" situation, I'd call my state's Department of Labor to find out what's legal, what's not, and how I can file an anonymous complaint.

[mama_d, BSN, RN]

We get called off in four hour increments as well, except on nights once they tell you at 2300 you're not needed they won't call you in at 0300. They recently changed the way it works, though, and not for the better either. I work nights, so I might get called at around 1715 (and I start getting ready for work at about 1700) and told I'm off for the first four...but I have to remain "ready and available" up to 1900, at which point I'm safe for a couple of hours. Then I have to call at around 2100 to see if I'm needed or not at 2300...and if everything is going crazy, they'll try to get me in right away, although I usually tell them that they'll have to wait until my kids get into bed at that point. Then, again, I have to remain "ready and available" up to 2300. We don't get "call pay", but we can use our PTO time if we're low censused.

Although we have so many people leaving in other units that low census usually doesn't happen, we just get floated instead.

[feralnostalgia]

is this on call stuff the norm or an exception? pretty sure that even housekeeping staff at the hotel I worked out got treated better than that, and our beds were full or empty with as much unpredictability as any hospital.

it sounds utterly ridiculous.

[lpnflorida]

On-Call Time

If you are required to stay on your employer's premises while waiting for a work assignment, your employer must pay you for that time, even if you don't spend it actually performing job tasks.

In addition, if you must be on call elsewhere, your employer must pay you for hours over which you have little or no control and which you cannot use for your own enjoyment or benefit. In other words, if your employer places significant restrictions on you when you are on call, then you may be entitled to pay, especially if you get called into work fairly often. For example, if you must remain close to the workplace, cannot drink alcohol, and are called into work several times during each on-call shift, you are probably entitled to compensation for all of your on-call hours.

full article at

http://www.nolo.com/article.cfm/objectID/0AB41C75-3C54-4BA6-83A224ADAA80DD64/104/150/249/ART/

[VORB]

They normally call 1-2 hours before my shift if they're looking for someone to call off. I simply don't answer my phone if I want to work. However if I want the shift off, I will dive for that phone when it rings. I've never shown up for work and been downstaffed. There's always someone out of my 6-nurse shift that wants the shift off. Sometimes they even call in early and request to be downstaffed. It's a way to take time off without having to use sick time. If you're downstaffed, you have that option; if you call in sick, you HAVE to use sick time.

[Music in My Heart]

My good friend is a PACU nurse. She loves being on call because she gets $16/hr for being on call, time-and-a-half for reporting, and a guaranteed 4-hr minimum.

[Freedom42]

My good friend is a PACU nurse. She loves being on call because she gets $16/hr for being on call time-and-a-half for reporting, and a guaranteed 4-hr minimum.[/quote']

Does she work in a unionized hospital?

[Music in My Heart]

Does she work in a unionized hospital?

Her hospital isn't unionized but most of its nearby competitors are so they derive a lot of spillover benefits in order to retain staff and because management is terrified that they will vote in the California Nurses Association.