On-call or cancelled? That is the question!

A new on-call policy at our facility has stirred up a lot of emotions in the nurses. Some good, competent nurses are talking about leaving.

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On-call or cancelled? That is the question!

Hello:

What is the cancellation/on-call policy at your facility? Last week, my facility instituted a new/updated on-call/cancellation policy. Basically, nurses are no longer cancelled, they are placed on-call, for their whole shift, up to the last two hours of their shift. Additionally, nurses are now being paid $3.00 per hour, for every hour they are on-call. Personal time can be used in addition to this new on-call premium, or nurses can elect not to use their personal time and only receive the $3.00 per hour. Previously, nurses were paid zero/zilch/nada/nothing for being on-call (which only lasted for up to 4hours, at which time the nurse was either cancelled for the rest of the shift or called to report to work by 11am/2300hrs).

So, the differences in the new policy are: Nurses are not cancelled, they are placed on-call for their whole shift (up to 5am/1700hrs); nurses are paid an on-call payment of $3.00 per every hour they are on-call; nurses can be called to work at anytime during their shift once they are placed on-call; and nurses can be placed on-call as late as 2 hours before their shift begins. Also, nurses are to report within 1hour after being notified they need to come to work.

As you might imagine, there are more negative responses towards this policy than positive responses. For example, night shift nurses are especially concerned about their safety/leaving their homes in the dead of night (sleepy, driving, safety); many nurses live more than an hour away; since nurses are now on-call their whole shift, other plans still cannot be made or events will be missed because there is no longer a time limit that a nurse can reasonably expect not to be called in to work (even at 2am or 4am); once a nurse is called in, the nurse is guaranteed to work the rest of the shift. More than a few single nurses with young children have been asking, "What am I supposed to do with my child(ren) once I am placed on call?" One nurse mentioned that she uses a night-care service, but she cannot drop off her child after 8pm.

To be fair, so far, those of us who have been placed on-call were called either not called in to work at all, or were called at 2am (night shift) notifying us that we were not needed for the rest of our shift. But, I think many of us had already decided that we were going to bed, whether we were called or not.

I predict that not many nurses will be signing up for overtime because those on OT are usually the first to be cancelled, and now, since there is no cancellation, only on-call, why put yourself in the position to wait around to be called for only $3.00? At least, if you only work your 3-12hr shifts, it is unlikely that you will be cancelled (or rare), and if you are not scheduled on a given day, if the census is high, they will call you and ask you to work (at least in this case, you're not waiting to be called to come in after being placed on-call).

Let me close by saying these are the kinds of policies that I believe put good, competent, staff in the position or mindset to leave the unit/employer/profession. At the very least, policies like these put nurses more at risk of receiving disciplinary warnings because they are made to feel there is no work-life balance. Other nurses talk about how, "All this is not worth $3.00," and still others say, "Well, they're gonna write me up because how can I be expected to come in at 1am or even 3am, and work for the rest of my shift." The nurses who are single parents feel even more stress because they feel their kids' safety and lives are now at risk.

Bottom-line: many nurses are saying, "It seems no matter what, nothing gets better for us; we're damned if we do, damned if we don't. Management just doesn't care about us, yet, we're supposed to be the caring/compassionate profession."

What say you? Maybe you have some good suggestions, thoughts, and ideas!

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Eschell2971

About Eschell2971, BSN

Echell2971 is an active & busy mom & RN, who likes to dance & sing, even with her patients.

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This is darn close to our policy, except we get put on call really close to our shift time (like theycall at 1800/1805 when we start at 1900)...and we get paid $2/hr to be on call instead of $3/hr.

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Specializes in SICU, trauma, neuro.

We are either cancelled or put on call, depending on circumstances. My suggestion for single parents would be to follow the childcare plan that was in place when they thought they were scheduled. So if the nurse is on the monthly schedule as working that night, child goes to the night provider. If the nurse gets placed on call for low census, child goes to the night provider. That way the nurse doesn't have to figure out where child can go at 0100, or have to wake up the child because s/he got called in.

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Specializes in school nurse.
We are either cancelled or put on call, depending on circumstances. My suggestion for single parents would be to follow the childcare plan that was in place when they thought they were scheduled. So if the nurse is on the monthly schedule as working that night, child goes to the night provider. If the nurse gets placed on call for low census, child goes to the night provider. That way the nurse doesn't have to figure out where child can go at 0100, or have to wake up the child because s/he got called in.

Big financial hardship, though, if you're paying for a full "shift" of childcare but ending up with $3.00 an hour of pay for your troubles...

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I worked as a tech for a hospital that did something very similar. However there were two differences usually only one/two nurses or techs were placed on call. Anyone not needed beyond that was downstaffed. Another thing was they put up a list for requesting down staffing on certain nights so those people would get called first. They cycled through the employees so that the same person was not always getting down staffed and if you didn't want to be downstaffed you could request that they call someone else. A lot of people liked it so I don't think it was really a problem finding someone who wanted to stay home.

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Specializes in Research.

Our policy is very similar, except I believe 4.50 is the on call pay. On top of that, I'm in the float pool so I'm scheduled more than I end up working, I'm on call pretty often. I've gotten called in as late as 230 am with a 1hr time to make it in. It's a pretty small hospital though and unusual to need a nurse for after 3am..

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Specializes in Nurse Leader specializing in Labor & Delivery.

Our policy is similar. Nurses are paid $4/hour for being on call. We don't cancel any nurses unless census is really low and we're putting 3+ nurses on call.

We can put someone on call as early as one hour before start of shift. Return to hospital is 30 minutes or less. If a nurse lives an hour away and is put on call, the expectation is that she needs to be in town or somewhere closer so that she can return within 30 minutes of call back.

So OP, no, I don't think your policy is particularly draconian.

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Specializes in ICU; Telephone Triage Nurse.

In 1998 when I worked in an ICU at a certain hospital that has since closed many years ago we had mandatory call once a week, and also for low census (this was a result of a unit nurse decision before I started - the nurses felt they were being used as float pool fodder, and didn't like floating to other units to fill staffing needs). Usually only one nurse at a time was placed on call.

We were paid $1.50/hr for every hour on call, but if you were called in you were paid time and a half. We had 1 hour to report once called.

Are you receiving any incentive pay if you are called in?

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Specializes in Nursing Professional Development.
Big financial hardship, though, if you're paying for a full "shift" of childcare but ending up with $3.00 an hour of pay for your troubles...

If it happened frequently, I would change jobs -- but if it was rare, I would eat the cost in order to save my sanity and the sanity of the kid. My hospital has a similar policy, but we try to use the "on call" option very rarely. We try to work with the staff to avoid the "on call" status whenever we can.

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I worked at a hospital that implemented this policy. I don't need $2 an hour for multiple shifts a pay period if I could afford no pay I wouldn't be working as a nurse. This hospital soon lost many of it best nurses to other local hospitals, naturally management had no idea why they couldn't retain their best staff members.

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From the article:

Let me close by saying these are the kinds of policies that I believe put good, competent, staff in the position or mindset to leave the unit/employer/profession.

Agree.

On-call policies such as the one described are simply not very just/ethical. After all, whether unionized or not, whether working under a contract or not, the "agreement" wasn't that you would sit at home for 1/10th of the agreed pay rate, or less (in lots of cases, MUCH less). Plenty of people need to make employment decisions based on the bottom line: feeding family, keeping a roof over their head, satisfying debts, etc. Earlier in my career when I faced this situation, I informed them that I needed to work, so they could call me off entirely but not put me on call because I would be arranging to work at my other job if they (first job) didn't need me - which was true. So they put someone else on call. Doubt I would get away with that now.

If the on-call situation is truly rare, that's more acceptable. But the over-all situation combined with all the other poor employer practices in nursing is just one more 'cut' in the 'death of 1,000 cuts'.

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I think this 'low census', 'flexing', 'on call' or whatever you want to term it is garbage and just another way for corporate healthcare to make more money off of the backs of their front-line providers!. I feel that as a permanent employee, there is an implicit agreement-that my employer will provide me with an agreed upon number of hours of work and salary and in return, I will be a competent, productive employee, who is a good steward of their time. I, personally, didn't hire on to be a 'sometime full-time' or 'occasionally full-time' employee and I don't think my creditors would understand if I explain to them that due to being called off numerous times from my job, I may come up a little short this month. One thing you can bet on though, is that the suits sure aren't taking off time to help the bottom line. In the past, when offered this arrangement, I didn't dignify the $3.00/hr offer to be on call and instead just took the day off free and clear and then looked for (and found) another job. We all deserve better-unacceptable

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