On Call dilemma

Traveler · Sep 20, 2004

One of the many reasons I left my last job was the call. I was 2 hours away from the furthest area we cover- not good since I had hospice also. They always promised to but never gave anyone else any time off if they had a hard night or weekend. Sometimes I was on the road and working 16 hours on my weekend day on call. I also frequently paid more in long distance returning calls than my call pay was. (No cell service at my house.) My record was over 200 miles one day on call. I will be taking call one weekend a month at my new job, but it is for a smaller area and the patients are mostly Medicare which means less calls usually.

renerian, BSN, RN · Sep 20, 2004

I have seen agencies have people on call for the Friday-Monday am 25 per day. Some as low as 15 per days/very stinkey and as high as 50 per day. All with pay for visits out in field. I have had some horrible weekends/holidays. The worst was 80 calls in three days. Stunk. I have seen places where the supervisors do weekday call and that is hard as most of the time their days are long to start with so they burn out. I have seen some agencies have weekend supers who do call/vists which does help the week day nurses from getting burned out.

renerian

AngiRN · Sep 22, 2004

Due to our staffing with nurses, each nurse has a designated day Mon-Thurs, it is the same day q week. Then they rotate weekend they are oncall q 4th week from Friday 5pm- Monday 0800. Thru the week, after 5pm, they are responsible for any PM admits, which we triage (will be an IV or BID wound or enteral feeding), then there may be scheduled PM visits, for BID wounds or PM IV clients, but they are already admitted. Then they also may have a PRN call, which we all know how that is....Some nights very quiet & others are a nightmare! We are unable to accomodate an extra day off at this time, hopefully this will change, but d/t staffing it is impossible.

The good part is they may have a slow day thru the week and be able to get home at 2pm.

Have any of you nurses had a comparable oncall to this? Do you guys think this is to much?

What has worked for you homecare nurses in the past?

Thanks so much!

renerian, BSN, RN · Sep 22, 2004

I guess if they are not out much in the evening the on call like that would be fine. Are they compensated per visit on top of their salary/if they are salary for visits after the office is closed?

Myself at other places I have worked all day, been out all night then worked all the next day. A person cannot keep that up long.

renerian

payday · Sep 23, 2004

that's why I am no longer in home health. I would work all day, get an evening admit and have to have the paper work turned in the next day. The queens in management wouldn't go near a patient or risk their life driving out in boondocks at night. Many times those evening admits could wait until the next day, but our director wanted everything right now like a spoiled two year old.

renerian, BSN, RN · Sep 23, 2004

On call is one of the reasons people do not stay in home health. On call compensation is all over the place as far as numbers. Driving around at night, dark and all in places you do not know is not safe anyway.

renerian

AmPmRnoncall · Sep 25, 2004

I do both after-hour visits and triage. Gets a little hairy sometimes. But most of the clients are peds and answering questions. If I am unable to triage a complications, I'll then go out. If it is in an area that I know is not safe after my assessment, I won't send a nurse or myself into that situation. I'll usually try and problem solve with them about transportation to get them to the local ER.

CardioTrans, BSN, RN · Sep 25, 2004

We take call every 5th wk. Its Mon-Thurs. We also have a triage nurse who handles all the calls. We have a nurse who works only weekends, so the week of our call we are her back up the weekend before we start our week. We back her up if there are too many visits for her to do alone, or if she is tied up with a patient and we have a hospice death, then we do the death. We have both home care and hospice. We are pd $40/day plus per visit for all the visits we do. During the week, our administrative person is our back up. We all decided that we liked it better to go ahead and do our 4 days all at once, that way we didnt have to take call for a month. Everyone seems to love it that way.

barefootlady, ADN, RN · Sep 26, 2004

As some of you know I have been working home health for a little while now, I am not comfortable with all of the forms and rules that seems to go nowhere. I am trying to give HH a open mind and a fair chance, but the on call thing has me a little uneasy. The original area I was to be working was close to my home, not too busy and no real danger except from wild animals. I know being out in the boonies for some is a scary experience, but I know most of the people for 100 miles so I felt ok. Now I have been filling in at the main office and they cover a larger area, more inner city, more in the drug areas, and in some places I just do not know how to get to. I have been having second thoughts since they announced last week we will be required to attend a weekly meeting for 90 minutes, get all of our paper work in next day, and take call more. I do not feel that I am making the money I should be making for the job we do. I was given a letter from the director who more or less said the insurance was going up 15% because the nurses utilize it more than other staff. I don't like the wear and tear it is putting on my auto, and I just don't feel like I am working with a top notch group of people who have all of the skills they need to run a agency. Any pointers? Please!

renerian, BSN, RN · Oct 14, 2004

It is so hard for home health nurses now a days. Do more with less. It is a hard spot to be in...on call is scarey to me doing inner city. I personally would not go into the inner city at night.

renerian

cynda · Oct 20, 2004

At the agency I work we don't have any problem with being on call, one person takes call 7days/week(was voluntary) with the understanding that if a call comes in the staff nurse who resides closest to that patients house would make the visit if necessary(we cover 5 counties), this usually works out well since staff nurses don't want to be responsible for carrying the pager and being on call they are usually very good about running out when ever asked. Scheduled PM visits(which thankfully we don't have too many of) are done on a volunteer basis, we post a sign-up sheet and everyone signs up for a turn(so far this has worked very well also), that way no one person gets stuck doing the evening visit just because it is their patient. This might not work everywhere, we have a great bunch of people that are always willing to volunteer to do extra to help out their co-workers.