On call for free?

Nurses General Nursing

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Where I work, the 4 nurses each take a week and take the beeper and are on call. The call is for questions,(med issues) advice, if its really bad, we come in... etc.. (residential facility for kids w/ behavior/psych issues.... NON PROFIT agency) ...But, it is completely uncompensated, we get not a dime for being on call... There is no contract, nothing, "just how they do it". Is this right? I mean, isnt this "nursing for free"... we are deffinitely off the clock, so, is this even legal, or does it even sound kosher to you BON -wise? this is a whole new world to me, and I cant find anything specific on my statesbon web site... so does anyone have any thoughts on this???? Thanks!!!

Specializes in school nursing,cardiology,and mental hea.

I agree with you SmilinBluEyes it is a scary situation,sounds like practing medicine.I did work in facilitity for youth that had this policy.The nurse was suppose to decide what OTC meds to dispense.I refused to do this,only would give meds that were prescribed.I told the higher ups that this practice was against the state board of nursing.I was told that they did not believe me.I offered to pay for the long distance call to the board of nursing to confirm this.Then they wanted me to put the med in envelopes for security officers to dispense,Again I said NO WAY.Needlesss to say I found employment else where.Think about it these are children with behavorial and emotional problems,how are you going to confirm allergies,etc.I worked too hard for my liscence.

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Specializes in ICU-Stepdown.

I agree, ideally, you should tender your resignation and run, don't walk, out of there. This situation is fraught with potential liability issues. But if circumstances dictate that you try to stay, I don't know of a way to broach the subject without basically getting them a little annoyed- but hey, they have been getting by scott-free, and honestly, its time they stop. You might start with telling them that unless they have some form of compensation (comp-time or pay) you will not continue to freely give up your after-hours time. You DO have a right to have a life outside of the job -and if you are responsible for THEM (on call) then you cannot freely use your own time. This is unfair -and if you aren't salary, then you should be justly compensated for reserving your time for the company.

As for handing over OTC drugs willy-nilly, that is a major risk you and the company are taking. If heaven forbid, something were to happen, a lawyer is going to get ahold of THAT little tidbit, and start laughing as he counts up how much to bill or sue for. Tylenol is freely sold at any fine refueling (gas) station and corner convenience store -but when you have patients (or residents under your care) you cannot give such things to them without orders.

Granted, the odds of something going wrong are infinitessimally small, but thats hardly the point. If something DOES go wrong, THEIR lawyer is going to point to this practice, and make it seem as though you caused the incident.

Its just not worth your license, time, trouble, or sanity.

Even in the hospital, the nurses commonly have a bottle of ibuprofen available for US to use -but we would NEVER give one to a patient, or their family member -unless they had orders for such.

WHY IS THAT??

--- L I A B I L I T Y ---.

.....^^^^^^^^^^

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Specializes in NICU, ER, OR.

jonzey, smilin, I completely agree. The first day I was there, one of the other nurses was telling me where the otc meds were... I said, how do we know who we can give them to (re: an ORDER!!!) She said, no, they all can have them. In fact, the units have their own supply of them. I remember thinking that they must be under different regulations than an acute care facility. We test for drugs w/o an order (the parent or state agency signs a consent when the child comes in) , we do strep cultures on sore throats w/o an order, etc. Do you know of any way I can find out exactly *what* regulations they have, since they are so different from a hospital? I dont know where to begin, but I have so many issues!!!!

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Specializes in Day Surgery/Infusion/ED.

You'd have to find out who licenses them. Are they licensed by the state? Are they JCAHO certified? (Doubtful.)

Honestly, the time and effort you would put into looking into this just isn't worth it. You are carrying a lot of risk with this arrangement, not to mention flat out being taken advantage of. You would be wise to find another position asap.

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Specializes in school nursing,cardiology,and mental hea.

RNOTODAY,when I read your post it reminded me soooo much of my situation when I was working at the facility for youth.I I,too was on call for free.Iam ashame to say.Staff would call me at home as needed and I would go on site and assess the situation.If I was at the site for 30 min or whatever that is what I would get comp time for,NOTHING ELSE.Looking back it is not worth it.Too many what ifs,not to mention the lack of compensation.We went to school to make a living,we are professionals with many opportunities.Now I intend to be compensated for services I provide.

I dont know where to get requlations;but I do know to stay within my scope of practice and that does not include dispensing meds without an order or performing procedures without the same.The administrator offered to write a letter stating I was instructed and given permission by him to dispense these unauthorized meds.I did not feel that would help if worse came to worse,b/c I knew better.Sometimes we as nurses just have that gut feeling that something is not right or something bad is going to happen.I had that feeling at the facility,sure enough it did,I thank God that I was not there.FOLLOW YOUR HEART.

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Specializes in OB.

RNOTODAY - Just thinking about your situation makes me nervous. I personally would not work at all without compensation, but my bigger concern is that if one of these children were to develop an allergic reaction to any OTC med that YOU told them to give, you are not "on the clock", not "officially" working, therefore would the facility's malpractice cover you? I've got a feeling they would throw you to the wolves.

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Specializes in NICU, ER, OR.
RNOTODAY - Just thinking about your situation makes me nervous. I personally would not work at all without compensation, but my bigger concern is that if one of these children were to develop an allergic reaction to any OTC med that YOU told them to give, you are not "on the clock", not "officially" working, therefore would the facility's malpractice cover you? I've got a feeling they would throw you to the wolves.

You know what? The facility *does not even have for us*.so, my new question is, does that make my issue of not being on the clock and giving medical advice a moot point, since if I *were* on the clock, they wouldnt cover me anyway?????:uhoh3:

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Specializes in NICU, ER, OR.
RNOTODAY,when I read your post it reminded me soooo much of my situation when I was working at the facility for youth.I I,too was on call for free.Iam ashame to say.Staff would call me at home as needed and I would go on site and assess the situation.If I was at the site for 30 min or whatever that is what I would get comp time for,NOTHING ELSE.Looking back it is not worth it.Too many what ifs,not to mention the lack of compensation.We went to school to make a living,we are professionals with many opportunities.Now I intend to be compensated for services I provide.

I dont know where to get requlations;but I do know to stay within my scope of practice and that does not include dispensing meds without an order or performing procedures without the same.The administrator offered to write a letter stating I was instructed and given permission by him to dispense these unauthorized meds.I did not feel that would help if worse came to worse,b/c I knew better.Sometimes we as nurses just have that gut feeling that something is not right or something bad is going to happen.I had that feeling at the facility,sure enough it did,I thank God that I was not there.FOLLOW YOUR HEART.

jonezy...

Were you the only nurse on staff at your facility? This area of nursing is so new to me, and everything they do there, just blows me away.but it is "just how they do it there".... I do have other questions about this type of facility, but have nothing to compare it to, and dont know anybody who works at another one in my area.could I ask you some questions about it if you dont mind, just to see if it is par for the course at these places, or is mine run completely differently?

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Specializes in ICU-Stepdown.

regardless of weather or not they would throw you to the wolves (and since they are asking you to do an unethical behavior, what do YOU think? ) what you're doing violates your standard of practice. You cannot just give OTCs to these 'patients' without orders to do so. Doing so is tantamount to prescribing, and you will have no defense against charges if something goes wrong and the poop starts hovering near the fan, if you get my drift.

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Specializes in NICU, ER, OR.
regardless of weather or not they would throw you to the wolves (and since they are asking you to do an unethical behavior, what do YOU think? ) what you're doing violates your standard of practice. You cannot just give OTCs to these 'patients' without orders to do so. Doing so is tantamount to prescribing, and you will have no defense against charges if something goes wrong and the poop starts hovering near the fan, if you get my drift.

:uhoh3: I completely get your drift..... the very first day there, bells and whistles went off in my head.... but then I second guessed myself, thinking "There are 3 nurses here, certainly not all 3 can be so clueless?" and thinking, there must be some loophole, so to speak, or different regulations for a place like this. I need to find out, because every day I am there, all I can think about is LIABILITY!!! LIABILITY!!! UHHHHGGGGGG, just when you think you found a nice, non stressful nursing gig....:uhoh21: But, my gut tells me, that there is no "loophole" that will override my duty as an RN. How can these people be so clueless!!!???:angryfire

Thanks so much for your input, it feels better to converse with someone about it.......

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Specializes in ICU-Stepdown.

Your instincts were right all along. Just glad you realized it before any harm could come to you.

I know what its like to think something may be 'not right' but 'everyone does it' and they claim thats how they always did it. It makes it hard, when you're not sure, to know for certain.

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Specializes in school nursing,cardiology,and mental hea.

Remember your pharmacology,MOST of the (BEHAVIORAL MEDS)can not be taken with OTC meds,you even have to be careful with the diets they recieve i.e pizza,smoked meats,extra salt,caffeine.I know it seems like a nice non stressful enviroment,but that will quickly change.Keep us posted on the outcome.I too for awhile just loved it.Iam now back in the real world with rules and regulations.I realize the rules are not only for the safety of my pts but also for ME.

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