On-call in the OR

CIRQL8 · Jul 17, 2012

It is important to have a culture of safety. 8 hours minimum between shifts is the suggested amount, I think. 20 hours straight? Waaaaay too much. After 14 or so, next call team should have been called in to take over. If some type of policy (written or unwritten) is not in place for this, it should be looked in to. And now. We have two call teams. If team one is working and team two is not, after 14 or so hours of straight work, we call in team two. While not always possible, if someone is working all night, they are not expected to work the next morning. Or at least we try to get them home as quickly as possible. From time to time this is not possible. I have been working 24 hours straight before. But we try.

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Ilovethe80s · Jul 23, 2012

I've been in the OR for 1 1/2 years....obviously not very long, but I already dread call. I have had weeks where I've worked 60 hrs because of the call. I've also been in the same predicament as you where I worked all day, quite a bit at night into the morning, gone home for an hr or two and then expected to be back in the next morning. On those days, I feel like a zombie. Our charge nurse tries to get release us as early as possible, but t's no always feasable when staffing is low and cases are piling up. I love working in the OR, but the call is prob what I dislike most about the requirements of the job. Have you thought of going to a surgery center?

Editorial Team / Admin · Jul 23, 2012

I'd have to say that my supervisor is excellent with this kind of situation. There was a night I worked a few hours late, then got called back in the middle of the night. I don't remember driving in that morning. We were so short with staff that there were exactly enough for the three ORs. However, I didn't feel safe, told my supervisor that, and she sent the three of us who'd been called in home. The unit nurse manager ended up taking my place, with my supervisor co-circulating (she's not an RN, so couldn't do it herself). The other two were replaced by staff borrowed from other specialties.

lozstar, BSN, MSN, RN · Aug 19, 2012

That is interesting CIRQL8 what you have said about calling in a second on-call team. So does that mean you have two on-call teams on all the time? How many staff do you have working in your OR? Our OR is not overly big as we only service one speciality so there is about 12 of us that do call this is for scout, scrub and anaesthetics.

Ilovethe80s I know exactly what you are saying about feeling like a zombie!! It can be dangerous and I know at times I am just way beyond tired! And like Ilovethe80s and Sweet_Wild_Rose mentioned my boss tries to get us home early but sometimes it's just not feasible and it always comes down to "its part of the job".

Anyway its good to hear about some things happening out there.

CIRQL8 · Aug 21, 2012

Yes we have two teams on call. General and ortho. We take turns being on first vs second call every two weeks. Very rarely does it come down to specialty. Most of us can do a bit of everything.

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GadgetRN71, ASN, RN · Sep 4, 2012

I am starting school in the next few weeks and Im tired of the call thing, so I went to Per Diem. Im looking for a surgicenter job.

kd7hfw · Sep 4, 2012

In our OR each RN is supposed to sign up for 5 call shifts. How it ends up working is about 1/2 the staff takes 10 shifts/month and then a few months later we switch. It works great for preventing getting too burned out. I average getting called in about 25% of the time.

shodobe · Sep 5, 2012

I take alot of extra call because I like it. Only get the long days and nights once in awhile but it isn't too bad. I prefer to work when on call to make it worth my time. I am the unusual one though!

msancheeze, BSN · Sep 24, 2012

I just transitioned from a small, regional hospital OR where I took over 100 hours of call every four weeks to a large, level I trauma center OR where I take approx 32 hours of call every four weeks. I can count on one hand the number of times I was on-call and did not get called in at the smaller hospital. The level I OR is staffed 24 hours a day, 7 days a week and if I get called, it's to backup the teams already working. It seems like the smaller the hospital, the greater the hours of call. I liked working call and my paycheck was pretty well padded, but my work/life balance suffered...a lot.

SandraCVRN · Sep 25, 2012

Anytime I leave after midnight I tell them I'm turning my phone off at 6 AM (when call is over) and will call them when I wake up to see if I still need to come in. IMO if we don't stand up for ourselves who will..... The reason I do that is because the first time I worked until 2 am and was told we will get you out early I was not the first to leave and worked almost all day.

CTORnurse · Jan 7, 2013

I agree! I have a rule of my own...if I am not in bed by 12:30am..I am not coming in the next day. first call works from noon until 9pm(or whenever cases are done) and on call(with trauma beeper) from home until 7am.. second call works 9am-5:30pm( or until cases done)... there seems to be no clear lines as to when second call gets called in...I know for sure that if we are in middle of a case and there is a trauma, second call gets called in..but I worked 17 hours straight on a holiday call once with only a 30 min break..brutal..I will not put myself or patients at risk because i worked past midnight and I am working at 7am next day..I call out. end of story. There should be no backlash from that...I know soem nurses and techs will go in next day anyway, but there are no medals or awards for that and I see it as dangerous. Some people might be able to function like that, I know I cannot. I know my limits.