On-call in the OR

Specialties Operating Room

Published

Hi everyone

I have been an operating room nurse for nearly eight years. I really enjoy what I do but I have had dreadful call ins over the last month. Over one weekend I worked an extra 20 hours on top of my normal 40 hours. Last night I worked all night so was up for 20 hours without sleep... then went home and had two hours sleep, and had to wake up to return to work but luckily my boss said stay home.

Anyway, when I get this tired and have been working crazy hours I find myself asking "why do we do it?". I know why I went into nursing to help people etc but I do find the call ins take its toll physically. Sometimes if I have had a really rough night or last few days with call ins I get to the point where I feel like I could break down and cry. This morning I really felt like I couldn't concentrate at all so was so grateful I didn't have to work.

I know some people will probably say I should give up the call ins and as much as they are a burden sometimes I still love the rush of adrenaline you get from being involved in an emergency case.

What's everyone's experience with call ins in the operating room? Do you get worn out with on-call? How long have you been doing it? I'd be interested to hear from you.

Specializes in O.R., ED, M/S.

Maybe some of you might be better off in some other form of nursing. Call is part of the game and when it seems most of you whine about too much of it this might not be for you. What part of call do you not understand? I'm sure this was explained to you when interviewing for the job. I'm sure it wasn't a sudden surprise. As you can see I am not too sympathetic to your cause. I like how some of you set your own rules if the call shift doesn't go your way. This is what OR nursing is all about. Go ahead now and rip me apart because I only check this place out about every 3 months or so.

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Specializes in OR Hearts 10.

Call is call...cover it as needed. Not working the next day is about safety for myself and patients. We don't need any more martyrs.....Doesn't have anything to do with working in the OR. We have a nice plaque in our break room honoring someone that feel asleep driving. Nope, not me, you can think I don't belong in the OR but I don't want my name on the wall.

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Specializes in OR, Nursing Professional Development.
Maybe some of you might be better off in some other form of nursing. Call is part of the game and when it seems most of you whine about too much of it this might not be for you. What part of call do you not understand? I'm sure this was explained to you when interviewing for the job. I'm sure it wasn't a sudden surprise. As you can see I am not too sympathetic to your cause. I like how some of you set your own rules if the call shift doesn't go your way. This is what OR nursing is all about. Go ahead now and rip me apart because I only check this place out about every 3 months or so.

Of course we all were told about call when we signed up for the job. However, there are times that a nurse does become unsafe after an extensive work shift and call shift, and should not be caring for patients the next day. Management (which I suspect you are) needs to understand that and advocate for safe patient care. There are many studies out there detailing the obstacles to patient safety when a nurse is exhausted from working too much.

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Specializes in Operating Room.

I went to Per Diem so no more call for me. I just live too far away and we have to cover OBs C-sections. I had to stay overnight every time I was on call..it got old fast. I have recently gone back to school too so call would be a pain.

My last hospital was union and they had to give you 8 hours rest time in between call and your next shift.

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Specializes in Operating Room.
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.
This is very true. The last hospital I worked for was a large trauma center. It really had to be life or limb for them to call you and being that I was ortho, we didn't get called in hardly ever. We needed to have anesthesia available for gunshots, stabbings etc. and we just covered ortho. I was there 4 years and got called at home to come in 3 times. The majority of my calls entailed me staying over a few hours, that's it.At this place, they call you for things that aren't even emergencies..often, the doctor just wants to get it done. And, of course, those stupid C-sections..;)Going per diem was the best thing I could have done...I'm not against taking a job with call again, but I will have to live closer and it'll have to be a big hospital. I found out I'm a big hospital type of gal anyway,lol.
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Specializes in APRN, ACNP-BC, CNOR, RNFA.

If you guys have shared governance at your hospital, then you have a lot to talk about.

First, if you're getting called in that much, then you must make a killing in OT. I think your director should open up 2 FTEs to staff a team on nights, M-F. We staff 2 in-house call teams, and 1 out-house call team, which is a day shift team that rarely gets called out. Places that aren't so busy, could just use 1 in-house call team, and use the other team as back-up call. Weekends will still need coverage, sorry.

Second, why aren't your OB teams trained to do C-sections? Do they have to provide a baby nurse, or do you do that too? There's a nice little program specifically for them through AORN. There should be no need for anyone to come out for a C-section, when able bodied people are already at work in THEIR dept.

Third, I'm a compressed weekender that works evenings/nights only. There are 3 of us, who work (2) 16 hour shifts for 32 hours/week, which is full-time. For a nice salary, I help keep the Mon-Fri people at home and in their beds on the weekends. That would probably be asking too much to have weekend staff.

Ask your director to consider these options, and have your shared governance reps advocate for you. Surgery drives revenue for the hospital, so you guys should have more negotiation with call. Remember: The squeaky wheel gets the oil.

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Specializes in Operating Room.
If you guys have shared governance at your hospital, then you have a lot to talk about.First, if you're getting called in that much, then you must make a killing in OT. I think your director should open up 2 FTEs to staff a team on nights, M-F. We staff 2 in-house call teams, and 1 out-house call team, which is a day shift team that rarely gets called out. Places that aren't so busy, could just use 1 in-house call team, and use the other team as back-up call. Weekends will still need coverage, sorry.Second, why aren't your OB teams trained to do C-sections? Do they have to provide a baby nurse, or do you do that too? There's a nice little program specifically for them through AORN. There should be no need for anyone to come out for a C-section, when able bodied people are already at work in THEIR dept.Third, I'm a compressed weekender that works evenings/nights only. There are 3 of us, who work (2) 16 hour shifts for 32 hours/week, which is full-time. For a nice salary, I help keep the Mon-Fri people at home and in their beds on the weekends. That would probably be asking too much to have weekend staff.Ask your director to consider these options, and have your shared governance reps advocate for you. Surgery drives revenue for the hospital, so you guys should have more negotiation with call. Remember: The squeaky wheel gets the oil.
They ( the OB staff) refuse to learn how to do C Sections. It has been this way for decades and the culture of the hospital is such that they get away with it. IMO, one of these days there is going to be a problem- what if your call team is already doing a case and an emergent c- section needs to go? They have a cheat sheet poster hanging up in their little OR upstairs..which is scary. Many of us have tried to make suggestions about alternative scheduling. It goes nowhere. People here are just very set in their ways. I actually caught grief for daring to suggest alternative solutions..so I go in for my shifts and don't bother anymore.
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Specializes in ICU, Operating Room, CVOR.

I would go so far to say that I am burnt out on call. There's just something about being yanked out of my bed at 2am and having to work every third weekend in addition to my 40+ hours per week that makes me want to leave the OR entirely. Harsh words for an OR nurse: "I'm thinking about going back to the floor".

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If you guys have shared governance at your hospital, then you have a lot to talk about.

First, if you're getting called in that much, then you must make a killing in OT. I think your director should open up 2 FTEs to staff a team on nights, M-F. We staff 2 in-house call teams, and 1 out-house call team, which is a day shift team that rarely gets called out. Places that aren't so busy, could just use 1 in-house call team, and use the other team as back-up call. Weekends will still need coverage, sorry.

Second, why aren't your OB teams trained to do C-sections? Do they have to provide a baby nurse, or do you do that too? There's a nice little program specifically for them through AORN. There should be no need for anyone to come out for a C-section, when able bodied people are already at work in THEIR dept.

Third, I'm a compressed weekender that works evenings/nights only. There are 3 of us, who work (2) 16 hour shifts for 32 hours/week, which is full-time. For a nice salary, I help keep the Mon-Fri people at home and in their beds on the weekends. That would probably be asking too much to have weekend staff.

Ask your director to consider these options, and have your shared governance reps advocate for you. Surgery drives revenue for the hospital, so you guys should have more negotiation with call. Remember: The squeaky wheel gets the oil.

Kguill975;

My hospital is just the same. We have 4 OR's, 4 circulators, and we still have to do the C-sections. They do provide the baby nurse. Those girls flatly refuse to learn to circulate, even though a couple of them have done it before at a previous job.

Our CEO allows scheduled weekend cases, we call each other for back-up & so far have not had a bad outcome...but we all say that it's going to happen one day...we'll lose a baby or Mom, or that AAA that could have been saved.

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Specializes in PACU, presurgical testing.

Our OR will call in the 2nd team later in the day PRN, I think around 6 pm, for a weekend or holiday daytime. I don't know what their coverage looks like overnight.

I'm per diem in the PACU and also have to take call. I hate it; it is the only part of my job that I dislike. Once I'm there, I find I enjoy the work itself, but I really need my sleep. Our policy is that any call hours you work within 6 hours of your next-day start time are designated "sleep time," and you can either go home and come in late by that much, or come in on time and go home early. I think that this must be a house-wide policy, so the OR team must get sleep time, too. I don't think it's enough, especially if you have to go home and drive back--you lose more sleep that way.

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I traveled as a Circulator in the OR for yrs.. went to many hospitals, mostly on the smaller side. Did I see the OB nurse's doing C-sections... give me a break. They knew if they complained and if they did anything to break sterility or open something wrong then they would not have to do another. They just couldn't cut the mustard and laughed all the way back to their unit..

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The other thing about call is this, it should be for true need and not scheduled cases unless the manager is going to staff that extra weekend day or shift and not use the call team and then there are the OR's that feel because you work in the OR you don't need a life.

I worked at one on the beach area in NC that has a "10" minute call back... ridiculous. They think it's fine because you can stay at the hospital! Oh and yes, this is not a trauma center but a average everyday OR that is just trying to kiss a few shiny one's with the doc's...

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