On call requirement-help needed

Editorial Team / Admin · Aug 18, 2018

The expectation at my facility is that 30 minutes from notification you are in the OR ready to receive the patient. As for leeway, not really as when getting called in it means true life or death emergency in some cases where the in house team needs help (urgent cases, such as appendectomies, will wait until the call team arrives to come to the OR, but the same 30 minute expectation is there). Maybe if it were a one time thing, there'd be leniency but definitely not for regular occurences. We do have access to an apartment where those who are right at or above the response time can stay when on call. Is that an option with this job? Also, how soon would you be taking call? It may be possible that you won't take call until towards the end of orientation, which may allow you to assess weather and traffic or create friendships with coworkers who may be willing to let you stay with them as well. Also how much call could influence the decision of moving/staying somewhere or with someone/having access to a place to stay at the hospital- but you'll never know until you ask.

springchick1, ADN, RN · Aug 24, 2018

We have a place at our hospital for people to stay who live more than 30 minutes away. Like Rose said, it could be a matter of life or death.

SweetSouthernLove, ASN, BSN · Aug 25, 2018

At my facility, and yours is probably similar: The purpose of call is to be available to the hospital. They are paying you because you are being "engaged to wait" in the event that an urgent/emergent case is booked and they need staff. You are technically still working while on call because there are requirements that you must adhere to while you are on-call such as: no drinking, no medications that will alter your mental capacity, no trips that could take you out of call-back distance and no events that mandate you to stay the entire duration without being able to leave for work duty.

There are people at my facility who live almost an hour a way from my hospital as well as people with very crappy reception even with signal boosters in their homes. They do two things: 1. Request a pager. This allows you two methods of communication and they can use either your phone or pager and increases your chances to be notified at the earliest possible convenience. 2. COMMUNICATE WITH THE OR FRONT DESK STAFF. I cannot stress this enough. Whoever runs the desk, notify them of your need for extra time to commute. Granted, try not to rely on this because it will not always be possible, but if the front desk staff knows youve spoken with them and need extra time, they will most likely pick up the phone and call you first because of your geographical location compared to your coworkers so you have more time. (Usually, they have a list of call staff and just go right down the line calling people. So they can make notes by your name to give you more heads up.) 3. Tell your boss everything. People appreciate honesty, and be pretty straightforward about it. In this field, it can be life or death as others have said, and they need to know you can be depended upon to take a patient at any time. If the boss is worth a crap, they will appreciate this forethought on your part. Express your concerns and just give a short run down about why. 4. Know all routes that lead to the hospital. Drive them every once in awhile so you know them like the back of your hand when you are in a rush. If you are rushing for time and need to be there immediately, don't forget to put your hazards on or you will get stopped and delay your OR. 5. Have scrubs and comfortable shoes in two places: your trunk (in case you can't return home) and beside your bed at night - so that if you're groggy and half asleep you wont be wasting time scrambling for this stuff. 6. Also, when they say 30-minute call back time, they mean commuting there, in the hospital, dressed in OR attire, behind the red line and ready to accept your patient to the OR room as Rose said. Not entirely commuting.

Being on-call is an extension of your job requirements. At my hospital, if you don't show up for call or if you are considerably late and someone has to cover for you, you can be written up or fired. Some hospitals are more lax than others, but it can impact your performance evaluations and your references at other hospitals that require you to take call. With that being said, there are people who will make remarks about call who may have more experience with it than you do, such as "two drinks is fine and I can sober up on the way there" or "I can make it, I probably wont get called anyway" or "it was quiet/calm when I left..." don't give in to their bad habits. The simple fact about this is if you are called-in its generally for something that cannot wait and if you're not at the top of your game someone could die. Take it seriously.

yanni225, BSN · Sep 8, 2018

Take the job offer. Yes, 30 minutes is ideal but I have called in teams that have taken over an hour to arrive. We are a level one trauma center and it has never been a problem in the past 30 years that I have been there. We always have a back up team (scrub and circulator) on our unit free to do an emergency if it comes crashing through the doors. The next team is called out at this time and will head in and be the next back up. We are prepared for every emergency from ruptured AAA's to Crani's and Ectopics with case carts and all supplies picked right outside the corresponding OR. Our trauma room is spread around and can be scrubbed, counted and set up in 5 mins or less. One more thing, don't badger the Rn calling you in with nonsense questions like "What is the case your being called out for", or "how many rooms are running"? This is my favorite, "I'm call number four, I shouldn't be called out." it's a waste of time to ask and she doesn't have the extra seconds to answer you. Be professional, prepared and do your job with excellence. Good luck with your new position, you're going to love it!

elkpark · Sep 8, 2018

I've lived and worked in a rural area where everyone is v. spread out. People who had an on-call requirement to be 30 mins from work got a motel room or found someone in town they could stay with for the days or nights they were on call. Call me a pessimist (I am), but I'm pretty sure that if you take a job with a 30-min response requirement and you live 30-32 mins away, under ideal circumstances, you're going to be late a lot, because there are going to be lots of times that circumstances aren't ideal.

Years ago, when I took a job 2 hours away from home in order to work in a specialty I really wanted, I started out staying in cheap motels, which didn't work out at all, and another nurse I worked with introduced me to an older widow she knew who was alone in her big house, wanted to make some extra money, but didn't want to have someone underfoot all the time. She rented me a room in her house for just the couple nights a week I needed to be in the other town. It worked out great. If you ask around at work, maybe you can find something like that.

Best wishes!

MP RN, RN · Sep 9, 2018

As alluded to, the whole point of the 30 minute window is to be ready to respond to high acuity/emerging cases. If your drive already estimates 30-32 minutes, and there are times and instances you are worried you won't be able to make it, you should let them know before you take that job. They may be able to accommodate or assist in helping you with someplace to stay during your call periods.

The 30 minutes time isn't just to make it into town. It's to be changed, have your case picked/opened/counted and ready.

This is for emergent cases. Depending on your hospital, this will include stat c-sections, where literally a few minutes can mean a life changing outcome. If your loved one was on the table for something like this, would you be okay having a nurse on call who has doubts they can make it on time?? Maybe there's snow, or traffic, or who knows.. and they didn't make it into the OR for 45+ minutes? That would be unacceptable and unprofessional.