On Call

Our company has 2 dedicated on-call nurses. For the past year, I have been one of them. I work 7 days, Mon evening to the following Mon morning, covering the hours the office is closed, including Sat-Sun. The other dedicated on-call nurse works the next week. I was a case manager for 6 years when we only had one on-call nurse, so the case managers would cover the other week. I usually ended up doing 2 week days and one weekend day. We are a small office, with 3 full time case managers and one part time case manager. When there was only one on-call nurse, we would help each other out if the nurse who took call had a bad night. All it takes is one patient going bad, or having problems in the middle of the night to disrupt your sleep. (and in my state, driving if you have not had sleep in the past 24 hours is considered "impaired" and can get you a "driving while impaired" charge if there is an accident or ticket...and it is treated as if your had been drinking!) During this time I found if I could have the morning off, just to sleep for 3 or 4 hours, I could see a couple of patients in the afternoon. I also found that the case managers made sure the patients were completely taken care of for symptom management, medications, supplies etc. before they were done in the afternoon. I HATED myself if the on-call case manager had to deal with any problem that could have been dealt with before the end of the day. I know that a lot of problems cannot be anticipated, but a lot can, and should not be left to the on-call to deal with, especially if that on-call is a full time case manager, not a dedicated on-call nurse.

Thank you for the response. I'm torn also because another company wants to interview me as their RN CM for the region I live in. They have Prn staff to take over for u if can't make it to all of your reg daytime pts, call with them is only back up call x2 mthly and no weekends, which we do have a wkend nurse she's on vacay this wk and prior wk.

It would be a pay cut though, currently mileage is .49, any visit after 5 is $50 and if u do an admit or death it's $100.00 plus beeper pay

I am comfortable where I am but at only 4 mths and I'm beginning to burn out. At least when I worked at the hospital when Ieft I was done

Any advice????

Of course call depends heavily on how big your company is. Obviously, the main issue is smaller companies needing to cover 24/7 with minimal staff. But even then, there's not much savings with larger companies either as they look at efficiencies by slicing and dicing territories so more on-call nurses cover shorter distances. Some larger companies have a minimal crew working the nightshift and you provide back-up call to cover them.

It can be a fine line between working hospice and living it. I'd keep a close eye on call schedules when looking at offers. Lately it seems I get called out almost every time I'm on call.

I worked briefly (6 mos) for a company a few years ago that treated its nurses horrendously- think 55-75 hr weeks and required to take call at least 1 day per week. I was oncall one night after working all day, had a 6pm admission, went to a Waffle House to finish up my paperwork and have dinner and while there got called out to pronounce a death about an hr away. I didn't get home until 4:30 in the morning. I got burnt out super-quick with that company.

The small company I work for now requires us to take call 1 weekend a month and we have a nurse that takes call in the evenings M-F. Occasionally, she will take a few days off and the FT and other PRNs cover those days for her. Otherwise, I now work 40 hrs/wk or less, usually. We have days, and weeks even, when it seems there is not enough time to do everything but it's very dependent on how bombarded we get with admissions. We have 2 FT RN case mgrs, myself included, and a few PRNs. No admissions nurse. So if we get too many referrals too close together, it can get overwhelming. Overall, though, I am very content with my job.

I work as a hospice LVN doing 830 - 5 mon - fri daily visits, I also cover oncall mon - fri after hours and yes it is hard sometimes but I love the on call pay.

I'm 40 hours a week, salaried, and with 7 years seniority, at $33/hr. But I lost OT when I changed to on-call, so actually lost pay each week as I always had between 3-6 hours of OT each week when I was a case manager. But as on-call, my mileage starts at home, not after the 20 miles it is to the office. And I get paid mileage to drive home from the visit too.