Operating Room Specialty Call Teams

[Alisia Pop]

I work at a level 1 trauma center in the pediatric/gynecology operating rooms. As the chair of a committee that creates unit-based guidelines within the language of our nursing union contract, I am tasked with the challenge of how to get more employees to join one of our specialty call teams. Our other specialty call teams are not struggling at the moment, but our neurology specialty call team has significantly less members. The problem is some of the limitations we face, such as we cannot provide increased call pay rate, employees must be off of orientation for a certain period of time, and our institution has a 30-minute call response time, but many employees live outside of a 30-minute radius, so they refuse to join a specialty team because they take more call which means they would have to stay in the call rooms. We also cannot dismantle the neurology specialty team, but current members are feeling burnout. I created a specialty call incentive guideline for non-team members to help with the call burden, but it is not consistent.  I worked with the service lead to try to recruit members, but no employees are currently interested. I feel like I'm at a point where we need to force employees trained in scrubbing neuro to take their call or join their team. Thank you in advance for your time! 

[Rose_Queen, BSN, MSN, RN]

Some other things to consider before jumping to "forcing" employees to take call or join a team:

1. What cases is the call team completing?
2. Do you have both a circulator and a scrub on call? If so, is it feasible to have just a scrub on call and anyone can circulate?
3. Of those cases, do they truly require a team member to cover, or is it something that someone with a reasonable level of experience could handle? For example, anyone with basic orientation to the OR could be expected to scrub burr holes, but the call team must come in for an aneurysm clipping 

I have worked in ORs where there was no specialty team call (except cardiac), and I have worked in ORs where there's a combination of specialty call and general pool call. In the ORs with the combination, at times the specialty call was disbanded (not the team, just the call requirement) or the call schedule was modified. For example, one small volume service line covers only weekend call; everyone is expected do the cases during the week. Another service line team covers weekday call for late running cases, but not weekends. At the one facility where only cardiac took specialty call, it was agreed upon by the organization that they would not increase the call pay rate, but if someone reached over 250 hours of on call per calendar quarter, they received a "bonus" of $1/hour. So if someone had 249.9 hours of on call, no extra. Someone who had 255 hours of on call received an additional $255 in the first pay in the following quarter. IS, cath lab, and cardiac surgery team were the only ones who ever met parameters for the bonus. Non-union, so not sure if that would fly in a union setting. But since it was for anyone who took call, it was universal, so might be an angle to play there- it could get your current team happier about taking the call and possibly (if they're crazy like some of those team members I worked with before) take extra.