OR Circulating nurses. What is your call schedule like?

Editorial Team / Admin · Feb 27

CAM3111 said:

we are taking approx 70 hours of call per month give or take some

(Tongue in cheek response) Laughs in cardiac team. I was taking up to 120 hours of call in a two week pay period if it was my weekend! Averaged about 40 hours of call per week between on call and loser list.

I have worked at two employers with very different models.

Employer #1: Large community hospital, cases started wrapping up at 3pm with expectation to run no more than 2 rooms after 7pm.

Only staff who took service specific call was cardiac. Small team covering 16 hours of call per day Monday-Thursday end of shift to beginning of next and 64 hours of call Friday end of shift to Monday start of shift. Call was normally 2-3 per week, plus we had the "loser list" if more than one team was needed.
The rest of the OR was one 8 hour block of call per week, evenings and nights, plus work or call every 3rd weekend 12 hour shifts (covered all shifts).

Employer #2: Large academic medical center, rooms start to slow down between 6-7pm. Can run up to 4 without call staff all night long.

About half of the services take service specific call, the other half falls into "whatever else" call.
Service specific call varies based on how many are on the team, how many are actually working that week (vacations can affect how much call the others take), and how they choose to split it up. Some take call for the whole week at a time, others have daily call. These folks have more call than the "whatever else" call, but also only get called in for their cases. If you're on the neuro team, you are only coming in for neuro cases - you aren't on the hook for the ortho fracture case or the appy. Call starts when the last person on the team leaves for the day (variety of 8, 10, and 12 hour shifts, so could be different each day).
"Whatever else" call is generally 1-2 calls per month, 11p-7a, depending on how many there are to divide the call. Can get called in for anything not covered by specific service call. On the urology team and a ruptured AAA is coming in? You're on the hook for it! On the general team and a ruptured globe is coming in? You won't even know about it until the next day because the eye team is getting called for that one.

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I am also considering going to a same day surgery center to avoid call

Make sure you do your research here. If they don't have call, you can essentially be stuck until the case is done or even until the patient is discharged because there isn't anyone else to take over.

You may actually make out better in the larger academic centers simply because they typically staff 24/7 and have more people to spread the wealth around to.

CAM3111 · Feb 28

Rose_Queen said:

(Tongue in cheek response) Laughs in cardiac team. I was taking up to 120 hours of call in a two week pay period if it was my weekend! Averaged about 40 hours of call per week between on call and loser list.

I have worked at two employers with very different models.

Employer #1: Large community hospital, cases started wrapping up at 3pm with expectation to run no more than 2 rooms after 7pm.

Only staff who took service specific call was cardiac. Small team covering 16 hours of call per day Monday-Thursday end of shift to beginning of next and 64 hours of call Friday end of shift to Monday start of shift. Call was normally 2-3 per week, plus we had the "loser list" if more than one team was needed.

The rest of the OR was one 8 hour block of call per week, evenings and nights, plus work or call every 3rd weekend 12 hour shifts (covered all shifts).

Employer #2: Large academic medical center, rooms start to slow down between 6-7pm. Can run up to 4 without call staff all night long.

About half of the services take service specific call, the other half falls into "whatever else" call.

Service specific call varies based on how many are on the team, how many are actually working that week (vacations can affect how much call the others take), and how they choose to split it up. Some take call for the whole week at a time, others have daily call. These folks have more call than the "whatever else" call, but also only get called in for their cases. If you're on the neuro team, you are only coming in for neuro cases - you aren't on the hook for the ortho fracture case or the appy. Call starts when the last person on the team leaves for the day (variety of 8, 10, and 12 hour shifts, so could be different each day).

"Whatever else" call is generally 1-2 calls per month, 11p-7a, depending on how many there are to divide the call. Can get called in for anything not covered by specific service call. On the urology team and a ruptured AAA is coming in? You're on the hook for it! On the general team and a ruptured globe is coming in? You won't even know about it until the next day because the eye team is getting called for that one.

Make sure you do your research here. If they don't have call, you can essentially be stuck until the case is done or even until the patient is discharged because there isn't anyone else to take over.

You may actually make out better in the larger academic centers simply because they typically staff 24/7 and have more people to spread the wealth around to.

Thank you for your response! Very eye opening. Man that cardiac call is brutal. I could never! Bless the nurses and techs who can live that lifestyle.

We have 1 cardiac team as well that only works with one doctor so that singular nurse is on call 24/7 for eternity until she retires.

All other cardiac calls with our other MD still come to the everything team. Our everything team takes that 70-80 hours per 4 weeks and we are to do any call case that comes in. We don't have any special teams or second call or anything. We can only run 1 room after 5pm so if theres 2 or more call/late cases we can potentially be there all night since we have 8 and 12 hour call shifts. Charge nurses refuse to take any call also. So that's why it's a bit frustrating to be on call so much all the time. I keep pushing for hiring evening staff but my hospital tries to squeeze as much out of us as possible unfortunately. It's a very poorly run facility.

Again, thank you for your information it deff helps!

RickyRescueRN, BSN, RN · Mar 29

If you're not at a Union (CBA) hospital , then technically the hospital can do what they like in terms of scheduling you and mandating call. I agree with Rose Queen in that larger academic hospitals have dedicated teams for all /most service lines and so the call is usually less as it is split up amongst a large, specific group of nurses /techs. I work in Neurosurgery at a Bay Area academic hospital that has its own in house Union for Nurses. The most call that one can be mandated in a week is 12 hours. I cannot remember the last time I had any call mandated to me as I pick up a 2hr after shift call once a week (7-9pm) and usually 1 overnight call (23:00-07:00) . I have colleagues who don't pick up any call and only barely ever get mandated . We only get called in for our service (Neuro) but sometimes if Ortho is busy and they have an ortho Spine case, we will come in for that ( but it's SO rare) . Smaller hospitals with fewer staff will demand ALOT more call . That's just how things work there.

Your best bet is to get into a big academic/ teaching hospital and specialty service line where call demands are alot less. Not cardiac though as it seems it's universal that CVT teams are on call most of their life, no matter where they work. Our CV RNs pick up a ton of call (as it says very very well) plus they can be mandated the 12 hours /week . That's their choice and they make $$$$$$$ for doing so.