pixiec11

That is an awful feeling. I have certainly been in a position like that before that just sucks your self esteem right out of you. Unfortunately, it was my first nursing job, so I didn't know any better. It took me 4 years to get the courage to leave. When I started med/surg, I realized what it is like to be appreciated and that there really can be fairness in a workplace. Then, I went to hospice and felt like the management would be good. I was right. My management team does a great job. They are fair and easy to talk to. But, I think managing nurses doing home care is a much more difficult job than in a hospital setting. Sometimes, it is difficult to see the job the nurses are doing or even sense their stress level because the management is working from the office and focusing on the bottom line. Of course, the bottom line is what keeps us all working, but job satisfaction is what keeps good, experienced nurses. I feel like everything will work out in the end, but I don't want to feel like I am being put on the defensive all the time. I just want to do my job well and leave it at that. I think they know I do my job well, but are looking for ways to make it more cost effective for the company and not realizing they are already getting quite a bargain out of their on call nurses. Of course, that's my opinion and I guess things will become more clear as time passes. For now, I am trying not to stress too much and just see where this goes. Lisa

Oh my... I imagine nurse turnover rate is really high there. I know our day nurses already work 45-50hrs/week just managing their caseload. I am sure if on call was thrown in there many would leave quickly.

Thanks everyone for your replies. This is a wonderful forum. I have learned so much from all of you. I am wondering for those that do admissions on the weekends, how do you take call and do an admission? I would be embarrassed to have to interrupt my admission to take calls. And, I can't imagine having time most weekends to get the paperwork done for an admission. On a typical weekend, I would say 25-40 calls is the norm with a couple deaths and in home visits for issues. BTW, our hospice is non profit. And, I made a mistake when I said 110hrs/2wks on call, it is actually 128hrs/2 weeks on call plus 10hrs of IDG/2wks , in addition to the in services, holidays, and staff meetings. I agree that "nothing is impossible for the person that doesn't have to do it" quote. I wish that everyone had to do on call for 1 weekend and then decide what is fair and what is not. If I could cut out daytime meetings and continue not doing admissions, I would feel like my job was perfect for ME. As it stands, my job plus meetings and admissions seems like an impossible task. Of course, if I was making $120k/year, I could rationalize it, lol. But at under $50k/year, not so much. Sad that I took a $15k/yr pay cut plus a cut in benefits to work at a job I truly enjoyed only to have everything change 2 years later. My dumb luck I guess. Maybe, it is better to work for money rather than fulfillment. I'm torn and praying things will get better. P

Thanks so much for your reply. I hope that's true about unemployment for NY. Hopefully, they reconsider these changes. Lisa

Hello, I am a full time, salaried, on call nurse for hospice. We have one on call nurse and one back up nurse that we can use if we are on another call. I like the job, but am nervous about "changes" to my job description. My hospice census is typically in the 80's, 3 counties-(about an hour and a half in each direction). CURRENTLY- I work about 110 hours/2weeks on call and about 10 hours/2weeks for IDG meetings. (Also, (4) 8hr holidays/year, 1 staff meeting/month, and multiple in-services during daytime hours.) On call hours are 3 nights one week and 2 nights the next plus ever other weekend. Nights are 15.5 hrs and weekends are 48hrs. I do not do admissions. We have a back up nurse that does evening/weekend admissions, and in patient visits. Paid time off is 4 to 1 for week nights and 2 to 1 for weekends. Meaning if we want a 16hr week night off, we use 4 hrs pto and if we want 24hours off on the weekend it would be 12 hrs pto. PROPOSED- Apparently, the management team feels like we could be doing more, such as weekend/evening admissions. And, that the pto should be revised so that we do not get as much time off. MY QUESTIONS- 1. How many on call nurses are expected to go to IDG's during daytime hours? 2. Do other on call nurses do admissions in addition to being on call? 3. How is your pto set up? 4. Is fundraising mandatory on your evaluations? 5. Do other nurses/management feel like on call nurses are working less than regular staff because they aren't running every minute of their 110 hrs on call? MY FEELINGS- On call nurses should not have to go to IDG's or into the office during daytime hrs, except for inservices or staff meetings. (I'm tired during the day and need that time to sleep) Fundraising should not be on your evaluation. On call nurse should not do admissions. (Who's going to take calls if I am doing an admission?) PTO time should not be changed after working there for 2 years for only the on call nurses. (Seems like being hired under false pretenses to me?) Although, I may not be "working" every hour that I am on call, I am still technically working. I can not make dinner plans, etc as I must be "available" at all times during those 110hrs. (Even if I only "work" 20 hrs/week, I was still required to be available at all times.) Unfortunately, I don't think I can do any more that I already do. When I worked 3-12hr shifts on med/surg plus overtime, I was less tired than I am now. I feel they should not require us to go to IDG, as it is too much. They feel they should add more work to our schedule. I have a feeling my time is short at this job, which is sad because I really love what I do and my coworkers are awesome. Any advice? Am I just whiny and really have it good compared to others on call nurses? How should I state my unhappiness about changes to PTO and extra work being added? Currently my 2 week schedule is- (doesn't leave much time for sleep or anything else for that matter) Sun-430pm-8am Mon- off Tues- 430pm-8am Wed- 9am-12pm- IDG, then on call 430pm-8am Thurs- 9am-12pm- IDG, then off Fri-430pm- (til Sunday 430pm) Sat-work 24hrs Sun-work til 430pm Mon-off Tues-off Wed-9-12pm- IDG, then on call 430pm-8am Thurs-430pm-8am Fri-off Sat-off Thanks for any input, P

Thank you for the responses so far. I am the on call nurse and was just faced with the fact that I would be taking calls for an infant out of the blue. With no pediatric experience, I was very shaken by this. According to professional misconduct guidelines, I can not accept this responsibility without proper training, and my supervisors can not delegate this to me. However, it is very difficult to place myself in a position to enforce this. It has been very stressful for me and I feel like this is being dumped on me without warning. I do not want to put this child or my license at risk d/t my lack of training.

Hello, In your organization, who cares for the pediatric population after hours? Your on call staff? The primary nurse? What training is given for caring for pediatric hospice patients? This recently came up at our Hospice and I am trying to gather info on what other Hospices do. Usually, we have the primary nurse cover these patients 24/7, however, at this time it is difficult for her to do around the clock and we have very few nurses with any pediatric experience. What's your take on this dilemma? Currently, we are considering pediatric training for the on call nurses and/or having 2 nurses go to assess this patient after hours. It's a difficult case, so I am a bit unsettled about assessing this patient at all without some kind of training. Seems like a ticking time bomb waiting to go off to me. Am I making too much of this, or should I just go and assess this patient to the best of my ability and report findings to the MD? Thanks, Lisa My thoughts for today: :prdnrs::cmptradct::wtosts::oornt::aln::urgycld:

Thanks so much for all of your input!! The funniest thing happened today after IDG... my supervisor asked if I posted the original message here, lol. Of course, I told her I did. We all got a little chuckle out of it. I guess the reason for my original post was because myself and the other full time on call nurse were being asked to make daily phone calls to the patients that were seen the night before to assess if their needs were met. This is one of our Quapi projects. In doing this, it quickly became clear, that it seemed nearly impossible to try and figure out who to call each day, d/t deaths, duplicate calls, revokations, etc. It was very time consuming and being on call it is difficult to find time to research and make these calls. Management felt on call had the extra time and this would help "justify" our hours. However, on call felt our calls are too inconsistent to make the time for this every evening. Today, we did find a solution. Myself and the other oncall nurse will make all these calls on Wednesdays after IDG, instead of daily. That way we will know who has passed and we can just give each other our list of calls that need to be made. Thank goodness my original post was politically correct, haha. Now that I know I am being spied on, I will have to make sure I let everyone know how great my bosses really are.:flowersfo ~Lisa

I have been doing full time on call for about 1 year. I really like my job and get alot of fulfillment out of it. Today during my evaluation, I was told my supervisor has been trying to justify a full time position vs actual hours worked. I would like input as to if I am being justly compensated for my position. Here are the details: Census-70-80, over 3 counties, approx 30 mile radius, some visits are 10 miles away up to about 65 miles away Hours- 4:30pm-8am x 5 nights= 77.5hrs plus weekend Fri430p-sun430p= 48 hrs, which equals 125.5 hrs oncall every 2 weeks. IDG meetings- 3 meetings every 2 weeks, 4hrs each= 12hrs in the office every 2 weeks. Typical night on call- Weeknights can range from a couple calls with no visits up to several hours of running. Weeknights usually 0-2 visits and a couple calls. Weekends usually crazy lots of calls, maybe a couple deaths and a couple s/s management visits. Probably 20 hrs or so, of weekend calls/visits/charting. I always have a backup nurse in case I have to make two visits at once and I don't do admissions. I am salaried at 24.50/hr x 37.5hrs/wk, which comes out to about $12-13/hr for being on call, regardless of the actual number of hours worked, sometimes I feel like I work non stop, others I feel guilty not being busy. No extra pay for nights/weekends/holidays/per visit, etc. as this is a salaried position. I do work between 8-24hrs extra for holidays also. Mileage is 0.585 cents per mile, decreasing to 0.55 cent in Jan 2009. I am blessed to be able to take time off almost whenever I want, due to per diems that are willing to cover for me. I am also blessed that I have great case managers that anticipate their pt's needs and supervisors that are very considerate of their nurses. So, my question is- Am I justified in making a full time salary? Should I be doing more, if so, what? When I work doing med/surg, I don't have to justify my hours. Some nights I am busy from the time I step on the floor, other times I am reading a magazine praying someone will put on their call light. Thanks for any input, Lisa

Well, I have been working on-call now for nearly 2 months, about 1 month on my own. I can honestly say that I can not believe how good it feels to know that I am helping so many people in the community. People are so grateful for our services. As far as my schedule, I work 3 nights one week and 2 the next, as well as fri 430p-sun 430p every other weekend. I have had several nights when I didn't have any calls and a few when I had to go out 1-2 times. We do not do admissions on the weekend and we have a backup nurse that does all scheduled visits and is available to do a visit if I am busy with a death. I think I have the best bosses ever, and the other nurses are great. They all really work together and seem to always go out of their way to make sure that I am not overwhelmed. It is wonderful, really makes you want to go out of your way for everyone else, also. Well, just thought I would give an update!! ~Lisa:nurse:

Geez, I am so sorry to hear that. It is not often that a nurse gets laid off, of course I have often dreamt of it!! When I was doing a triage/call center job from home, they did away with the at home nurses. It wasn't that big of a deal as it was only $11/hr and part time, but it still is not what you want to hear when you like your job. Of course, I believe everything happens for a reason and I am sure the reason for you will be clear very soon. Best wishes, Lisa

Thank you to everyone that responded. Now I am a bit scared. I did take the job and they increased the pay to 48k plus mileage. I also was offered 7days on and 7days off or the alternative schedule I listed above. They seem very nice there and keep telling me that during the week I will probably only have to go out 1-2 times. I am just getting tired of the long hours at the hospital and I am hoping this job will allow me to be home a bit more. I guess I will know more in a month or two. I will definitely update on my trials and tribulations through this process. Thanks again, and any responses to 7on/7off or a regular schedule would be appreciated. Lisa

I am a nurse with 8 years experience in LTC and currently, 4 years Med Surg float. I have also done telephone triage from home for a short time. I had an interview with Hospice today for FT on call RN. Currently, I make $56k working 3-12 hr shifts doing med/surg. Hospice is offering $43k salaried for FT on call. Which consists of 430p Fri to 430p Sun, with 2-16hr nights one week and 3 the next. This is 80hrs plus the 48 hours every other weekend= 128 hrs/2 weeks. Also, must attend 1 weekly meeting and one qow meeting at Hospice. Census now is 88 and serves 3 counties, which is about an hour in any direction, however, 2/3 of pt's are local. No admissions for on call and there is a back up nurse until 9pm most nights. I will have to continue doing med/surg a couple days/month to make up the salary, but it seems like I would have more time home with my family if I took this job. I am just afraid I will take this job and have a beeper that is ringing off the hook and will be out of my mind crazy with calls which will be the opposite of what I am looking for. Please tell me the pros and cons as you see them. Is there anything I need to find out before accepting/declining this job? Are there actually "slow" days being on call? Thanks for any input, Lisa