Question for On Call nurses-response times and situations

[AtlantaRN, RN]

Question....i was told that once we got a call we are to arrive at patients home within one hour of the call...

I was told that a "situation" is whatever the facility, patient, family says it is....go without question.

Tonight I got 2 calls back to back, one was a facility-nurse reported stable vital signs, except patient was unresponsive-and that was new (granted she is 98), second call was a home hospice patient with projectile vomitus that is yellow.....so, i started to the second patients home, I called my backup nurse and my boss (because my backup nurse didn't answer initially).

Boss said she would go, then backup nurse called me, said she talked with facility and they said "patient opened her eyes," backup nurse educated them that vitals were stable and talked them into just a visit tomorrow....

I spoke with my boss, she said "really, if the facility wanted a visit, you could have seen patient after you finished with the patient vomiting...." my concern with that is-is it really appropriate to show up at a facility 2.5 to three hours after their call?? am i really responding to their concerns at that point, showing up so late (this is a big facility where 10% of our patients live--I don't want them upset with my late arrival, hence why i called my boss and backup nurse).

But i was educated that a "situation is whatever the facility, patient, family says it is....go without question.

So what i learned tonight is if it's me-go without question....but if i have to trouble my boss or backup nurse, you can go

when you can....something isnt right.....

There was a memo that came out recently that said the on call nurses position is "not to get out of making visits...." so we are expected to respond to whatever facility/patient/family needs.....I just don't want anyone to think i'm not doing my job.

thanks for listening, anyone else run into this? Im gonna check policy and procedure book tomorrow on this....

[caliotter3]

I run into discrepancies with following the rules all the time. Sometimes it can be quite a feat to follow the rules the way we understand them, only to be held in derision by other workers who let things slide and management that seems to be on the side of those employees who take the easy way out. I suggest you do what you feel comfortable with.

[AtlantaRN, RN]

Thank you Caliotter3- so i'm not the only one trying to do the right thing....If you always do the right thing, you don't need a good memory.

[Hospicetex]

Thank you Caliotter3- so i'm not the only one trying to do the right thing....If you always do the right thing, you don't need a good memory.

That's true! We are told when they call go no matter what...I do use my judgement and if a facility says they are just calling to report and don't want a visit then I don't go. I also don't go when med refills for Monday are needed unless they need them delivered during the weekend.

I do love it when my boss doesn't answer the pager and apologizes for "being asleep" when I would be written up for not answering the phone/beeper while on call.

[ErinS, BSN, RN]

Our agency has no required policy on how we respond to calls. If nursing judgment says we should go, we go. If everything is okay, then we do not go. If 4 calls come in at the same time, we prioritize. Our patients know up front that while they can get a hold of a nurse within 30 minutes of calling, it does not necessarily mean we are at a place to drop everything and run to them.

[caliotter3]

Our agency has no required policy on how we respond to calls. If nursing judgment says we should go, we go. If everything is okay, then we do not go. If 4 calls come in at the same time, we prioritize. Our patients know up front that while they can get a hold of a nurse within 30 minutes of calling, it does not necessarily mean we are at a place to drop everything and run to them.

This policy makes sense.

[RehabRedRN]

The company I worked for tried for the response time of on hour. We have on call nurses but if they are busy the primary takes the call and if they are busy then the supervisor takes the call. In a situation like yours I would call the facility to recheck on the patient and see if they wanted a visit or could wait until morning for the visit. Since the patient is in a facility they do have support, if it were a family at home I would have gone no matter how much later it was. Just my thoughts on this topic.