Rant About On Call

SuesquatchRN, BSN, RN · May 17, 2009

I think you're absolutely right. If it all hits the fan during that 24-hour period everyone is endangered.

Maryann RN · May 17, 2009

Been there,done that and I now absolutely refuse to work for a hospice where I have to do on call. when I interviewed with the hospice I currently work for the first question I asked them was if I had to do call. Fortunately we have a wonderful on call team of nurses who do just that. We also have a weekend team. On rare occasions we have had to cover just our own patients from 4:40pm - 8am. this was only when the on call nurse was ill and thre was no one to cover for her. I agree it is an unsafe situation. Are you an on call nurse or do you also have a case load? Bless you and sweet dreams.

Sue Damonas, BSN · May 18, 2009

I have a large case load plus I have to do all of the inpt Hospice evals at the local hospital. We have on call nurses for during the week but we do weekends and holidays and when the on call nurses are off for illness or vacation. We're all so burnt out. The supervisors refuse to hear about hiring more on call nurses. I'm speaking up this week and will keep stating about how unsafe it is. Somehow they seem to listen better when you say the word "unsafe". I've got a bee in my bonnet about this. Thanks for all your kind words!!:wink2: I'm going back to bed:yawn: to get ready to start all over again in the am. So much for my one day off!!

caliotter3 · May 18, 2009

I wouldn't consider doing on call unless that was what I was specifically hired for. You are working too much from what your posts say. Start looking.

AtlantaRN, RN · May 22, 2009

Ive gone from a m-f 8h/day position to the weekend call position, it's friday 5p-monday 8am. good thing is one staff nurse is available for backup call from 8a-5p saturday & sunday so if i'm out all night, or get 2 problems at once, i have back up coverage.

The RN that had this position before worked a full time m-f job, and did this on the weekend. i've seen his call lots for the last 6 months and he only worked about 12-20 hours from friday through monday (for salary)...

i just had to get out of the monday-friday grind. i've had too many folks die in the last month and needed a change.

linda

BandEmom · May 23, 2009

I work 5 friday till 8 monday. There is a second nurse on during these hours as well. We have a census of 130+, and we are now going to hire a third nurse for the weekend as well. We typically have 2-4 admissions over the weekend and 1-4 deaths. We take turns receiving calls from the answering center, so that we can each rest, but still back each other up. I love my job and I don't think I could do case management. I love to solve the problem, give some hugs and get outta there. Sometimes the pager doesnt even go off much and I still get paid anyway. It's pretty good. I couldn't imagine what it would be like to carry a caseload during the week and have to participate in a call rotation where you are the primary call and not a backup. I wish you the best and hope you can find an organization that is realistic about staffing needs after hours.

americanTrain · May 24, 2009

wow, thats tough working with a full caseload and 130 census. oncall hours like that would

kill me and i'd be out of hospice in a heartbeat. my job is f/t mon-fri, 30-40hrs week. we

take every other week on call. from fri 5p to the next fri 5p every other week. we always have

a backup nurse.

our census is low, so we might get 4-5 calls during the week and weekends are sometimes a nightmare.

the only time i dont like it is when i get called at 2am to pronounce death. its hard for me to

stay wake on the roads, i've had some dangerous moments where i've reconsidered this career.

if i didnt have to take call, this would be the best job i've ever had. my caseload is 12.

Maryann RN · May 25, 2009

I should count my blessings. I've been feeling discouraged lately but after reading these posts I am pretty lucky. I work M-F 8-4:30; no weekends or holidays. No on call ( we have an on call team ). My average caseload is 12 and my travel is about 20-30 miles max. I have had to do on call with another hospice and it stressed me out so much I spent the day before worrying about it, couldn't sleep the night I had on call and was exhausted the next day. As I said in an earlier post, I won't work for a hospice where I have to do on call.o those of you out there who are overworked and stressed, please be safe.

indianahope · May 27, 2009

This really gets me going..I've posted about this before. After almost 9 years, I think I've hit the wall. I work 40+ a week as case manager...take primary call 4 weekday nights and backup call 1 weekend day,then primary call 1 weekend night...... on a 6 week rotation. My census just hit 8, down from 12 last week. We sometimes must do our own admissions. A few weeks ago I worked all day, had a really wicked call that night...only got 2 hours fragmented sleep, then had to go back to work the next day and finally crashed at noon. Actually felt dizzy on my feet...it was horrible. On call we only get pay if we leave our homes...we could be on the phone all night and put in time for the necessary documentation.... and get only our beeper pay of $2.00/hr. Management won't consider any other options. We hear stuff like, well, way back when we used to have to cover blah, blah, blah territory...look how good you have it now. Well, back in the old days, if you took call and were tired the next day, they allowed time off. Now, if we work and are exhausted, we have to use our PTO time to take off. Really, I pray every day I can get up and do it again. I have loved my "Job" for years....but now just wondering how on earth will I survive. There's my rant....sorry.....For the rest of you, my thoughts and prayers are with you that you will be safe.

jeannepaul, BSN · May 27, 2009

I usually work 13-27 hours during the week (by choice) and I do call friday 5p-monday 8a. I have been doing this for about 3 years. I did full time case management for 4years. When I first started doing on call we had about 175 pts and I was the 3rd. full time on call nurse. It was not too bad. I might get called out once on friday, see 4-5- pts sat and sun. I actually worked 20-32 hours, but I got plenty of sleep. Only on occasion we had a bad weekend. many on call nurses came and went and at times I was the only full time on call. the case managers did back up and we usually had a total of 5-6 nurses on call. fast forward. our census is 300+, we had 4 on call nursess, one just quit and they may not replace her. they cut the total nurses to 4, sometimes 3 on sunday. On friday, I usually see up to 3 pts and out until 3-4am. only to have a full days worth of pt, and then back out all night. I'm working at times 17 hours out of 24, and two weeks ago, out of 24h, I worked 22 with 1 1/2 hour nap. The management didn't feel we were seeing enough pt's, so along with the crisis care visits, the prn visits, the actual On call visits, they decided to add the 1st RN visits, AND if anyone said "fall" even when they actually didn't fall, the cg sat them down on the floor, or the slid off the chair and there are no injuries. If a COPD pt call about anything we have to go. If a nursing home calls, we have to go. If anyone calls twice for any reason, we have to go. What happens is while we are out on these NON-EMERGENT" calls, someone calls in that really needs us and they have to wait. We have tried to talk to management and they just dont care. They don't understand that it's not the amount of calls we go on, it's time in which we have to go. I can see 7-8pt during the day and be fine, but when you have to go during the night, it reeks havoc on you, no matter if you get a few hours sleep during the day, you just cannot catch up. Last weekend I drove 367miles. 11hours worth of driving in a 24 hour time span. Truck drivers cannot drive that much. Aren't there some sort of safety laws in place? The day I worked 22 hours, the triage nurse was trying to explain to the administrator on call that if I am working all day, that I cannot be expected to be out all night, her response was "she has too" the triage nurse said "no, she doesn't, if she says she us unsafe, I cannot send her" do you think that made a difference, hell no, I was out all night also. We are all about to quit, i have 2 small kids that need a mother. Anyway, sorry so long, but I just had to get it out.

grdmdb · Jun 25, 2009

i work for profit organization

we have approx 125 cencus for 8 rn's

my case load is 20( i have a busy area)

i case manage and travel( not usually more than 150 miles on for the week)

i make 32 an hr for 40 hrs( dont usually get paid for overtime)

we have no on call nurse for the weeknights(4p - 8am) our area is huge--- on call can travel over 150 miles a night

or less, but the area cover 6 counties

( on call week nurses don't last) the day nurses cover on call

we are burnt out and anxious about the weekend nurse quiting( on call weekend can travel 350 miles a weekend easily)

we also have not back up for either position

the company and the nurses we work with are great! but we don't seem to find anyone to stay( its either the salary or the travel)

any suggestions