What is your inpatient call like?

[nicoleANP]

Hi everyone,

I'm new to this site but I have been a practicing Adult Nurse Practitioner in an acute care setting for a little under a year. I'm curious to know how inpatient call works for any NPs on the acute care setting.

Here is mine

I work M-F 8a-5p (sometimes 6 or 7 depending on admissions )

My call is every 5th weekend- saturday and sunday

When I am on call I am usually paired with a Nurse Practitioner who works primarily in a clinic who has very little confidence, comfort, or efficiency in the hospital setting and has expressed this to my director years ago. I have been told by my director that given her discomfort I am expected to contribute more for patient safety and efficiency.

We cover 2 services Palliative and Geriatric inpatient medicine which equates to about 25 patients total per day. not including any new consults or ER admits which must be done.

The geriatric pager must be picked up from the night resident at 0630 am and can be passed off to night float no earlier than 2 pm. Although most weekends we usually end up clocking upwards of 10 hours each day per NP

This extensive (I say extensive because this is much more demanding than a usual day with MDs and residents around for back up) call is done without any compensation such as at least one day off during the week to recooperate (in other words we are expected to work 12 days in a row.)

My overall question is:

Since this is my first NP position, Is this standard to expect this? I know some NPs are on call every other weekend for their practice but usually this is an outpatient setting and it is truly "Call"= taking phone calls of patients. I just want to know what inpatient NPs experience

Thanx!

Nicole

[traumaRUs, MSN, APRN]

I've been with my practice for six yrs and our inpt call was sat/sun 0700-1900 seeing nephrology pts, consults, admits and discharges at two different hospitals. We rec'd $250 per weekend and we were on call every 4th or 5th weekend. We did get one day off during the week.

[zenman]

I'm on call 2 weeknights a month and 1 weekend a month...5pm Friday till 8:00 Monday morning. I'm then off the next 2 days.

[mammac5]

I don't take call yet, but am very interested in this discussion since my job may entail call responsibilities in the next year or so.

Right now I work 1 wkend a month, seeing inpatients and new consults. We don't consider it "call" per se. I start at 7:00 and finished when I'm done...usually around 5:00 on Saturday and Sunday - sometimes earlier. But I am salaried so I work a certain number of shifts/month and the weekends are not different or paid in a different manner. I have not worked more than 6 days in a row and can schedule myself so I don't have to work more days in a row than that. I'm not sure I would be thinking straight after about 7 since I seem to be at the end of my mental abilities at that point and really need some time off to veg and watch trash TV - not to mention that my house is falling apart after several days and the laundry is reaching critical mass.

[Corey Narry, MSN, RN, NP]

I am a critical care NP. Our "call" is actually our night shift rotation. We work 3 twelve hour shifts a week. As of right now, all NP's have a 50/50 commitment to do day shift (7A-7P) and night sfhift (7P-7A). There's a plan to reward seniority with less night shift commitment (75/25 in favor of dayshift).

Our night calls involve covering any one of Adult ICU's by yourself (two 16-bed Med/Surg ICU: medical, solid organ transplants, general surgery; one 16-bed Cardiac and Vascular ICU - Cards:HF's, MI's/Cardiac Surg: heart & lung transplants, ECMO, CABG/Vasc Surg: aneurysms, LE bypasses; and two 16-bed Neuro/Neurosurg ICU).

Our ICU's are semi open model - there is a resident or an NP assigned from the Critical Care Service to each of those ICU's at night and there is one Critical Care Fellow who oversees all ICU providers and acts as the ICU triage person (screens all ED admits, outside admits, transfer from non ICU beds).

The primary service writes most orders while the Critical Care Service writes for sedation and pain meds, places all lines, intubates and manages vents. There are services who are never primary when they bring their patients to the ICU (OB, Urology, Oncology, Ortho) so the Critical Care Service is automatically primary on those patients.

Nightshift call can be heavy but at times it's not. Most admissions in all the ICU's occur at night though rarely in the Cardiac ICU. Intubations, line placements, codes, etc happen at night and your'e on your own for most things that need to be done with the fellow acting as back up. There is a call room for sleep if it's not busy. NP's are paid hourly with shift differential for nights.

[mammac5]

I don't take call yet, but am very interested in this discussion since my job may entail call responsibilities in the next year or so.

Right now I work 1 wkend a month, seeing inpatients and new consults. We don't consider it "call" per se. I start at 7:00 and finished when I'm done...usually around 5:00 on Saturday and Sunday - sometimes earlier. But I am salaried so I work a certain number of shifts/month and the weekends are not different or paid in a different manner. I have not worked more than 6 days in a row and can schedule myself so I don't have to work more days in a row than that. I'm not sure I would be thinking straight after about 7 since I seem to be at the end of my mental abilities at that point and really need some time off to veg and watch trash TV - not to mention that my house is falling apart after several days and the laundry is reaching critical mass.

Just forgot to mention one thing: I can leave at 4, 5, 6 or whenever I'm done rounding and seeing the new pts for the day but I'm responsible for the BlackBerry until 7:00 p.m. I have access from home to the charts so I can see what's going on if a physician or nurse calls me with a question. I reckon that does count as "call".

[delfin]

I work for a neurosurgery group, so it may be a little different then inpatient/hospitalist. I am on call one night per week and one weekend per month. For the night call I take calls from the neuro floor about inpatients and calls from the answering service about clinic patients. I am also expected to be available for emergent surgery though this very rarely happens. On the weekend I round on Saturday morning, it takes 2-3 hours. The surgeon on call rounds on Sundays and takes call from the ICU. We are not compensated for call, unless it is above our normal call schedule.

As far as hospitalist call. I have several friends that work for an inpatient group and do not take call, but they do rotate shifts as another poster mentioned.