We are a small CAH hospital at Lake Tahoe. We have the same problem with a small staff taking a lot of call, especially in peak tourist season of winter and summer. Since we get a lot of Orthopedic injuries from the ski resorts and same in the summer from all the outdoor activities, our call team was exhausted from working all evening, and sometimes into the night after working that day. As you know, then the next day when this staff has to return in the morning for another full day of work, it was not safe.
As a result, we started an “on-call” shift seasonally. The on-call shift is comprised of two staff on call from 17:00 to 0700 the next morning. They cover for 14 hours and get paid 8 hours straight time whether or not they are called in and no matter how many hours they actually work. We assign the two staff members to this on-call shift for a week at a time. They cover 5 shifts, either Monday through Friday or Sunday through Thursday. Only full time staff qualify to work this “on-call” shift.
This was implemented not necessarily to save money (because it usually does not save money), but because we needed to ensure safe patient care. To do this “on-call” shift, it requires the part time staff to have to flex up their hours at times to have enough coverage during the day for scheduled cases. This has been quite successful for the past four years. There are some issues that arise at times over this call shift, however, we still seem to be able to justify it and work through the issues.
I would be happy to answer any questions and address the issues that we encounter at times because of this call shift.

Linda Harman, MS, RN, CNOR
Director, Surgical Services
Tahoe Forest Health System