A Nurse with a Gun

Wednesday, December 31, 2008

Being On Call

I am on call again, and I will remain on call for two hospitals until Monday. Many people who are not nurses or physicians don't really understand what the unrelenting stress of being on call means.

For me, it means remaining in my scrubs for the duration. If I take a shower, it's with my pager and cell phone outside the curtain. I don't go out to eat where I might have to wait for ten minutes to get food. I don't go shopping where I might have to wait in a ten minute line at the register. Any social engagement where getting up and leaving gracefully presents a problem is out of the question. No activities where exiting a grid locked parking lot might be a problem. No church. No funerals. No theater. No school functions for my child. I don't even watch movies on DVD. No wine or spirits. None.

I try to catch up on my sleep when I can, and I keep something to eat pre-prepared and ready on the kitchen counter. Preferably something pre-prepared that I can eat while driving through the night to the hospital. Something like a burrito or a chicken wrap. I keep my car's gas tank full of fuel.

I have to stay within a thirty minute radius of the hospital at all times. When my pager beeps, the clock starts ticking. I have thirty minutes until I should be starting the case. It is not very different than when I was in the Navy, being called to General Quarters again and and again. As I drive towards the hospital, my cell phone hums. I am getting as much information on the patient as possible from the ER staff. I am fielding calls from the doctors and my team, everyone wanting to know what is going on and what needs to be done. I do this because some person desperately needs us.

Call is supposed to be for life threatening emergencies. The truth is, it is frequently abused so physicians can meet (or avoid) the demands of their spouse's social agenda. It is not uncommon for me to be roused out of a deep sleep only to rush to the hospital and start a case that could easily have been done the next morning. I have learned to expect to be called out at any time, with no regards to when I was last called out. There have been times that I have turned into my driveway at 2:00 AM only to have my pager go off again. Keep in mind that while this is going on, I still have scheduled cases that start at 6:30-7:00 AM. Sometimes I just stay at the hospital and sleep on a gurney in a dark room.

I usually do not take five days of call in a row. Doing so brings a person to the brink of total exhaustion and irrationality. The most I usually take in a row is three days, a Friday, Saturday and Sunday. I am doing five this time because other people took call so I could spend Christmas and Thanksgiving with my family. Unfortunately, my scheduled call weekend fell right after New Year's Day, so I get five days in a row.

My pager just went off............



Anonymous Anonymous said...

happy new yeAR
and a link to self defence berkley style


11:01 PM  
Blogger DouginSalcha said...

I understand and sympathize.

I was in a Pershing Battalion in the Spring of 1967; we began to receive deployment levies about every week to ten days. Everybody with a missile MOS was going to Germany and everyone else was going to Vietnam. As our Battery shrank from around 87 to 90 percent strength to about 70 percent strength, I found myself performing guard duty and KP more and more often.

Finally, I found myself on the duty roster(s) 4 times in 5 days. This is how it worked. KP was a one day duty and guard was a 24 hour duty with the following day off. I had KP on a Wednesday, Guard Duty on a Thursday (with Friday off), and then KP on Saturday and Guard Duty on Sunday.

By the time I was called to the Personnel Office, I didn't care if I was going to Vietnam, I just wanted off of the 1st Sergeant's Duty Roster(s). Turns out I wasn't going to Vietnam afterall; I was headed to Thailand instead.

11:33 PM  
Blogger Keith Walker said...

Praying you stay safe...

1:43 AM  
Blogger Ed Skinner said...

Dunno how you do it, man. After just one or two of those, they'd have to take me to your ER.

9:56 AM  
Blogger Don Gwinn said...

I can sympathize a little. I run as a volunteer with the ambulance service here, which means I don't have to go sit in an ambulance or even sit at a station. I run overnights, and I'm on call, so if there are no calls, I stay home with my family and get a good night's sleep. But dinner has to be done before that 6:00 PM line is crossed, and after that I can't leave our little town.

The bigger deal for us is that that my wife can't leave me alone with the kids when I'm on call. That has caused us more trouble than anything.

3:45 PM  
Blogger Montie said...


That is why my daughter got out of nursing. She was a surgical nurse for a team of neurosurgeons and seemingly on constant on-call status for emergency surgeries. Fine with no kids, but after my grandson was born, it was just too much with an infant. My son-in-law is a fireman and thus on 24 hour duty every third day which would really put them in a bind if she were called out unexpectedly at 0400 or so when he was working.

After seeing what she put up with, I never again complained about being the on-call detective one weekend a month.

4:41 PM  
Anonymous Anonymous said...

Xavier I usually stop by here once a day, because just about everything you blog about is interesting to me. Just want to say thank you for your dedication and commitment to your job and to your blog.

You seem like the kind of guy who would be cool to have a beer with and shoot the bull. Best wishes for a happy and healthy 2009 from Ohio.

6:19 PM  
Anonymous EP nurse said...

I'm on call for the New Year's holiday and the weekend as well. I TOTALLY understand. Actually, I'm glad to see someone else who has the same "call rituals" that I have.

You also hit the nail on the head about doctors abusing the call teams to get around scheduling or for working around their social schedules. It is extremely irritating and makes a difficult situation worse.

Keep up the good work...

8:11 PM  
Anonymous magC said...

I feel your your pain brother!

I am a Nuclear Medicine Technologist and like you I am on call. I am in a deeper hole than you though cause I am on call for 8 days (started New Year's Day 'til Thursday next week). I do this ritual every 5 weeks.

Glad to know I am not the only one who gets so rattled by call. Someday, when I win the lottery, I would turn in my pager. But for now, I'll have to keep my sanity best way I can.

2:46 PM  
Blogger Brigid said...

I understand that well. 24 and 7 for me every so often, sometimes days and days go by with little more than a nap, but not often.

I get plenty of days off though, the only good part. Now with 5 of them in a row, I'll be getting restless before it's over.

3:33 PM  
Blogger Budd said...

Oh do I know what you are talking about.As an EMT I do 48 on,48 off,72 on ,its to complicated to explain but it means that half my life is spent away from my family.Then I am on call when I'm off.
You are right about Doctors.How many times have I gotten up at 2 am to transfer a pt.150 miles because a local doc found a bed in another hospital.

1:41 PM  

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