Gwynn, I knew that I was the only person on-call last night. But at ten o'clock I found out I was the not only the primary, but I was the only one on-call. I worked a full-eight hours yesterday, and I saw five patients. I cannot be the only one on call when I've already put in a full day!
I was called out for two patients, AND I had to pronounce a death. I only got three hours of sleep. I can't go on like this. It's killing me, I hate my job, and it certainly isn't good any for the patients. My hands are shaking, I feel nauseous, and I just can't do this any more. I'm sorry, but you can consider this my two-weeks. I've got a locum tenens offer, I'm going to take it. I can work three days a week, day-shift, and make as much as I do working all week here, with no forced overtime." Gwynn Halsey looked across her desk at Lisa Deering, a bright, hard-working RN with a genuine commitment to her patients. "I understand," said Gwynn Halsey. "We'll be sorry to see you go."
Lisa stood, gave Gwynn a wan half-smile, shook her hand, and closed the door behind her. That wasn't the only door Gwynn felt close. The hospital was already closing beds in units due to the lack of nurses. She wasn't likely to get much sympathy if she complained about her problems as director of home-care. She certainly wasn't going to get any nurses from them. Something had to change from within, and it had to be affordable.
She called Nancy Gilman, her administrative assistant in and explained what had happened with Lisa. To her surprise, Nancy began bubbling with enthusiasm before she even stopped talking.
"This is probably the right time to mention something I've been thinking about for a long time. You know how many complaints I've had from our on-call staff over the past several months. Well, I've been doing some checking. We can actually outsource all of our on-call to a professional medical service. We can stop relying on the hospital's switchboard. Our staff can enter their own call-schedules online and they can even page one another directly over the phone, without waiting for the switchboard to mediate. We don't have to worry about lost beepers or phones. We can see to it that there aren't oversights leaving only one person on-call."
"Nancy," Gwynn interrupted, "you know that's going to cost money. And, its money we don't have."
"Actually," Nancy replied quickly, "we are already paying the hospital for one FTE to cover our calls. We can switch to the agency for substantially less."
