I’m on call this weekend. ALL weekend long, as a matter of fact.

Generally, the RN Case Managers are on call about 5 times per month. Not a bad deal, really. However, with this move coming up - I needed the extra cash in my pocket to pay for all the extra expenses that come along with moving. Since we get paid $300.00 per day for being on call - I picked up extra days this month. LOTS of extra days. We get paid the money over and above our usual salary, and we get paid $300 whether we actually get a call, or not.

Last weekend - I was on call Friday, Saturday and Sunday. I made $900 for the weekend and put in about 15 hours of work. My pages included:

A patient who fell, couldn’t get up and hit his head and sustained quite a laceration to his forearm. His blood sugar was reeeeaaaallly low, so I drove to his house and got him up, dressed his wound, performed neuro checks to be sure he didn’t have a head injury and fed him so his blood sugar came up again

A patient whose pain was getting out of control. Drove to the patient’s hosue, called the doctor - ordered stronger narcotics (Morphine) - drove to the pharmacy and picked up the meds and delivered them to the patient and stayed with her until her pain was in control and her family knew just what to do with the meds to keep her pain down to a low roar

Another patient with pain control issues - - did the same for her as I did for the above patient

A patient whose Morphine Pump was running low - - needed to change the cassette within the pump that contains the Morphine so that her steady flow of pain relief wasn’t interrupted at all

A patient who was taking her last breaths. Drove to her house, she was gone by the time I got there. Called the doctor for the pronouncement; then the funeral home for pick up. Spent 2 hours with the family helping them deal.

Not a bad weekend, really.

Now this weekend, I am on call Saturday, Sunday and Monday. I’m crazy, I know - although the other RNs I work with are relieved that I’m taking so much call this month — because it means they don’t have to. Let’s hope that they remember this next month when I cut waaaaaay back on the days on-call for June. This weekend, so far - has been quiet. The pager hasn’t gone off once.

Of course, now that I write that - - it will probably start beeping.

Nurses can be a cynical bunch of people, you know? I didn’t even realize how cynical and jaded until one day C. brought it up to me. It was a conversation we were having on a Friday - - the day before I was to be on call for Saturday. I made a short little comment about how I had listened to report for the weekend and was relieved to hear that 4 of the patients who were ‘crashing’ over the week, had passed away before Saturday. That way - a quiet weekend was sure to be my fate for my on-call day.

Selfish? Yes. I know. I’m just being honest, though. I’m not the only nurse who ever says things like that. I don’t think it’s cold, though - - I mean these are hospice patients who are dying - - the morbid joke around the office is just the hope that they don’t do it on ‘my watch’.

Death calls. That’s how we refer to them. The RN is required to go out on ‘Death calls’. If the patient has already passed - - we’re required to go out and pronounce them — or, I should say, do the assessment and see if there is a pulse, respirations and blood pressure. If not - - we call the Doc and get a pronouncement. Then we call the funeral home for pick up - - and help the family, as much as we can, by offering emotional support during this time. It usually ends up being a 2-3 hour call.

Not so bad - - unless you know, going into the weekend, that there are 5-6 patients who are “close” - - because, inevitably - they all happen at once…which can sometimes make for an 18 - 20 hour day.

I’ve had days like that.

It’s not so bad, really. Because days like that balance out days like today - when I receive zero calls. Call me jaded and cynical because I did breath a little sigh of relief that all of our ‘crashing’ patients this week all died on Thursday and Friday night. I knew, then, that my weekend would be easy and I’d be able to get some tasks done for the upcoming move.

Believe it or not - - I do struggle with those kinds of feelings. My boss says they are normal feelings - - however, somehow - - they don’t feel quite so normal, really.

*shrug*