Clinical Staff and Weekend Call

April 1, 2008

We are considering using our nurse practitioners (NPs) to take weekend call. What would be the pros and cons?

Question: We are considering using our nurse practitioners (NPs) to take weekend call. What would be the pros and cons?

Answer: It can be great to have NPs take first call on the weekends. They’d take the calls and triage using protocols agreed upon with the physicians. If they can handle it, great. If not, they kick it to a physician on call.

Before you do it, though, realize it will take some work to set protocols.

It’ll also take some convincing and cash to get the NPs to agree to do it. They don’t want their weekends interrupted any more than the physicians do. You’d likely have to pay them hourly regardless of how many calls come in, since they have to be available. It’s worth taking the time, first, to assess how big a problem you are talking about and what other solutions there are. You don’t want to start paying more when there actually aren’t that many calls.

So look back or begin tracking how many calls you actually get after close on Friday through opening on Monday. If possible, identify why the patient called in and if they also called on Thursday or Friday.

If the volume of calls is pretty low, it’s not worth making the change. You also may be able to influence the flow by staffing up and opening the schedule to allow for more same-day appointments on Thursday and Friday. If you’ve pushed patients off, they just call on the weekend. Or, perhaps, you can better educate patients at appointments on the issues they are calling in about.

In short, explore the options. Using NPs for call isn’t an easy solution.