On-Call Nurse Guidelines

General on-call guidelines:

  • Be readily available to take patient and other hospice related calls, as well as make patient visits during designated on-call hours.
  • Understand and abide by Legacy Hospice Policy and Procedure.
  • Legacy Hospice expects nurses to utilize their judgement and apply critical thinking skills when determining if an on-call visit should be made vs. handling the issue over the phone.
  • Examples of when visits should be made are, but not limited to, the following:
  • Symptom exacerbation requiring medication adjustment not successful after first titration
  • Pts/caregivers who are anxious, nervous, or emotional
  • Pts/caregivers requesting to go to the hospital
  • Pts/caregivers requesting discharge
  • Nurses should notwait for a visit to be requested by the pt/cg. Use your judgement even if the pt/cg does not think a visit is warranted

On-Call Visit Guidelines:

  • When the call is received, the situation should be assessed and interventions given to the caregiver to provide until the nurse arrives in the home.
  • If arrival time of the nurse will be greater than 30 minutes, the nurse should call the pt/cg every 15 minutes while enroute to the home in order to continually assess the situation, provide additional intervention, or simply reassure the pt/cg.
  • Nurses should remain with the pt/cg until the symptom/issue is controlled and/or resolved.
  • Courtesy “check-up” phone calls should be made within 12-24 hours after an on-call visit.
  • Interventions or care not requiring a visit by the on-call nurse should receive follow up phone callsevery 15 minutes until the issue resolves.
  • Courtesy “check-up” phone calls should be made within 12-24 hours after symptom resolution.

On-Call Documentation Guidelines:

  • On-call visits and/or phone calls should be documented on Progress Notes.
  • Documentation should be comprehensive and include details of the call, interventions, results of interventions, and phone calls made to physicians or other persons involved in the treatment or resolution of the issue.
  • IDT notes, DME and Treatment care plans, med profiles, and Physician Orders should be updated as necessary.
  • The On-Call Response Form should be updated the morning of the next business day.
  • On-call visits/phone calls should be communicated to members of the IDT the morning of the next business day.

Note: These guidelines should be applied to all patients, regardless of residence. Nursing Home/ALF patients should receive the same care as home bound patients.

5/2015