How bad is 'being on call' + how best to handle it?

February 22, 2015 11:25 AM

I'm a mental health professional due to hear back about an interesting (but tough) job interview tomorrow. It's not 'in the bag' yet but there were indicators it went well. If offered I'd take it for various reasons. It would involve being on call every 10 days or so. I've never done this before. It didn't sound too bad until I realised that you are on call at night (may have to go to A and E/deal with suicide attempts etc) and then go to work as normal in the morning...

I luurrvvee my sleep. In addition I find it a crucial part of my self care, particularly with the type of work I do. Friends who'e done it said it's rare to actually get called in (I have no idea..) but if anyone had any insights/survival tips that would be great. Is it something you just somehow adjust too? How do you get back to sleep after dealing with a crisis? Job would be UK NHS. Thanks.

posted by tanktop to Work & Money (10 answers total)

I would ask how frequently people are actually called when they're on call. My Dad is a mental health professional and in his day he would be on call. It's fine if there's not a problem, and it rots when there is, because yes, you get up in the middle of the night, put on your clothes and go deal with stuff. Sometimes it takes all night. And then you go to work at the regular time.

If this is a deal breaker for you, that's legit, but on call is a thing. Do you get extra pay for being on call? That's really normal.
posted by Ruthless Bunny at 11:36 AM on February 22, 2015 [5 favorites]

In my workplace there is such a thing as on call. If you get called in the middle of the night to deal with something, no one expects you to function at 110% the next day. Or you come in at 10am instead of 8am or whatever. People who work in the field tend to have empathy. Ask about it.
posted by ThatCanadianGirl at 12:35 PM on February 22, 2015 [4 favorites]

From indirect but close-hand experience:

It is very useful if you have a partner who is willing to drive you in, stick around and drive you back, or can book a taxi both ways and have work pay for it. It allows you to focus your energy towards the time you're doing assessments or making phone calls: you can shake out any cobwebs and get into a clinical mindset on the ride in, and relax a little on the way back.

Have your clothes and folders and badges and etc. ready to go.

How do you get back to sleep after dealing with a crisis?

Sometimes you don't. Sometimes you put enough coffee in your system, make it through the next working day (where it will be understood that you're not operating at 100%) and sleep as soon as you get back home. A rotation that's one night in ten is better in that regard than five consecutive days every two months or some other variation, because you don't run the risk of it stacking up.
posted by holgate at 12:43 PM on February 22, 2015 [2 favorites]

Being on call sucks, no doubt, but one-in-ten is totally do-able and shouldn't mess up your sleep schedule too much. If you have control over your own daily schedule, make sure your next day ends when it's supposed to end. Be aggressive about going home at (or even before) quitting time on that day after. Nothing's worse than a long day after an all-nighter.

Sometimes it's better after the call to just write off the sleeping and make a pot of coffee and read a book for the rest of the time. YMMV, but I find a short nap to make me feel worse than nothing sometimes.

For a data point, one-day-in-three or one-in-four duty rotations are standard in the military, even doing complicated things like operating reactor plants. Even with zero sleep you'll still function all through the next work day. Worst that happens is you get unpleasantly grouchy. Don't schedule any meetings with clients for last thing that next day. :)
posted by ctmf at 1:15 PM on February 22, 2015 [3 favorites]

And be careful on the drive home the next day! Better to carpool with someone who didn't have the night duty.
posted by ctmf at 1:19 PM on February 22, 2015

I actually find that it's not the day when I'm functioning on no sleep that is bad, but rather the day after that. So, if I work all day Monday, stay up all night Monday night, work all day Tuesday, and go to bed early Tuesday night, I feel generally ok on Tuesday, but groggy and gross on Wednesday the most. Find out if either your office is understanding and lets people flex their schedules after they've been on call, or if you can negotiate that yourself.

Also, plan ahead. Pre-make or buy healthy food meals and snacks you can nuke in the microwave. Don't make social plans for a day or so after the all-nighter. If you have kids or family responsibilities, make sure you have backup care and that your backup understands that you might be cranky or unable to function at full capacity for a day or two after.
posted by decathecting at 1:20 PM on February 22, 2015

I was in an on-call position on a crisis hotline and have friends in similar positions. In my experience, I was really really worried about it for the first few on call cycles, and then it was just a part of my life and it sucked but was fine. To this day, my sleep patterns have changed - if my phone makes a sound when I am asleep, I am awake and adrenalin charged and not going to be able to fall back asleep even if there's no crisis. But then, I'm a hyper alert nervous type person, so that works for me. If you decide that adapting to this schedule would damage your self care, then trust that you know that about yourself.

It might also help to think about it in terms of career advancement - as in, this is a thing I'll do for X time and then do something else, and these are the skills it would help me develop. Even if it's just moving within the NHS, tenure in on-call positions (at least for hotlines) tends to be shortish, as people have a time in their lives where they can do that kind of thing, then they move on. Mental health employers know this.
posted by theweasel at 1:43 PM on February 22, 2015 [2 favorites]

I work at a job that has a 1-day-in-7 on-call rotation. If I get called in overnight, I usually am allowed to work a short shift the next day (either come in late or leave early, depending on staffing). I would speak with your supervisor & other rotation members how they handle it internally (as opposed to the "letter of the law" version of expectations you tend to hear in interviews/from HR).

My normal shift is 6:00 AM to 2:00 PM, so I make it a point to try and turn in to bed an hour or so earlier when I'n on call. This way, if I'm are called in, I've had that much more rest. Every bit helps, as I find it difficult to go back to sleep after getting called in, so depending on the actual time I'm finished addressing the issue, I will either catch up on paperwork at thev office or will go to a 24-hour diner for an early breakfast until its time to go in to work.
posted by KingEdRa at 3:09 PM on February 22, 2015

I did on-call as a hospice nurse for a long time, personally I think it's awful. I never slept well because I was worried I'd miss a call, I was grumpy from lack of sleep and I still get jumpy when I hear a phone ring at night. But in my situation, on-call meant chances were very good you'd go out at least once a night and usually to pronounce a death.
posted by yodelingisfun at 1:27 PM on February 27, 2015

I had a mental health job where I was on call for a week at a time and it was physically and emotionally draining. I had a hard time falling back to sleep after getting a call in the middle of the night, so I could go to bed at 10 pm, get a call at 2 am, finally fall back to sleep at 4 am, only to have someone call me again at 5 am. And then I had to work a full 8 hour day. My employer was not supportive or sympathetic. I also had to plan my entire life around being on call because, inevitably, whatever I had planned (going out to eat, going to a movie, etc.) would be interrupted by a call. I could go the entire week without getting a call, but as soon as I tried to leave the house and anything, the phone would ring.

Honestly, even after writing all that, being on call one night every ten days doesn't sound too bad. The stress and sleep deprivation doesn't stack up quite as much as it does after 7 days of being on call. But I would still proceed with caution -- as others noted, try to find out how often people actually do get called in and how the next day is handled internally (can you go in late or leave early?), and, most importantly, what kind of middle of the night access you will have to a supervisor. There probably will be situations that come up where you will need support and advice. Having access to that is of the utmost importance. When I started my on-call job, my supervisor was amazing and wanted us to call in the middle of the night if we needed her. I would be in more trouble for not calling her if I had a question than I would be for calling her. I felt better about my on-call shifts knowing that I always had backup/support/advice in the middle of the night. Eventually, my supervisor changed and the new one did not want to be contacted and did not offer the same level of late-night support. It really made an already-hard job that much more difficult.
posted by whatideserve at 9:00 AM on March 1, 2015