On Call in a Patient’s Hour of Need

Being “on call” in a healthcare environment typically means being near the phone (and not far from the hospital or nursing facility) during evenings and weekends, waiting to respond to the needs of patients in distress. In hospice, being on call is similar in some ways, but very different in others.

Healthcare professionals who are on call will stand by, prepared to step in quickly to meet emergency medical needs. But in hospice, the team that must be “at the ready” comprises a more encompassing group than physicians and nurses. Because there can be a wider range of emergent needs for terminally ill patients and families — physical, emotional, and spiritual — the on-call team will also include additional specialized staff, such as aides, social workers, and chaplains.

“Hospice staff that is on call will be dispatched to handle pain management and other physical needs, yes – but it goes deeper than that,” explains Mary Christ, clinical director for Crossroads Hospice in Kansas City. “Families need emotional support, too, when a loved one is actively dying.”

While hospice on call is different than traditional medical on call, the Crossroads Hospice philosophy adheres to a different standard altogether. Most hospice programs will schedule their daytime staff to handle evening and weekend emergencies, placing them “on call” in addition to their daytime duties. The result for staff who is called out could be added stress and exhaustion. The Crossroads philosophy is to hire a dedicated group of staff scheduled exclusively to work evenings and weekends as their regular, routine shifts. Their sole purpose is to attend to patients’ emergent needs at night and on weekends. Because frequently these off-hour shifts are filled with more calls than can be easily handled, daytime staff is ready as back-up on-call to handle the overflow.

Specialists at the Ready

The Crossroads emergent care team truly is a team of specialists. These team members go in, assess the situation, and address problems quickly. They are strong in evaluating problems and facilitating solutions. “Working in emergent care is similar to being an ER staff member…but the difference is we go to the emergency instead of the emergency coming to us,” explains Christ.

Christ goes on to explain that ER nurses tend to be successful in the role of emergent care because they’re used to the pace. “It takes a special personality to work with multiple situations and handle frequent schedule changes,” she says. Adaptability is also an important skill for the role. “You don’t know what the next phone call with bring.”

The standard on-call hours, when the daytime staff has gone home and quiet sets in, bring unique challenges to hospice patients. “At nights and on weekends we find there’s more anxiety, and emotions can run high in an already challenging situation,” says Christ. This is where social workers and chaplains can make a dramatic impact. Families often welcome the comfort brought by someone to pray with or who will listen to them. And the more practical issues — such as handling health care directives and other documentation — may be easier to manage with a compassionate expert who is willing to lend a hand.

At Crossroads Hospice, teamwork is the key to success in handling the multi-faceted dynamics of working with the terminally ill. It’s not unusual for chaplains and social workers to accompany a nurse to visit a hospice patient and the family. “We often spend more time taking care of the families than the patients,” says Christ. “Teaming up works well in addressing multiple needs.”

Many people are surprised to know the act of dying is not an emergency; it is a natural process. However there will be emergent needs that require prompt attention. The Crossroads Hospice way means no one will die alone and no one will die in pain. Towards keeping this vow, calls that come in after-hours get a face-to-face visit. While other hospices may rely on phone calls alone to handle emergent care, Crossroads “does more” for patients and their loved ones. With a dedicated evening and weekend staff of emergent care experts focused and ready, Crossroads hospice patients and families can be assured all needs — physical, logistical, emotional, and spiritual — are well managed.

To learn more about Crossroads Hospice, please call 888-564-3405.

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