When Does a Lack Of Sleep Mean It’s Time To Quit Being On Call?

Doctors, supervisors, 24-hour locksmiths, tow-truck drivers, and others can be affected by this.

Is it time to get a different job?

Not all “call” is created the same.

There’s no one answer to the abovementioned question in the headline that makes sense for everyone, everywhere. 

Somebody needs to be on call for some businesses, industries, and jobs. Economics dictates it. It’s how work is done, and it’s hard to change. 

While the person on call doesn’t necessarily have to be you, if it’s not you, you might end up looking for different employment.

You’re on call because someone may need the resources you have to provide during the night or off-hours.

When they call, you may be asleep. You may be out of the office for the night. The on-call period may stretch over the whole 24-hour day.

Then, because it’s sporadic, you can find yourself being called frequently during one stretch and then very infrequently during another. It can all depends on factors beyond your control.

If that fact, in and of itself, if true about your situation, can cause a lot of anxiety.

The amount you can be paid for being on call can vary greatly between employers, worksites, and careers. Sometimes it’s a terrible deal for you. Other times being on-call can turn out to be a sweet perk; it can be an opportunity.

That is, if your sleep isn’t affected too often.

Is this just a time when they’re calling a lot? Is the “call” likely to improve?

What’s your situation?

When you’re not called, little goes into earning the money that you get paid, however much it is. It’s as if you’re being paid to sleep. While you might have to stay in a geographic region or at a facility in a standby room, you’re free to do whatever you want, whether it’s read, watch movies, or sleep. We shouldn’t say it’s money for nothing. You’re being paid for the obligation. That’s something. And sometimes, while you’re not actually doing anything, the fact that you could be doing something else calls for compensation. It’s a subtle form of job stress.

Then there are the issues with being on call that are rare or unique to a particular employer.

At one hospital, charge nurses would often offer on-call pay. Unfortunately, the payroll administrator would fail to note it on your timecard when you accepted. To ensure you were compensated for any on-call shifts, you had to double-check the details on your paycheck stub. Although the wage for being on call wasn’t, you were generously rewarded with time-and-a-half if you were called in.

Because of the system, getting consistently paid for those shifts was more trouble than it was worth. You had to be prepared to do a lot of follow-up.

Being on-call and your sleep

Finally, there is a direct effect on your sleep; the effects vary between people. Are you one of those people who has difficulty going back to sleep if you’re on call? Are you expected to be on call, call back, and then have to come in, in the middle of the night? Does your being on call wake up your family when you’re called in? Is there a possibility that you’re going to have to spend a lot of time at work in the middle of the night dealing with a situation and then be expected to come in the next day? Never let yourself become sleep deprived.

Can you get good, refreshing sleep while you’re on call? Or do you find yourself sleeping with one eye open? Studies have shown many people have difficulty getting restful sleep if they’re on call.

Further, do you have other obligations that might interfere with this arrangement? 

Finally, is there a way that the situation can change? Can you arrange it so that you’re rarely called in, so that the money for being on call truly becomes money for nothing?

Conversely, if it suits you, say you’re paid a whole lot of money for coming in and can defer more of your hours to this higher rate of pay, can you arrange it so that you’re constantly called and have to respond? How much freedom do you have in the process?

Being on call doesn’t have to be all bad. It can be a perk.

Other on-call issues

Sometimes the issue is with the way you’re called in. You might want to keep your phone on silent while you sleep to avoid the incessant binging of text messages, it’s not unreasonable. Then, when you’re called, there’s a problem because you don’t get the call.

Old-school pagers and beepers aren’t supported in many places; they’re not an option.

Simply getting and using a pager instead of your phone can ease your anxiety about being called. Unfortunately, in many places, they’re not supported anymore.

Being on call can lead to a lot of issues with your employer, and those issues = stress.

Determining your personal on-call situation

Ultimately, what matters is how well it suits you or how well it can be made to suit your situation. Deciding can be complicated.

Make a list of the positives of being on call on one side and the list of negatives on the other. For the best results, try to come up with at least five items on each side. Having some quota encourages deep thought and challenges you to think of various situations. If you can’t come up with a negative or a positive, give it a “one” because there’s probably one there that you cannot deduce when you’re making your list. Chances are, it’s pretty minor.

Next, you’re going to rate it between one and three. If the item listed is a major factor, give it a three. If it’s a minor factor, give it a one. If it’s somewhere in between, rate it a two.

Make a list and decide

If you have problems getting and staying asleep, then the choice should be clear. Being on-call can ruin your health and even be dangerous.

If you don’t, if there are other concerns to sort through. Go ahead. Make the list described above.

Here’s an example…

Positives about being on call.

I don’t go out much at night anyway. It’s usually easy money.


I somewhat enjoy the idea of having to respond to something different. 3
I can stop by the supermarket in the middle of the night if I get called in and shop when the store is empty. 2
They let me come in later if I get called in. 1
I can stop and look at the stars. 1

Negatives about being on call.

I don’t feel safe driving to work if I’m called in. 3
The sleeping room is always dirty and smells. 2
I’m called too frequently and can’t get back to sleep. 3
One crew is fine. They’re able to resolve their issues. The other crew, not so much. They call too much. 2
My phone doesn’t ring, and then I get in trouble. I could lose my job if I don’t respond. 3

Remember: someone might have to be on call; it doesn’t necessarily have to be you. 

Making a list of the positives and negatives can help you determine what’s important to you

Knowing what you want from life and your job can help the organization meet your needs.

If you decide to quit

Start your job search. Be sure to give a couple of weeks’ notice, if possible, so you’re leaving on good terms. Before giving notice at your current job and accepting a new position at a different company, understand the work environment you’ll be in.

Unfortunately, in some fields, that’s easier said than done.

Consider being upfront about how you were tired of being on call at your current job. That can lead to a frank conversation about the on-call expectations at your new job with the hiring manager or supervisor.

If you have an exit interview with your current employer, mention your difficulties with being on call. That might lead to brainstorming ideas with others about minimizing the effects of being on call in the first place.

Being on call is not for everyone.

For Further Reading:

The strain of always being on call.

On call work and health

How to sleep less and stay healthy

Physical constraints, a tree, and you’re asleep at the wheel

Should sleep be your hobby?

James Cobb, RN, MSN, is an emergency department nurse and the founder of the Dream Recovery System. His goal is to provide his readers with simple, actionable ways to improve their health and maximize their quality of life. 

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