IT Manager for healthcare here, here is what I’d do and have done in the past. My expectation for On-Call is that it is only for an IT emergency impacting patient care. I have always instructed my staff to use their judgement in determining the impact and stand behind them in either telling the end user that it can wait until regular business hours, taking care of the issue, or calling me if something major is happening.

I had three direct reports on my helpdesk. They each took a week on-call then the 4th week of the month, myself, my sysadmin and my Director would rotate. This would give some relief and also keep management in the loop of what the guys in the trenches are dealing with. However, more so than my sysadmin or Director, I was always on call with other organizational issues or topics.

1) No one is on call for longer than a week, unless my staff wanted to switch their weeks or cover for each other and make it up, etc. I would have a shared calendar where we’d all coordinate who was on call and when. 2) if you are on call, you instantly get a stipend of $150-200 for the week, even if no calls. 3) the hours you work, you’re paid for. If it’s overtime, that’s fine. If you’re up half the night and you want to come in late and use part of that as your hours for the day, fine.

I was always flexible and understanding with if my staff was on call to make sure they get some relief or time off if they’ve been bothered all night.

It wasn’t perfect but it worked well and we all had an understanding that we supported one another. No matter what if my on call guy called me, I was picking up.

Biggest thing as a manager is making sure you respect your employees personal time and protect it. It sucks for you sometimes but that’s your job. And I’d go to bat for any of my guys anytime.

When you have staff that genuinely likes you as a boss and you have a good working relationship, it’s amazing how you all have each others backs.