Why the Next Generation of Nursing Won’t Accept 24/7 On-Call Expectations
- ACS
- 28 minutes ago
- 3 min read
Lori McGuire, Co-Founder & Chief Clinical Officer
If you’ve been in nursing long enough, you know what “on call” really means. It doesn’t just mean being available. It means never fully turning it off. It means going to bed wondering if your phone will ring. It means carrying responsibility, even when you’re technically “off.” I’ve lived that for most of my career.
For over 30 years, I’ve worked in senior care as a nurse, a caregiver, an Executive Director, and a Regional Director supporting multiple buildings and teams. I’ve helped lead through acquisitions, opened new communities, navigated licensure, and managed teams of more than 1,000 employees. And through all of it, one thing has always been true. When something happens after hours, it falls on a nurse. For a long time, we just accepted that as part of the job. But that doesn’t mean it was ever sustainable.
The Nursing Reality We Don’t Always Say Out Loud
In senior care, the work doesn’t stop when the day shift ends. If anything, it gets harder. Fewer resources. Less support. And no room for hesitation when decisions need to be made. I’ve been the one taking those calls. I’ve been the one responsible for the outcome. And I’ve been the one leading teams of nurses doing the exact same thing.
That kind of pressure adds up. And for years, we’ve asked nurses to just keep carrying it.
Nursing During COVID Made It Impossible to Ignore
If there was ever a moment that changed how I saw this profession, it was COVID. I watched teams stretch beyond what anyone thought was possible. But I also saw something else. Burnout. Mental fatigue. Nurses were trying to hold it together at work while their personal lives were falling apart. And it wasn’t just nurses. It was caregivers. Executive Directors. Entire teams. Coming out of that, the workforce didn’t bounce back, and the expectations didn’t change. That’s where the real problem started.
The Next Generation of Nursing Is Saying What We Didn’t
The nurses coming into this field today are not less committed. If anything, they’re more aware. They’re asking better questions. They want to provide great care, but they also want a life outside of it. They’re not willing to accept a model that requires them to be available 24/7 to do it.
“This isn’t a work ethic issue. It’s a sustainability issue.”
Honestly, I don’t blame them. Because the truth is, many of us stayed in roles that asked too much for too long.
The Cost of Holding Onto the Old Way
We’re seeing it now across the industry. High turnover. Chronic staffing shortages. Teams that are stretched too thin to function the way they should. If the system only works when people are overextended, it’s not a system that works.
Why I Knew Something Had to Change
After everything I experienced, especially during COVID, I couldn’t ignore it anymore. The need wasn’t just better staffing. It was better support. Support for the nurses. Support for the caregivers. Support for the leaders trying to hold it all together. That’s what led to the creation of Accelerated Care Solutions. Not as another layer. But as a way to step in during the moments that are the hardest, after hours, when teams are most vulnerable.
What Support Actually Looks Like
To me, support means this: When a nurse’s shift ends, they can actually step away. When something happens at night, there’s an experienced RN there to take the call, guide the decision, and carry that responsibility forward. When the next shift walks in, they’re not walking into chaos. No nurse should feel like they’re in it alone, especially after hours. That’s the gap we’re filling. Not replacing teams. Supporting them in a way that allows them to stay in this profession longer, and show up better when they are on shift.
The Future of Nursing Depends on It
The next generation of nurses is not asking for less. They’re asking for something better. If we want to keep them in this field, we have to listen. Because the future of senior care isn’t going to be built on asking nurses to give more. It’s going to be built on finally giving them the support they’ve always needed.
And until we solve that, nothing else will truly change.
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