How is your on-call rotation setup

I am wondering how other places do their on-call rotations.

tl;dr Ours is 24/7 for 7 days in a row and I absolutely fricken hate it.

I really really hate our on-call rotation, it's incredibly stressful, I normally don't have anxiety but during on-call it's awful. We are all on "salary" so we don't get any extra pay when we do respond, sometimes we get a free vacation day if our manager thinks we were called too much.

Geographically our team of 12 is in one area. We support 6k devices, 25+ sites, some are 24/7 or the business opens by 0600. The on-call person is responsible for 7 days of 24/7 on-call time. Because of how large we are, getting paged in the middle of the night 4+ times during that week is likely, I've had it where I've been paged every day.

During business hours on-call still gets the page but can easily delegate to a better resource. Outside of normal business hours 18:00 - 06:00 the on-call is primarily responsible.

I was talking with a friend who explained that their rotation as a surgeon is a bit different. Each person gets assigned 1 day of the week ( Monday - Thursday ) and then they rotate the weekend shift (Friday - Sunday) With this structure, we have one on call one day every 3 weeks and responsible for the weekend every 3 months.

To me, the surgeon's rotation sounds more stable and way less stressful without having to put life on hold for an entire week. At the worst, you would only lose 1 night of sleep during a work week. It would also be easier to find people to cover for vacation or to trade days too.