Clueless academic medicine states 24/7 coverage is a must...
Real world standard of care from ARNPs to even a Big Box shop with several Psychiatrists / ARNPs I worked at, emergencies are managed by patients toing to ED or UC, phones are responded to only during business hours.
I provide an after hours number just for patients detailing for urgent issues, and not emergencies, and outline what emergency options are. 911, crisis line, ED, psychiatric units, etc. In like 4-5 years I've only been called 2-3x after hours. Called some times during hours, which I shunted to assistant to address and clarified with patients don't call that number during hours. None were emergencies. One was geriatric patient unaware of what the number was for. Another was anxious patient who their cold was serotonin syndrome. Another was patient thinking it was main office number.
I take my phone and lap top with me on vacation. I check 1-3x a day the computer for messages. Frequently the cell phone for any transcribed cell phone messages.
When out of country I stay near WiFi to respond to E messages, and coordinate with assistant to be one to call patients. Haven't yet had need to call a patient while out of country, but with WiFi based phone calls, not expecting to be an issue. Same thing, check messages twice a day, and if on other side of the planet, yes I'll get up in the middle of the night if needed to coincide with business hours here to do my 1-3x a day check.
When hunting in the middle of nowhere, I diligently must keep my cell phone charged, and whenever in random pockets of cell coverage I'll check messages/emails etc. Can't tell you how many times I've been sitting on a mountain top in rain storm freezing my arse off thumbing a response to assistant or patient. As much as I might want to hunt from before sunrise to after sunset, I typically have messages or longer things that need typed out [and not thumb/cell phone done] so I return to hunting camp for lunch to do work. Once I was on a ridge line on windy day, sounded like I was at the beach, but had trees getting blown down around me cracking and smashing. When I'm packing an animal out, I've found doing a work check is a great excuse to catch my breath and also get a water break. LOL
The biggest issue I've had, is I must keep my cell phone on when sleeping. Typically on vibrate. So I can hear phone ring in middle of night. So I do get some sleep disruption from rare spam callers. Biggest disruption is friends in different time zones texting when they are awake, I'm asleep, and not I get woken up by their text message vibrations. This is the thing I look forward to the most in retirement years - phone off at night.