Nurse advice calls

TaraER-RN · Sep 25, 2003

When someone calls asking for advice we outright tell them that we can not give advice over the phone and tell them that if they would like we can transfer them to the advice nurse or if they feel they have a medical emergency they can either call 911 or go to the nearest ER. People don't like to hear it, but we tell them its the law and that we are not certified to give medical advice.

Rena RN 2003, RN · Sep 25, 2003

we have a greeting to our main ed number that states something like "thanks for calling. we can't tell you anything. please hang up and seek advice from you PCP or if you have a medical emergency, call 911." if that person is persistent enough to continue long enough to get to the desk clerk, she/he will basically repeat the same thing. i haven't seen a nurse take a phone call requesting information in months.

JJFROG · Sep 25, 2003

Rena

Do all callers have to listen to this message? Do you have a separate line for consultant call backs? Both ERs that I have worked in we have been bombarded with phone calls and I really want to know how other facilities deal with the calls. JJ

Rena RN 2003, RN · Sep 26, 2003

our main published phone number goes to the automated line as well as any phone calls put through by the operator that isn't an MD. our call back numbers for docs are listed only in the hospital directory. we have a 12 phone line system and all but the automated line are basically unlisted and considered overflow lines.

of course, we can't completely shut the public out. :chuckle so there is always the options of "press this number to do so and so" until that person gets to the clerk. the buck stops with the clerk. our policy is simply to not take nurse calls. if a patient is angry and starts nagging the clerk, the call is transferred to our wonderful nurse manager who again repeats "call 911 or come in if you think you need to be seen."

our biggest pain right now is "my mother/brother/sister/friend is there. is there a phone in the room so i can ask them what to fix for dinner?" :chuckle it has now become my policy to kindly explain that we don't have phones in individual rooms and that i can try to get a message to the patient but i can't make guarantees.

it's not the hyatt. i'm not a personal secretary. i'm a nurse that has things to do.

dm2 · Sep 27, 2003

We tried the automated line for nurse calls. Any call that came in to the main ED number asking for advice was manually transferred to that line. It gave the standard disclaimer plus something like " we must focus our primary attention on the current patients, so hold if you still want to talk to a nurse.... blah blah...... we cannot give advice, but can assist with information that you can use to make a decision (I did not like that part, but our medical director thought it added a nice caring touch) Anyway, we rarely picked up the line! Just went about our work..... The calls eventually slowed down as people learned they would be put on endless hold. Am not sure that is how the manager thought it would work when it was installed. Tapes were recorded and kept filed, in case of problems, when we spoke to callers.

That machine broke...... now our clerks answer and give the repeated schpeal "no advice" but if you have been a pt in the last 3 days and have a question about your care, i can put your thru to the charge nurse". That drives me crazy when i am charge! But i do feel we owe it to patients we've seen to try and be more helpful. We document the calls on our computerized t system charts as an addendum, so there is a record of the question/problem and action, if any.

All the calls re incoming pts also goes to the charge nurse who shares what is needed with the triage. All panic values and bed control calls also go to the charge....... a busy phone!!! Plus charge takes patients....... how about your charge? Does that person take patients?

Rena RN 2003, RN · Sep 27, 2003

yes, our charge takes patients. charge also informs the floors if we have an admission but more times than not, each nurse pitches in and helps with this. charge also the go between for the ED and staffing to let them know throughout the shift of our possible admissions to make sure the floors have the staff to take them.

in regards to the phone traffic and how much the charge takes, it just depends. we all tend to take care of what we need to to help keep the ED flowing.

Sarah, RNBScN · Sep 28, 2003

We have a tele-health line that we give out and they call and speak with a RN. They are always referred to ER. ????

We used to log triage calls and that didn't last long, thankfully.

I advise people if it is an emergency, call 911.

When people call and ask the wait in our ER, I tell them minimum 4 hrs. After all, if they are calling to find out the wait, IS IT AN EMERGENCY? I don't think so.

C'est la vie?

galenight, BSN, RN · Sep 29, 2003

In our small rural ED we do take nurse calls. Our administration thinks that it is a good public service. I am usually very noncomittal on the phone with vague answers like, well, sir, it's really hard to say what that rash is without seeing it. You can always come in and be seen or go to your doc. (we have a clinic also). or no, abdominal pain is never normal. if you think you need to be seen we are here for you. I hate them. If they ask specifics and are persistant, i will bluntly say that legally i can't give advice over the phone. I've even gone so far as to say that I can't xray through the phone. pt.."my ankle is swollen, do you think it's broken?" I have done it in a joking way, but my point gets across. We could never realistically go to an automated system because of the backlash we would get from the community. God knows they would hold a grudge forever and go to the competing hospital for sure. As for saying how long the wait is, our management won't allow us to estimate, because people are so ignorant that they hold us to it. Puhlease. Who do they think we are? Dominos?

Rena RN 2003, RN · Sep 29, 2003

Originally posted by Sarah, RNBScN

When people call and ask the wait in our ER, I tell them minimum 4 hrs. After all, if they are calling to find out the wait, IS IT AN EMERGENCY? I don't think so.

:chuckle :chuckle i do the same thing! :chuckle :chuckle

JJFROG · Sep 29, 2003

I always say...."There is never a wait for a true emergency!"

Does anybody else have an answering system (other than nurses) to direct these calls? Our secretaries are so busy, if we could get a "secretary for the secretary" they could be more productive. I can't wait to tally the number of calls we take a day.

Todd SPN · Sep 29, 2003

Some of these answers disturb me. My dad's wife drove him (88y/o) to the ER one morning at 0200. After sitting and waiting to be seen for 1 and a half hours he was told he might want to go to the hospital at the next town as they were quite busy. His problem was serious enough that he spent 3 days in the hospital. He thought he might call next time if he has to go to the ER to avoid this happening in the future. Guess I'll print some of these responses out and give them to him. Sheesh.