I'm not answering call lights

pookyp, LPN · Feb 1, 2014

At least not as many as usual. I'm getting memos from pharmacy and management about charting that's not getting done. The nurses who follow me are finding me the next day and reminding me to take care of forms I failed to do on my shift. At my age, I'm afraid these oversights will be attributed to my advancing age, and my feeble mind. Instead of the truth, which is I don't have time to be the aide and the nurse both. I'm helping patients to the bathroom instead of crossing my t's and dotting my i's. Where I work, they staff decent for nursing, but are eliminating the CNAs. Because I can do both jobs. So. I'm letting that call light sound. Just because I'm sitting down, doesn't mean I'm doing nothing. I'm not stopping and filling ice pitchers, delivering coffee, or fetching warm blankets unless my nurse job is caught up. My fellow nurses have no problem letting their lights sound for 10-15 minutes. Neither am I. If I'm to be reprimanded, suspended, or (shudder) fired, it's not going to be because I didn't waste that Dilaudid. It'll have to be because I didn't fluff a pillow. I can explain the pillow, not the Dilaudid.[/quote']
But what if that one day it's not someone needing their pillow fluffed, but someone on the floor with a broken hip? Or dead? (Happened on a shift once and the nurses were scared out of their mind) if only they answered that call light...

Lev, MSN, RN, NP · Feb 1, 2014

Makes sense to me.

Pangea Reunited, ASN, RN · Feb 1, 2014

I always answer my call lights quickly, but I have no trouble putting off non-essential requests. You want jello, again? No problem! I'll bring it in with your next IV antibiotic.

After I'm done with all the "paperwork", everyone can have what they want instantly. Until then, I have to ration my time.

Esme12, ASN, BSN, RN · Feb 1, 2014

At least not as many as usual.
I'm getting memos from pharmacy and management about charting that's not getting done. The nurses who follow me are finding me the next day, and reminding me to take care of forms I failed to do on my shift. At my age, I'm afraid these oversights will be attributed to my advancing age, and my feeble mind. Instead of the truth, which is I don't have time to be the aide and the nurse both. I'm helping patients to the bathroom instead of crossing my t's and dotting my i's.
Where I work, they staff decent for nursing, but are eliminating the CNAs. Because I can do both jobs.
So. I'm letting that call light sound. Just because I'm sitting down, doesn't mean I'm doing nothing. I'm not stopping and filling ice pitchers, delivering coffee, or fetching warm blankets unless my nurse job is caught up. My fellow nurses have no problem letting their lights sound for 10-15 minutes. Neither am I.
If I'm to be reprimanded, suspended, or (shudder) fired, it's not going to be because I didn't waste that Dilaudid. It'll have to be because I didn't fluff a pillow. I can explain the pillow, not the Dilaudid.

Unfortunately documentation is tied to reimbursement and that is all they care about. sigh

brownbook · Feb 1, 2014

I understand completely. "They" don't care how wonderful you patient care was. "They" care that you didn't sign page 3 line 6. "Too many charts are coming back incomplete....we are going to start tracking who is not completing their charting."

It is sad, I wish I knew the solution? Actually I do I "buff" the charts often after the patient has gone home.

I don't run to the nurses station, sit down, and complete my charting (ignoring the patient.)

I spend my time with the patient at their bedside, teaching them and their family, giving snacks, etc. Getting them out the door (because they are asking "when can I go home", not because I am rushing them.) Providing "wonderful" patient care (that does NOT show up on the charts), and "buff" my charts after they are gone home. With admittedly very sketchy charting. As long as the correct boxes are filled in and signed "they" are happy!

And I don't work on a busy med/surg floor. I work in a relatively easy out patient surgery facility! I know I could not make it on a busy med/surg floor any more!

applewhitern, BSN, RN · Feb 1, 2014

I hear you. I work in an ICU. We have NO nursing assistants, and NO unit clerk. That means we nurses are running back and forth all day to answer the phone, put in our own orders, do all the initial admit stuff on any patient we get, etc. We are putting a patient in their gown, assessing them, toileting them, etc., all the while we are trying to put several pages of orders in the computer. Our ER docs do not enter the orders themselves. We do not need another RN, we simply need someone who can answer the phone and help bathe, turn, etc. I am finding myself simply ignoring the telephone. Add to that, we have to chart at bedside only, so we have to log off and log on constantly, if we leave to answer the phone or call lights!

MatrixRn · Feb 2, 2014

If documentation needs to be king, and it does for reimbursement, than something needs to give and that will be patient care.

I hate to say it but if someone meets all their patient needs, but fails to chart on a regular basis that nurse will be reprimanded and eventually lose her job. However, if you let some of those lights go and do the charting the hospital gets paid and you keep your job.

The patient may complain to admin about their care and you know what that is okay. The only way things will change for the better for bedside nursing is when patients start complaining about their care and threaten to go elsewhere.

Cal-Neva · Feb 2, 2014

ShillaBSN,

You are right on the money. With the new CMS reimbursement for hospitals, if patient satisfaction scores go down so does the money that the hospital gets. I see the situation going one of two ways: either the hospital invests more into increasing satisfaction scores or they just reprimand the staff/manager when patients are unhappy on their unit. I hope the first one happens, but I know better than to expect that to be the norm.

Sam J. · Feb 2, 2014

Are you in Reno, OP? This town appears to be so wiped out from the Indian casinos in CA, that I decided to stay a while to ca$h in on the loose poker winnings, to include @ the Cal-Neva. A thought about call lights, though: Make rounds, tell your patients you'll be making rounds routinely, and that they don't have to bother (but they can) pulling the call light because you'll be around routinely, and ask if they need anything- if they do, give it to them. You'll cut down call lights by 90%, and when one does go off, you can be more certain it's urgent.

But it's never a good idea to ignore a call light. You just never know when you might be dealt a ... dud of a hand?

MedicalPartisan · Feb 2, 2014

As I always state, I'm not a nurse, but this won't change when I become one...

Often times I'll walk pass the unit coordinator and the call light is beeping over and over so I answer it. Yes, it's almost always an "I need more pain meds", "my blood is going into my IV!", or something of that nature. But there's going to be that one time where a patient's life is being compromised and they're just going to pass it off as another needy patient. Do I get annoyed by that damn call button? Yes. But a patient is not going to lose their life because I ignored a cry for help.

allnurses Guide · Feb 2, 2014

Unfortunately documentation is tied to reimbursement and that is all they care about. sigh

Ahhh, but now patient satisfaction is also tied to reimbursement! In my hospital not answering call lights is grounds for disciplinary action and termination. All we get lectured about these days is satisfaction scores!