Answer Your Phones! Love, Tele.

[Stephalump]

I work as a PCA (CNA/MT/US) in a telemetry unit. We monitor tele for our floor, and most of the non-intensive care units in htt hospital.

A while ago a coworker was at the monitors and a patient on another floor went into asystole. The MT called the pt's nurse, the charge nurse on they unit, the front desk - NO ONE would answer. After running out of people to call, she made the judgement call to call a code overhead.

The code team was able to resuscitate the patient, and everyone was happy EXCEPT administration. The MT was ripped a new one for "calling a code without a license to do so" and creating a situation instead of being discrete.

Recently, the same thing happened again. No one answers their phones! So this time we called OUR charge nurse who grabbed another RN from our floor, ran upstairs, and proceeded to get ready to perform CPR. Right before they started, the pt's nurse ran in the room and told them the pt was DNR.

Why the heck was he on tele? But that's a question for another day.

So that situation created a bit of a mess because we were close to reviving someone who had no desire to be.

I've heard our nurses have had to run up to this particular floor more than a few times.

Here's my thing: at this rate, someone who wants to be resuscitated is going to die while I'm watching, and no one is going to answer their phones. And when it happens, heads are going to ROLL, and based on my experience, mine will be included. We can't just barrel into a room and start CPR. We can't call a code. What the heck can we do? I can get behind faulting the system rather than the people, but no one seems interested in fixing the system.

[Sun0408, ASN, RN]

Do you have a nursing supervisor you can call or the rapid response nurse?? I would think, if you can't get anyone on the floor to answer their phones; the nursing supervisor needs to know as well as the NM of that unit to fix this issue.

[Pangea Reunited, ASN, RN]

It sounds like the place is understaffed. I'm often scolded for not answering my phone, but sometimes I'm in an isolation room giving and IV push medication and conversing with a family member. And when I'm not in that situation, I'm often in some other situation that prevents me from chatting it up on the telephone.

Some other system needs to be in place for emergencies. Either that, or give me a personal assistant to follow me around and promptly answer my calls.

[mala in se]

Well you can be DNR w/ meds so the pt should have been on the monitor depending on the MD orders.

As for the MT who called a code, the hospital is just covering their ass for liability reasons. I would have taken that MT out for dinner. That person should be commended and made a SAFE judgement call (even though it was out of his/her scope). Those are decisions that make good, under pressure RNs.

[RNewbie]

This is definitely a system issue. Maybe you should find out how to go about making changes to the policy; something that works for the MTs, RNs, and pts. Our phone system sends an alert alarm directly to our phone for critical rhythm changes. The alarm sounds different than any other sound on the phone. I once heard the alarm, looked at my phone to see asystole. I ran so fast. Pt was fine. Tele box batteries were dead. Our DNR pts also have a certain color arm band but that is one of those things that someone could forget to put on.

[DoeRN]

If I'm up to my armpits in feces, isolation or something else I'm not answering the phone. Like another poster said, if I'm doing an IV push or something similar that needs my full attention I'm not answering the phone. The mt did what's right by calling the code and shouldn't have been chewed out. What if a visitor suddenly falls and becomes unresponsive in the hallway will a non license person go run and find a licensed person to call a code? Makes no sense. If the unlicensed person is CPR trained then they will follow those protocols.

The hospital you are working at should have a policy put into place about chain of command. If you can't get ahold of the nurse, call the charge nurse, then nursing sup so on and so forth. And if the mt is using their best judgement and feels the patient isn't ok what's the problem with calling a code to save someone's life?

And I've had plenty of DNR patients on tele for various reasons. But I make sure I tell tele they are DNR and the reason why they are still being monitored.

Sent from my iPhone using allnurses.com

[havehope]

On our unit any employee that goes into a patients room can call a code. Our facility actually encourages, that if we even THINK a patient is about to code, to go ahead and call one just in case. Better safe than sorry.

However, for your question I agree with RNewbie, plus it is very discrete also. Only the employees know what that sound is. Just about everyone knows what "code blue" is.

[cancermom]

At the facility I worked at there was 1 phone that was designated as coming from the monitor room. It had a different ring than any other phone on the unit. When that phone rang, it was priority to be answered by anyone nearby who would grab the nearest nurse to take the message. This seemed to work well.

[jadelpn, LPN, EMT-B]

I would bring this to risk managment. You can use a 2 way radio specific to codes/rrt's that the "#1" member of the code team would carry. That would only be used for codes/rrt's. So you could just literally say "room 332, room 332" into the radio. Every day the "code team" is listed, as well as the RRT nurses from the floor.

There needs to be, I would think, a specific communication device that you use as opposed to someone's general phone.

[sistrmoon, BSN, RN]

We have an emergency tele line. Regular "lead off" and low battery calls go to the main line but when the emergency line rings, I've never seen it go more than 2-3 rings without being answered.

[Morainey, BSN, RN]

We're supposed to carry hospital issued cell phones, but on our floor nurses can be casual about it. That's why I call the monitor tech at the start of my shift w/ my cell phone number so they can call me directly. It gets things off the on the right foot, and as soon as something's up w/ my patient, they can reach me directly and immediately.

[TiffyRN, BSN, PhD]

Does the OP believe that the floor staff in question is refusing to answer a ringing phone or unavailable to pick up a phone? Do they have portable phones on them or are they all up at the nurses' desk? No matter what the answer, some new processes need to be put in place for patient safety. OP, as a monitor tech you are unfortunately not real important to management, and by that I'm pretty sure the nurses are pretty low on the totem pole also. Your best first action may be to start documenting every time you make a call and no one answers to start a "paper trail". Some hospitals have incident reporting systems that include the ability to document a "near miss". I would start filling one of those out every time you don't get an answer. Those go to risk management and maybe they can help your floor management come up with a solution for how to report possible telemetry emergencies.