Call light abuse. What to do???

[IBleedGreen]

Today I had a pt. who was A&O x3. The nurse giving me report (this was a pt. transferred to me from another unit) said they like to push their call button. They will push it to tell you that they are going to watch a show on TV. As soon as you walk out of the room, they will push it again to tell you they are watching TV. So I got the pt settled in, do my assessment, etc. I walk out of the room and they put the call light on. I walk in and ask what they need. The conversation to follow goes like this:

RN: Your call light is on, what can I help you with?

Pt: I don't need anything.

RN: Did you push it by accident?

Pt: No

I leave the room after asking if there is anything they need once again.

5 minutes later... the call light is on. As I walk into the room I see them holding the call buttin and then putting it down real quick. It was intentional that they pushed it. Repeat above story. Then repeat it again, and again. Then again with the PCT, and another RN, then another PCT. You get the story. I feel like it was a game to them, but it could end up with them getting hurt because nobody wants to answer the call light if they are abusing it.

What do you do? How do you set limits?? Is there another way I can approach this??? Any help much appreciated.

[rnmi2004]

Do you have a patient relations department that you can call? We have had more than a few patients that have had a behavior contract drawn up & enforced.

[loriangel14, RN]

Where I work a patient like that will be assisted into a chair/wheelchair/geri chair and parked out at the nursing station away from their bell.They are made to spend as much time as possible out of their room.( I work in a hospital). If they are well enough to be ringing constantly they don't need to spend all day in bed.

[Tricia76]

Oh I have one who does that.. As soon as he sees me walk by he pushes his light.

[LOVEGREEN]

Where I work the call bell is on the same remote as the TV. There are 3 buttons, one for the TV, one is the call bell and the one in the middle operates the light. It is not uncommon for a patient to hit the call bell while trying to change the channel or turn the TV on.

[tigerlogic]

sit them in a chair in front of the nursing station

[neonatal_nurse]

Get your charge nurse/supervisor.

[imintrouble, BSN, RN]

Who knows what makes people tick? It might be as simple as they're bored. Sometimes I think I'm the entertainment. What a game! There are so many variants. The "how long will it take to answer" game. The "who will it be this time, can I guess right" game. The "will they be mad" game. The "can I say I didn't do it and fool them" game.

Every once in a while we'll get the guy who likes the younger CNAs in the room. When I suspect that, I take call light duty for that pt. It generally stops since the reward is removed.

Where I work we can't anger a pt by suggesting they're being unreasonable. Even when they obviously are.

On a really bad night, all I can do is count down the minutes til I can go home.

[beeker]

Ask if they ever heard of the story called "the little boy who cried wolf?" If not print it off Google, hand it to them and tell them to think long and hard about why you picked that to read.

I would be giving them this lecture. Then de prioritizing their call light. I can't remember ever taking one away, but for this case I think they need theirs off or taken away.

[Jenni811, RN]

Sometimes their weird behaviors are just boredom. As long as they are appropriate ill send in volunteers to play a game with them or watch a movie...something!! They are always looking for something to do.

[Ruby Vee, BSN]

I'd give them a couple of freebies, then the third time the patient pressed the call light without actually needing anything, I'd sit down with them and explain to them that I'm concerned about their mental status. It's not normal to abusing the nursing staff like that, and I wonder if there is some psychiatric issue that is causing this. I'm going to notify their doctor and recommend that he request a psychiatric consult to see what's going on. I act pleasantly concerned about them, saying I'd hate to let a real issue go unresolved. Most patients are so embarrassed by the idea that they're going to get a psych consult, they shape up immediately. Some require an actual MD consult -- the provider sits down with them and has a "come to Jesus talk".

If the patient really IS crazy and/or needs a psychiatric consult, then you've got a different issue. A friend of mine swears he's had good success with answering the call light and saying "This is God. I want you to stop abusing my nurses." I can't recommend that; I haven't seen it used. What I HAVE seen work is, for the patient that constantly yells "Help Help Help", a physician pick up the call light to call into the room and say "This is God speaking. I need you to be quiet now."

[uRNmyway, ASN, RN]

I'd give them a couple of freebies, then the third time the patient pressed the call light without actually needing anything, I'd sit down with them and explain to them that I'm concerned about their mental status. It's not normal to abusing the nursing staff like that, and I wonder if there is some psychiatric issue that is causing this. I'm going to notify their doctor and recommend that he request a psychiatric consult to see what's going on. I act pleasantly concerned about them, saying I'd hate to let a real issue go unresolved. Most patients are so embarrassed by the idea that they're going to get a psych consult, they shape up immediately. Some require an actual MD consult -- the provider sits down with them and has a "come to Jesus talk".

If the patient really IS crazy and/or needs a psychiatric consult, then you've got a different issue. A friend of mine swears he's had good success with answering the call light and saying "This is God. I want you to stop abusing my nurses." I can't recommend that; I haven't seen it used. What I HAVE seen work is, for the patient that constantly yells "Help Help Help", a physician pick up the call light to call into the room and say "This is God speaking. I need you to be quiet now."

Lol, so for someone who thinks they are God to say that is better than for a nurse to say it, not the same level of lying I guess

[Lesley Cook]

Just ask. Why are you doing this? you never know the answer might surprise you. I had a patient that admitted they were frightened and a night light helped, they were pretty anxious as well but ashamed to admit it. But I have also had patients who will continue. Be upfront and firm. A move closer to the nurses station where the patient can be seen is also an option. It is usually brighter and noisier there, and if you tell them that they may not get much sleep if you have to move them they may desist.