Clinic provider rings bell and expects nurse to respond immediately

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Call bell is used by the provider to get the nurse into the room to schedule an appointment for the patient to come back. I am a traveling nurse I work at a primary care clinic where we have 3 providers, 2 nurses, and 1 part-time transporter (uber driver) / 1/2 time receptions who does not use a computer to do her job, she is 84 years old, so it is unlikely that she would be trained to check in or check out patient. I work at a primary care clinic where we have very few staff members because the facility could not find people who are willing to work for less than $20 an hour. Besides doing nurses' responsibilities at this facility nurses are expected to check and check out patients in addition to scheduling an appointment for patients to come back. I and another nurse split providers I work with providers who have 30 + patients per day and she works with 2 other high-maintenance providers. Once in a while her provider used a call bell to get the nurse into the room, so we could schedule an appointment for the patient to come back. I have too many patients, so every time I hear call bell I am rooming the patient. I usually choose to ignore the call bell because I am busy with patients. What would you do in the situation? Would you continue working with your patient or apologize and leave room to schedule an appointment for another patient to come back?

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2 Answers

Specializes in Tele, ICU, Staff Development.

In your situation, the primary challenge is managing your workload efficiently while ensuring that patient care remains uncompromised. Here are a few strategies to consider:

Prioritize Immediate Patient Care

Focus on the patient you are currently with. It's important to provide undivided attention to the patient in front of you to ensure high-quality care.

If the call bell rings while you are with a patient, unless it is an emergency, continue to prioritize the immediate needs of your current patient.

Set Up a System for Handling Call Bells

  • Communication. Have a conversation with the providers and your fellow nurse about the challenges posed by the call bell system. Explain that responding immediately to call bells is not always feasible given your workload.
  • Protocols. Establish clear protocols. For example, if a call bell is used, the provider could document the need for a follow-up appointment in the patient's chart, which you or your colleague can review and address once you are free.

Team Coordination

  • Delegation. Coordinate with your fellow nurse to see if there can be a rotation or specific times where one nurse is designated to handle call bells and scheduling while the other focuses on patient care.
  • Support Staff. Utilize the part-time receptionist for tasks that do not require computer use. She might assist with non-computer-based check-in or check-out tasks, freeing up some of your time.

Workflow Optimization

  • Pre-Scheduling. Whenever possible, schedule follow-up appointments before the patient leaves the room. This can reduce the need for call bells for scheduling purposes.
  • Technology Utilization. If you have access to electronic health records (EHR) or other digital tools, leverage them to streamline scheduling and reduce the manual workload.

Propose Additional Support

  • Justify more staffing. Using nurses for administrative tasks is not the most efficient way to run a clinic. A medical assistant could perform many of your tasks. Document the challenges and time constraints you face due to the current staffing situation. Use this documentation to justify the need for additional support or increased wages to attract more staff.
  • Volunteer assistance. Discuss with the facility administration the possibility of temporarily bringing in volunteers or part-time staff to handle non-clinical tasks.

Personal Time Management

  • Schedule blocks. If possible, schedule specific blocks of time for non-patient-facing tasks, such as scheduling appointments. The providers would know not to use the call bell during these times.

In summary, continue to prioritize the patient you are attending to and work towards a more efficient system that reduces the reliance on the call bell for scheduling. Clear communication with your team and optimizing workflow can help manage the workload better.

Thank you 

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