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Discussion

Constant interruptions

I've been working on a surgical floor and I am about ready to lose it over the constant interruptions, especially when I'm passing meds. We have an intercom system that the secretary uses to call into the room to tell us that we have a call. She says that all she is allowed to do is answer the phone and contact the nurse. She either is not allowed to ask who is calling or doesn't have the time - I'm still not clear on that. So I can either drop what I'm doing and take the call - sometimes it's a call I've been waiting on - or I can take a chance and leave the caller hanging until I finish what I'm doing, though they'll probably hang up. I was called away from one patient to answer the phone three times in about 10 minutes while trying to give his meds. It's just too many distractions and a med error waiting to happen.

I'm not going to change the culture of the floor and so I need to find a way to manage this better. Or to find a new job.

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    • Featured Replies

    1 hour ago, Rexie said:

    She says that all she is allowed to do is answer the phone and contact the nurse. She either is not allowed to ask who is calling or doesn't have the time - I'm still not clear on that.

    I'm not going to change the culture of the floor..

    Have you verified this with the Nurse Manager, could be the secretary is just trying to make it easier for him/her.

    The constant calls drove me crazy too, we had phones and the secretary would just transfer all calls (even if the person didnt ask to speak to the nurse) so I would be getting many unnecessary calls, I just had to ignore the phone sometimes. The NM finally talked to the Secretary who did start (and was supposed to have been!) screening calls. But even with that I ignored the phone sometimes or i would have never got anything done.

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    I think she (secretary) is not telling the whole truth. ?

    A secretary not allowed to ask who is calling?

    Yea. We're all in Preschool.

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    • Admin

    Do some homework. Look up "interruptions during medication administration." Multiple interruptions decrease the efficiency of medication administration, and increase chances of error.

    Then review with your NM exactly what the US's responsibilities are r/t taking and passing on staff phone calls.

    Then brainstorm about an improved system. What might work better, to attain all goals (e.g., getting your return calls in a timely fashion, triaging phone calls [does US have a template to guide her as to which calls to pass on and which to take a message?]) -- including a system for distributing messages to the RNs (a central area, a standardized sheet [not just a torn-off scrap of paper] w/time of call, who called, return number -- at the very least).

    Nursing by its very nature is prone to interruptions in duties and tasks. However, if these can be reduced, especially during critical times (i.e., med passes), the day just might go smoother for all. Good luck!

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    • Guides

    The Professional Practice Committee at Kaiser South San Francisco hospital worked out a way to avoid unnecessary interruptions in 2007. It is still in effect. Several of those nurses are my friends.

    Quote

    Decreasing Disruptions Reduces Medication Errors

    Nurses at Kaiser South San Francisco Medical Center wear sashes or vests to reduce disruptions when passing meds.

    “It’s so simple and it came from front-line nursing staff,” said Becky Richards, RN, BSN, MA, adult clinical services director at Kaiser South San Francisco Medical Center and a leader of the initiative.

    Nurses on the hospital’s quality forum recognized a need to reduce medication errors and began brainstorming ideas. The facility put into place special procedures, such as double-checks on morphine drips, insulin and other high-alert medications.

    “We felt there needed to be a safeguard in place as the nurse went through the entire process of medication administration,”...

    [ They decided that nurses would wear a vest when passing meds]

    ... When the medication administration data came in at the end of the year, the hospital found that during the four and five months after the pilot finished, those two units combined had a 47 percent decrease in errors. The units had not done anything else to reduce errors, just the education about no distractions and the vests. “At that point we knew we could not turn our backs on our patients,” Richards said.

    The quality forum nurses tweaked the program, finding more attractive neon yellow vests and reaching out to the medical staff, housekeeping and other departments for support.

    Kaiser South San Francisco kicked off the new program hospital-wide in April 2007, with the exception of oncology, which refused to participate, writing letters and signing a petition...

    ... “We were blown away in May. The hospital experienced a 20 percent decrease in medication errors, even though one unit refused to participate,” Richards said. “And that was the only unit that experienced an increase from their previous month’s error rate.”

    One by one the oncology nurses joined the no-distraction program...Nurses suggested wearing a sash, instead of a vest, if the nurse preferred, and Kaiser hospitals throughout the region kicked off the “MedRite” process in March 2008. ...

    https://www.americanmobile.com/nursezone/nursing-news/decreasing-disruptions-reduces-medication-errors/

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    I would simply ask the UC to take a message (after ensuring it isn't a call I've been waiting for).

    There are a lot of these little things to which nurses acquiesce when it makes no sense to do so. Safety is a serious matter - and it's time that everyone started acting that way instead of promoting or allowing terrible nonsensical practices such as this and then dutifully taking our beatings after the fact/after there are errors. This is kind of black and white: Unless it is something objectively urgent such that a safe medication process might reasonably be interrupted, it will have to wait. If you/we want a more safe environment, then we have to take steps towards it without a bunch of hand-wringing, as if we should have to apologize or make a case for something so obvious.

    ??

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    Interruptions are annoying. I tell the secretary (or whoever is answering the phone) to find out who it is and take a message if it is not a call I have been waiting for. I am not going to just run to the phone simply because the ask for "the nurse." Most times it is something that can wait until after I give meds.

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    The hospital where I work "solved" the interruptions by giving all the nurses a in hospital phone to hang on their scrubs so no matter where you were if the phone rang you were expected to answer it. If you were in the room with a patient in the midst of an assessment, giving meds, teaching, or at the drug machine pulling drugs you were expected to stop what you were doing and answer the phone. I don't know what the solution is but it was impossable to take care of any patient while carrying a phone.

    Call bells all went to the nurses phone.

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    • Guides

    So I was just at the urgent care where my son goes and nurses were running around in red vests that said 'NO INTERRUPTIONS I'M PREPARING MEDICATIONS!"

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    If I get a call during med pass I ignore it or answer when I am done passing the meds. I laugh when upper management and management want us to put our number on the patients whiteboard. Yeah, like I dont get enough calls during the day.

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    Not the same setting but I deal with the same thing in LTC. I pass meds to 24 people, on a good day it takes me about 2 hours. No way I am getting through that without multiple interruptions from other staff, family members or the phone. It seems about once a year or so some "don't interrupt the nurse when passing meds" initiative is tried and it never works. Of course it never works. The med pass simply takes too long to devote all my time to just that, there's always something else in that time frame that needs to be addressed.

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    • Guides
    3 hours ago, hppygr8ful said:

    So I was just at the urgent care where my son goes and nurses were running around in red vests that said 'NO INTERRUPTIONS I'M PREPARING MEDICATIONS!"

    I know nurses who had that system years ago. It is silly and could be unsafe.

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    On 5/5/2019 at 11:33 AM, Daisy4RN said:

    Have you verified this with the Nurse Manager, could be the secretary is just trying to make it easier for him/her.

    We had this nonesense for awhile,until I demanded to see the clerks job description of her duties, lo and behold.....playing clueless was her game...

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