Cordless Phones/Call Lights

[jennh1982]

Good morning,

I work on M/S at a facility where the nursing staff are required to carry cordless phones. I am doing some research on other hospitals practice for cordless phones and call light answering practice.

First, we had all calls going to the LPN and if they did not respond, then to the RN, then to the Unit secretary. This was problamatic because the LPN's were receiving all the calls and made work very disruptive.

Second, we had 1/2 of the calls go to the LPN and other 1/2 go to the RN. This was less disruptive for the LPN but RN's were receiving calls for things that the LPN could handle.

Currently, we have the call lights roll to the Unit secretary then they call who is needed. The phone numbers for the RN and LPN are written on the wipe off boards in the patient room, but patients rarely use this, just push the call button. The staff like this option but we have been receiving complaints that the patients feel there call is not being responded to in a timely manner. We are also thinking that the patients feel better when they can talk to the RN or LPN directly.

Does anyone have any suggestions or ideas on how to improve our patient satisfaction without disrupting the staff as often? What is the current process at your facility? Any feedback would be greatly appreciated.

Thanks so much!

[psalm, RN]

We carry phones but the pts. use the call light and depending on their need the CNA or RN gets the message. I would be reluctant to give my phone # to patients...the potential for abuse is high!

I may be in a pt room and my phone will ring. If I have my hands free, I will excuse myself and answer the phone. Usually it is info that pt. so-and-so needs prn pain med etc. Then I will tell my pt. it was a message for another pt. I reassure this pt. that there are times he uses the call light and I will get HIS message...that it saves time.

[brax881]

I worked on a unit where the unit clerk answered the calls bells via intercom and would forward to patient's needs to the appropriate staff. This worked great. Let the RN/LPN focus on their responsibilities and the techs got to their work. Patient satisfaction was very high and you could actually focus on being a great nurse.

The unit I work on now, we have to physically go into a room to answer the call bells, the RN/LPN answer apprx 80% of the bells most of the time the techs are MIA.

The job satisfaction on the unit is low, just hired 17 new nurses and techs. Last summer we had the lowest patient satisfaction rating in the hospital. I just started on this unit 4 weeks ago can't wait until my 6 months is up, and I can post out.

[classicdame, MSN, EdD]

Patients cannot tell the difference between a hospital-supplied cell phone and a personal one. So when it rings they are insulted that you would place personal business over their needs. Don't blame them there. We have tried beepers, but they had the same effect. People's expectations were higher since they had direct access. So we are back to Unit Sec, or ANYONE, can answer the phone. If the request is within your ability and scope of practice, go do it (hey! anyone can take out a meal tray). Otherwise, the charge nurse or appropriate party is notified ASAP. This systems has flaws too. Works best when each staff member takes time to ask if they had any messages, but most won't.

[miko014]

Ours is just whoever gets there, and it can be done from the station (intercom) or going into the room. The techs are supposed to answer lights but they get busy doing other stuff (and don't want to, haha), and a lot of the nurses do it. The problem is, they say that on our unit, they expect every person to answer every light. Even if you are an RN and the light that is on is not one of your pts, you are supposed to answer it. The problem with that is, when you are knee deep in stuff with your own pts, how are you supposed to deal with other people's pts?

This is one of the biggest complaints we get - that lights aren't answered fast enough, but I don't know that our pts don't expect too much of us. They tell us to tell them on admission that we will respond within 5 minutes. That would be great. But last night I was elbow deep in a wet-to-dry with packing, all sterile and all that, and my tech came in and said, "so-and-so wants pain meds". I said okay as soon as I'm done here. But it was at least another 15 minutes (she had another dsg also that I hadn't done yet, and I couldn't just leave her in the middle to go give someone else pain meds, and my charge nurse was busy) before I finished in there and then by the time I washed my hands and got the pain meds, that pt had to wait about 20 minutes. She was not happy, and I hate to make them do that, but they don't seem to understand that we aren't just sitting at the station reading magazines, waiting for them to call out.

Our unit gets mad because they can't find us. We have the technology available for two different nurse-tracking systems, but will they pay for it? No. So we get little magnets to stick outside of our rooms so that everyone knows where we are at all times. Stupid!

[AlwaysTired]

My horrific first experience on M/S was made even worse by the cordless phone system. Ours rang straight to the nurse when the pt hit the call button. While it's a great system for comm between staff (calling for someone to bring supplies or needing assistance without leaving the room) I found myself being embarassed constantly because I couldn't do even the simplest task or carry on a short conversation with patients without it ringing numerous times. I was constantly apologizing and felt like my pts weren't getting the attention they deserved from me. And heaven forbid, if I was in the middle of a dressing change or something else and couldn't get to it and it rolled over to the unit secretary...well, let's just say she would ream me out when I got back to the station about not answering. I guess she thought I was in the break room eating bon bons. The whole system increased my stress level tremendously. By the end of the shift I found myself resenting what was really the sweetest little ol' lady in the world because she literally called around 30 times in a 12 hr shift. Then I was mad at myself for feeling that way toward her. Anyway...my experience with the cordless phone system was terrible!!!!

[jojotoo, RN]

I've only had one job where we carried phones. I NEVER answered it if I was in a patient room. After all, I'm in that room for a reason, and the patient deserves to have my full attention.

[tntrn, ASN, RN]

Probably another thing we can thank JCAHO for. Patients who now believe that every patient is getting 1 to 1 care. Some call light requests need quick, even immediate attention. Some do not. We have to carry big, heavy phones. They throw my balance off and by the end of a shift, I know my body is seriously misaligned! Not to mention that they are very loud and always ring at an inconvenient time. I hate them. And I never, ever give out the number of that phone to a patient. Won't do it.

And don't you love the patients who call and say, "would you send in my nurse?" And we ask, "Can she bring anything when she comes?" And they say, "No I just need to talk to her." And we go in and with a cast of a thousand visitors, she wants her water bottle refilled. Oh, and this patient is usually ambulatory on ad lib diet who could benefit from a little walk to the kitchen to get her own water.

[mpb615]

Our phones are handed out to us at the begining of each shift, and we write our numbers on the patient's dry erase board. The patients still have the option to use the call button, but I remind mine to use my phone. I love having the phones as it is a direct line of communication with the pt. On days when I don't have it, I feel lost! Sometimes people forget to tell you that a patient called when you have to rely on the call light. The techs have phones too which works out great.

[All_Smiles_RN]

At my old hospital, each pt's room had a dry erase board with the number for their nurse and for their tech. It was a bit cumbersome taking all these calls while trying to take care of another pt. I was not a fan of the pts being able to call directly.

At my current hospital, we keep a master list at the station of all the nurses' and techs' numbers for the shift. The pts call via the call light and whoever is nearby answers the light and notifies the appropriate person immediately if urgent. I prefer this method much better. Whenever we page a doc, we have them call us back at our direct line. Works out nicely.

[bethin]

I worked PRN on a floor where everyone was given a pager. When the floor was split and we received our assignments somehow (don't ask me how) we only rec'd pages for our pts. When a call light went off it first went to the aides pagers (me) and if I was busy and not able to answer for a certain length of time (I think it was 90secs) it went to the RN's pager. If she was unable to answer (for 90 secs) it went back to mine. If I was still unable to answer it went to the charge nurses pager and we all knew that if it went there there would be hell to pay. If we were legitimally busy she wouldn't get mad but if we were sitting on our butt she would be upset (and rightfully so). There was a certain fear instilled into us so we would answer promptly. This system was used hospital wide and the times could be adjusted. We were a smaller unit with lower pt:nurse ratios so our times were shorter. The floor was the smoothest I have ever worked on. Not chaotic at all.

[diane227, LPN, RN]

We use a pager system. The unit secretary usually answers the calls and then pages the appropriate person for that pt need. It usually works well for us most of the time. The problem arises when someone goes to lunch and does not pass off the pager to someone to answer the call. As the charge nurse I would love to have a cordless phone to carry around. Right now, I am almost tied to the desk a lot of the time.