ER Call-back system

We do call-backs at our hospital, and the nurses are expected to do it in their "free time", yeah right! Half the time the calls don't happen because there simply is no free time. I personally have a bad attitude about the whole concept because I think it's a total waste of a nurse's time to be expected to do this, I HATE doing it! I think it's a great people pleaser, a good marketing technique to show that we care...but it's a marketing job, not a nursing job. If the patient asks medical questions, then they can be put on hold until a nurse or doctor can get involved, (but they almost NEVER ask medical questions of any kind) but for us, having the nurses do these calls is a HUGE morale buster with the nurses, some are indifferent, but most resent it deeply.

What they do is pull the names of the previous day's discharges...and if the names are not properly pulled, which seems to happen about 1/3 of the time, we end up with names on our list where the patient was actually admitted, so we call to talk to them and are told they're in our hospital! That just makes us look stupid, like we have no idea where our patients are!

Then usually the birthdate of the patient is listed, along with the diagnosis, BUT sometimes this field is left out, so you end up sounding like an idiot when you ask for "Tommy" only to find out Tommy is 4 months old!

In the 15 or 20 minutes that I spend, when I have the time to do it, (yes I realize it's not HUGELY time consuming) sitting down making these stupid calls, 95% of the time I don't actually talk to the patient. No one answers at all, or an answering machine picks up (can't leave info on the machine, not private), or they're not home, or they don't speak English, or they've given us the wrong phone number. It's just a huge waste of my time and I resent it.

Sorry to be so negative, but this is just a sore point with me, I am a nurse, not a public relations employee. Certainly, public relations is part of nursing while I am with the patient and the family, but these calls are, in my opinion, simply not something the nurses should be asked to do.

Was I clear enough?

VS

PS. Sorry, forgot to tell you what we are supposed to say. We ask for the person by name. We state our name, that we're with XYZ Emergency Dept and that we understand that they were here with us yesterday. "I'm just calling to check up on you, make sure you're doing OK and see if you have any questions about the care you received while you were here in the ER". We are supposed to ask if they have questions about wound care, prescriptions, or anything else, although I don't always do that because to me, asking about "wound care" seems silly if there is no wound, so if I don't have a diagnosis (sometimes they forget to include that in the list I'm given), it just highlights the fact that I really don't know this patient or his details, and makes the whole conversation even that much more impersonal. We are also supposed to use the words "excellent care", like "I just want to make sure you received excellent care while you were here" but again, that comes across sounding so silly & hokey that I rarely say it, just that I want to make sure that they're happy with the care that they received.

Our social workers do the call backs but if there is questions by the pt they are either spoken to by a nurse or called back after the answer is found. Usuallly is a smooth system where the social worker asks questions from a survey and the results are talked about in our staff meetings.

We do call backs, our fast track nurse does them form 9am to 11am, when fast track opens. We fill out a sheet on the patients we talk to and ask them if there pain is better, if they understood there discharge instructions, and if they where happy with there care. We also ask if there was any staff that they want to recognize for doing a good job.

We have 2 LPN's that do all the callbacks for our department. We have a follow-up form that we print. She makes all the follow-up Dr's referralls and schedules outpt testing, Alot of our pts. don't have family Dr's so we try to get them referrals to speciality Dr's if needed or follow-up out of town, They also check all the x-rays from the following day to make sure that no fractures were missed and that all exams were followed up appropriately. They also check on the urine cultures to make sure they are on the appropriate antibiotic, and all the std cultures and let them know how to be treated and follow-up for that.

They are very busy girls and do a great job. They tried to get the RN to do the call-backs and follow-up with patients to make sure they are getting better for P.R. but as of yet we don't have time and haven't had to start that. We see about 200 patients daily in our ed.