Fustration with new technology on the floors

[JDougRN, BSN, RN]

There are so many different ways of keeping in touch with people than there used to be when I was growing up. In addition to picking up the phone, people have email, face book, instant messaging, phone texting, twitter/tweeting. It has even traveled across into my nursing career. I don't want to come across as a techno-phob, but there are times when I wonder what is wrong with the way things used to be? I sometimes feel like we are losing a portion of our humanity in face to face contact, in lieu of easy access.

I'm speaking specifically about the phone issue on our new floor. My unit was just relocated and revamped to become "modern" and "nurse/patient" user friendly. I'm not sure who they spoke to about this design, but I doubt they had spent any time actually working as a nurse. I was used to the "old call light system." The patient would press a button in their room if they needed something, a light would go on out at the desk. The nurses or aids would see that a light was on, during the day you could call into the room from the desk, and ask the patient what they needed, so you could send the correct person. It was fairly simple, but it worked well.

Instead of putting in a call light system, during the move they decided to install phone systems. Now all nurses and CNAs have to program what rooms they have, and carry around a heavy, industrial phone. When a patient rings, it will go directly to the nurse, who has to speak over the phone to the patient in the room to find out what they need. In theory, this is a great idea. The patient has immediate access to the nurse. That would be wonderful, if the nurse to patient ratio was only one to one. Unfortunately, it is usual for us to have six or seven patients during a shift.

I find myself constantly being called by other patients when I am in the middle of assessing or caring for another. I feel that each patient is deserving of their own, one on one time. How rude must it seem to the patients to be in the middle of a conversation with the nurse, when the phone rings at their belt, and the nurse has to break off therapeutic communication to answer it? Cell phones are not allowed in hospitals while on duty because the facility doesn't want staff talking on them, and it looks unprofessional to have ring tones alarming from a caregivers pocket in front of the patient. WHY would they decide to go to a phone system then? Nothing on admission is in place to alert the patients that those big gray phones everyone is talking on is a hospital communication system. I've gotten numerous baleful looks from my older patients when I answer the phone in their room. They obviously believe that I am carrying on personal business while I should be working.

The other issue I have is that outside or desk business comes into the rooms as well. I am caring for patient x, when patient y's family calls for an update. Instead of getting a call back number and the nurse returning their call, it is sent directly into the room. Physicians also are patched through, asking questions, or requesting lab results on a patient who's chart is out at the desk. What about HIPPA violations? Each time the phone rings in that case, I have to excuse myself from the room, and run for the chart to answer the questions or get the results.

Another issue that we have come up against is infection control. Numerous patients are admitted with isolation precautions in place. MRSA, VRE, C-Diff, ESBL, all require the staff to gown and glove when entering the room. If my phone is in my pocket, and I have an isolation gown on, each time it alarms I have to remove the gloves, gown, and wash my hands before answering it.

I've decided to boycott by not answering when I am actively caring for my patients, but this has led to friction from other staff who are trying to reach me, or medical staff/family being on hold so long they hang up. When they call back, they are upset because they perceived that their call is being ignored. There are times when I would give anything for a simple tap bell.

[LACA, BSN, LPN, RN]

I agree with you on this one---it doesn't sound like a well thought out plan to me. BIG disruption in patient care!

[rosey2007]

I have to agree with you also. My OB carries a phone on him and I find it rude when he has to answer it while with me. I know that there is a reason for it, but it make you feel less important.

[Flo., BSN, RN]

We have to carry phones too and it drives me nuts! We have the old call bell system but I find that highly ineffective. I feel that since we all have phones the unit secretary should answer call bells and pass it onto the RN or CNA depending on the need. 99% of calls are not important. It would be a good system if people could leave a message. Basically I don't need physical therapy calling me while I am with a pt to tell me that another pt is cleared. It's not urget and it is disruptive.

[JulieCVICURN, BSN, RN]

The phone thing sounds like a big pain in the patootie. Can't they rig it so that if you don't answer it it rolls over to the desk so the unit clerk can answer it? That way, you can ignore it when you need to.

[Pinkster]

It just sounds like they have dumped part of the secretary's role directly onto your lap.

I would bring this up to the managers and see if your co-workers are having the same issues. I agree that it is very disrupting to your care and safety of the patients.

I like call light system, where its lights above the room and shows at the nurses station, with the little speaker where the secretary or nurse if available can speak to the patient, as usually it is nonemergent, and if it is, it can be addressed just as quickly or faster than calling the nurse in the middle of a dressing change or something.

[Music in My Heart]

Disruptions to answer the phone reduce the overall efficiency and increase the risk of errors. Fragmentation of care is never a good thing. It's also downright rude to favor a ringing phone over a person directly in front of you.

I think I would do the same as you... refuse to answer the phone if I'm already with a patient.

[BookwormRN]

This post hits home! We are building a new hospital in the near future and am told that the nurses will be carrying cell phones, in addition to a new call system. I just cannot imagine the interruptions when in with a patient! It is bad enough when someone comes to the door of the patient's room looking for me. At least at that point I can tell the person that I'm busy, but will be available in X amount of time.

Technology has it's place and at times is a wonderful thing. In this instance however, I think we're missing the point of bedside care.

[classicdame, MSN, EdD]

I worked somewhere that used beepers for the same purpose. The day I was assisting an MD insert a central line at bedside and the beeper went off several times was the LAST day I wore it. When the nurses boycotted they did away with the beeper. Stupid idea.

[scoochy]

Just another mechanism to boost those customer satisfaction scores. What an awful system, IMO. Per usual, no input from nurses who have to work with such a "brilliant" idea.

Next up, the unit secretaries "will no longer be needed," since the phone is always at your disposal.

YUCK!!!

[amarilla, RN]

The hospital where I work went to individual on-hand phones nearly a year ago and I'll agree with you: they're AWFUL!

Beyond the incessant interruptions, (our phones are connected to our rooms as well as able to be paged or forwarded calls from any landline), I can't stand that the technology is so poor. The voice recognition log in never recognizes you unless you spell your entire name - first, middle and last - and never can locate someone to call or page them unless you are able to spell the other person's full first, last and department. Can't tell you how many times I'm trying to call someone back for report on an admission or follow up on a message and get the error message 'cannot locate this person at this time. Try again later.' If your phone decides it is having a bad night, it will refuse to connect, drop your calls or tell others you 'are logged off or not in the building.'

UGH!

I'm with you. Thank you for letting me share your vent!

[pednursedeb]

I have to agree with all of the above. One of the "newer" units in our hospital has gone to the phones. It's like answering your own call light while caring for a patient. Paging through a physician to you is just not efficient. You don't always have all the info you need.