How many phone calls do you get as a bedside nurse?

Nurses General Nursing

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I work on a busy tele floor. We get 6 patients to a nurse and the acuity can be pretty high (we have stroke, STEMI, dialysis patients). Lately I felt like the number of phone calls I receive has been getting very high. On my last shift, I felt like all I did was answer phone calls to my cisco phone. At the end of the day I added up my calls, and I RECEIVED 64 CALLS IN ONE 12 HOUR SHIFT. I felt like I could hardly concentrate on one task because my attention was constantly being divided. I brought this up with management, and they said they are looking into ways to decrease the number of phone calls the nurses receive.

These are the main reasons I receive phone calls:

1. Transport calls to tell me they are taking my patient off the floor for a test.

2. Transport calls again when the patient is back in the room.

3. PT, OT, and speech therapy each call before seeing my patients.

4. PT, OT, and speech call when they are done to let me know how it went.

5. My techs/CNAs call me to let me know when a patient needs me or has a request.

6. Other departments call to let me know they are coming to a patient's room to perform a test and want to make sure the patient is in the room (X-ray, respiratory therapy, echo tech, EEG techs)

7. If a patient is off the floor for surgery or cath lab, they call to let me know when the patient is in recovery, and then a second call to give report and let me know the patient is on the way back up.

My question is, which of these phone calls do you think can be safely eliminated? Does anyone work at a hospital that maybe uses a different system to keep nurses informed of patient whereabouts? I am hoping to make suggestions to my management on how we can safely reduce the number of phone calls to the bedside nurse.

Our unit clerk is an RN and takes most of our calls for us. She can take orders, critical lab results, etc. if a patient calls and says they're feeling nauseous, she checks the chart and puts out a call to the MD if there are no PRN orders.

It's wonderful.

Therapy calls unless they have questions or need something urgently. I assume they write notes, so no need to call.

No need to call before in room imaging/exams. I assume you know these will be done. No need to know the exact time.

I work on a neuro floor and we have a HUC that fields all of those calls. They call the floor, he/she answers, looks up where we are by our locator, and lets us know if it is urgent. If not they write it down and give it to us when we walk by the nurses station. If we are busy and it is something as simple as needing to know if the patient is in their room, either the HUC will check or ask a nursing assistant and then let us know when we are not busy.

- PT, OT, and ST have to stop calling prior to seeing the patient. Change that to "we will call you if the patient can't participate today." I assume there will be pushback on this, since many of these are probably "okay to come now?" calls. Not sure what to say about that except it is just disruptive for you to use your time this way. I say the plan should be that they do their own rounds checking on and working with their own patients and you will show them the courtesy of a head's up if you know the patient can't participate or will be off the floor for an extended time.

- The other departments who want to do a test have to stop calling too, or else run these calls through the UC or techs.

I keep my phone on vibrate and if I'm directly working with a patient it will have to wait. It makes me angry that this goes on despite all the customer service and safety initiatives nurses participate in and receive feedback about. We are interrupted multiple times per day without regard for what we might be doing (or discussing with a patient) - too often for nothing more than someone's convenience.

Discuss this in terms of not just the interruption but also in terms of safety (contribution to alarm fatigue, for example) and the (likely) negative impact on patient interactions/customer service.

Specializes in Emergency, Telemetry, Transplant.

1. Transport calls to tell me they are taking my patient off the floor for a test.

2. Transport calls again when the patient is back in the room.

3. PT, OT, and speech therapy each call before seeing my patients.

4. PT, OT, and speech call when they are done to let me know how it went.

5. My techs/CNAs call me to let me know when a patient needs me or has a request.

6. Other departments call to let me know they are coming to a patient's room to perform a test and want to make sure the patient is in the room (X-ray, respiratory therapy, echo tech, EEG techs)

7. If a patient is off the floor for surgery or cath lab, they call to let me know when the patient is in recovery, and then a second call to give report and let me know the patient is on the way back up.

1. Everywhere I have worked, the nurse has to fill out a paper indicating the pt can go with transport, and does not require an RN for travel. If you have that paper and it is filled out, that is all transport should need. They can let the secretary know that they are taking the pt and he/she can notify you when he/she sees you.

2. Again, transport can notify the secretary and he/she can tell you at an opportune time.

3. I don't know about getting rid of this one. When I work, the therapists often want the pt to be cleared to be seen by the RN. Not sure if this is in response to a bad event at someone, and this was someone's solution?

4. I liked a call from speech so I could call the doctor and get a diet order. Otherwise, I can read the therapists reports. No need for a call.

5. I'm not sure how to prevent these calls. I would rather have a tech call for a stupid thing rather that have them not tell me about something important.

6. They can call the secretary for this one. Too often other departments call and say, "can I talk to the nurse for Mrs. Smith in room 5," and the secretary transfers it automatically to the nurse rather than asking what the call is about and handling him/herself.

7. I see no purpose in the call to tell the floor nurse that the pt is in recovery. Then again, I was lucky if they called report and transported the pt correctly (i.e., with a nurse, if needed).

In other words, it would be difficult to get rid of all these calls, but 64 is ridiculous, and some of them can go away.

Specializes in Public Health, TB.

When I worked on a tele floor the number of calls were ridiculous, plus so many patients were in contact precautions, that it was almost impossible to answer immediately. There was a clipboard near the HUC desk that transport sign patients out and in on, and then they had to let tele know where the patient was going. I never understood why other departments just didn't call the patient directly in their room prior to pick-up. Most of our HUCs would screen calls to see if they could provide answers, but not all. Often times the question was about visiting hours. I think know therapies are present is helpful, but just one call is enough, either before or after the visit.

As to PACU and OR, we had a light system outside the room doors that the HUC could utilize to give the nurse and or aide notice that the patient would arrive in 10-15 minutes.

Specializes in Neuro, Telemetry.
Therapy calls unless they have questions or need something urgently. I assume they write notes, so no need to call.

No need to call before in room imaging/exams. I assume you know these will be done. No need to know the exact time.

I need the therapy calls. What if I have something I need to do with the patient and walk in to find therapy with them? What if there is a reason therapy shouldn't see the patient right now?

I personally take these same calls from the various services and use them to plan my day and keep track where my patients are and what they are doing. When a doctor asks me how therapy went, or where the patient is, or if a certain exam has been done, I need to know the answer. I may not always be right by my computer and most services don't chart immediately after each patient.

These are all quick calls and then move along with my day. If I had to stop and look to see if there is a therapy note or see where the heck my patient went when I go to give my meds, the day would be more unorganized probably less efficient.

I always travel with my patients so I go when transport shows up. On my unit, speech, OT, and PT come to the unit because there are multiple patients to see and just come ask me in person if they can see my patients. Do they not cluster their patients like that?

64 phone calls would annoy me as well.

I maybe get 20-25 a day between family, physicians, pharmacy, CT, and MRI. That seems excessive to me. Lol

Specializes in Cardiac Telemetry, ICU.

Dear God this is why I don't miss day shift. I'd get approximately 20-30 calls during a shift. On nights I get about 5 and it's usually tele, a patient, or a CNA. I found it especially difficult to manage as a new graduate and it felt unsafe having 2+ calls during the same med pass alone... Our PT/OT try to ask in person which I found less disruptive or they'd wait at the nurses station for us. Transport would do the same and have us sign a slip agreeing to the transport basically.

Our unit clerk is an RN and takes most of our calls for us. She can take orders, critical lab results, etc. if a patient calls and says they're feeling nauseous, she checks the chart and puts out a call to the MD if there are no PRN orders.

It's wonderful.

This sounds amazing.

We all carry Ascom phones, and I feel like they ring ALL. THE. TIME. Not only do I get calls from docs, PT/OT/dietary/RT/lab/child life all day - I am also forced to give out my ascom number to every patient as well. Which means they can get me on the call bell (which the US then assess and pages out to my phone), or they can call me directly for towels/meal cards/water/sprite/sandwiches/vouchers/etc. :/

It's so much.

And we are supposed to take a lunch every day. The phone still rings.

I hate it.

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