Vocera

[flonitengale]

Pts in ICU/CCU already have high risk of delirium. Vocera on a nurse over a bed is very, very confusing to an ICU pt. Hearing two voices and seeing one person. In the hospital I work in, it is commonplace to hear all staff using patient full names, even charge nurses, managers. It is also a violation of staff rights to be blaring your full name to all to hear. You do not put last name on badges d/t your own safety & privacy but it is all out there with Vocera. Think of that when taking care of inmates or prisioners. There are rules but I do not see them enforced at the 5 places I have worked/visited that use the system.

[Here.I.Stand, BSN, RN]

Unfortunately there really isn't a silent AND practical way to find who you need every time. Sure you can physically go and look for them, but that can be a drain on nursing time; depending on the situation, it can also be dangerous to leave your patient.

You're right about privacy concerns though. Where I work, we generally refer to room number rather than pt name when using the Vocera.

And then I consider other ways to reduce risk of delirium. Things along the lines of clustering cares, using lighting appropriate for time of day, not using more sedation than needed, keeping on top of pain control.

[melizerd, ASN, RN]

Where I did clinical that had he, they all wore ear pieces so you still get the nurse talking on one one but don't hear both side of the convo. And almost all nurses I was with would say "I'm in a patient room" immediately upon answering and her end of the convo I never heard any names if patients etc.

Another place used phones which were harder to answer in isolation and would ring forever.

There no perfect solution.

[Karou]

If someone calls me on vocera while I am in a patient's room then I answer with, "I'm a patient's room, I will call you back". I haven't had a problem with that. I have ignored vocera calls (example: when I am on the phone speaking to a doctor/family member). I then call the person right back. Could you do that? I personally never silence my vocera, even on break. However, if you know you are going to be with a confused patient for a while, can you silence your vocera and let your charge nurse know where you will be, and why you are silencing?

You should not be on vocera in one patients room, discussing identifiable information about another patient. I would let your caller know you will call them back when you are out of a room. This sounds like a problem on your unit that you could discuss it with your manager. Staff need to be reminded that if identifiable patient information is exchanged over vocera in the presence of another patient, this is a violation of patient privacy.

Edited to address what you said about your first and last name being used. I have always been told that if a patient asks for your last name that you have to provide it, because the patient has the right to know who their care providers are. How would that work when you are dealing with psych or inmates? Do you have to tell them? Curious because I do not know the answer.

[klone, MSN, RN]

I guess I thought it was always common etiquette to say "Can you talk?" before you start talking to someone on the Vocera.

[TiffyRN, BSN, PhD]

OP, I sympathize with your efforts to maintain a peaceful environment for your confused patients. I agree with a previous poster that many of your other issues could be handled with some simple changes like beginning every conversation with "Can you talk?". This is what I have seen. Most of the time, the conversation can wait or can be handled without disclosing patient information by calling on a land line.

As for the last name deal, it drives me insane the paranoia I hear here on AN about that topic. I can't think of another profession or even most regular jobs where first and last name are not readily disclosed! I looked up images and found (female) airport gate agents with full name badges and they certainly deal with some regularly irate people. Also found images of (female) corrections officers. I will admit, it appeared they only had their last names on their badges; dangerous job and exposure to volatile people you think? How about bus drivers? Female and male both wear badges (maybe not every one out there, but found images of NYC drivers) and even jackets with their full names embroidered on them.

Why why why are our patients not permitted to know our full names if they can know the full names of their teachers, secretaries, accountants and social workers (pulled from a list of common female dominated jobs). I would say for the most part, we invade our patient's privacy a lot more than the average teacher or secretary and they (patients) should be able to know our full names!

[klone, MSN, RN]

At the hospital network at which I work, we have our first and last names on our badges. It's never bothered me, and I agree with you, Tiffy, about the paranoia.

[melizerd, ASN, RN]

Our first and last name is on our badges too.

[/username, BSN, RN]

Our first and last name is on our badges too.

Random question - Do you know if the psychiatric hospital has last names on their badges? I've been asking around and nobody seems to know.

[ILoveHealthCare]

I worked in corrections as a medical assistant and our first and last names were on our badges.

[iluvivt, BSN, RN]

I use a Jabra headset with a very comfortable ear wrap and the device fits really well in the ear. You need the 1.2 size I believe and I got it on Amazon for 10.00 to 12.00. I had to put a little glue on the spongy ear bud because it kept falling off. I bought my co-worker one too and she just loves it. I also state that I am in a patient room when I answer and either call back,ask them to call back or edit my conversation as needed. I try to use the device so I am in control of it and that it is not in control of me. I also use the do not disturb if I am going into a longer procedure and then the call just goes to our answering machine. You can also adjust the volume if needed. Remember that you control it!

[anon456, BSN, RN]

We are very careful not to mention patient names or identifiers. We use the "Can you talk?" or "Are you in a room?" at the beginning of a conversation. When we do talk we will most often use room number or something that can describe the situation without giving away who the patient is: "Can you come and help me adjust the BiPap in room 3 please?"

You can adjust the volume to not disturb patients or blast things to the whole unit. You can also put it on do not disturb, but I almost never use that (just when I'm in the bathroom) because it's easy to forget to turn it back on.