How about a secondary call button - please comment

[aylene]

Here is my email sent to a patient advocacy department at an Ottawa Hospital. It would be good to get nurses' views on this very early in the process.

Hello xxxxxxx,

Thanks for taking my call and agreeing to pass on my suggestion to xxxxxx xxxxxxx. My daytime numbers are as follows:

Office +1 xxxxxxxxxx

Mobile +1 xxxxxxxxxx

I look forward to seeing what can be done to fully explore this idea and, if appropriate, track it through to pilot and possible adoption.

Recap on the idea:

• Secondary button to call nurse with the intended interpretation "Please visit me when you have the opportunity as I have a non-urgent request that would be best addressed sooner than your next scheduled patient check-in"
  
• Have this button further away than the emergency button such that it is not accidently used when the intended message is that there is an urgent situation requiring immediate care.
  

Background on the idea:

• I just spent 2 weeks at the foot of my sister's hospital bed (not here in Ottawa) and realized that we were annoying the nurses with these types of needs that, by nature of the button, necessitated them to respond under the assumption of urgency but were, in fact, not as urgent as the care they were attempting to provide to other patients at the time. I could understand their frustration and yet our needs were of a nature that we should not simply wait for the next 'check-in' by the nurse which may be not anticipated for quite some time, especially if they had visited us recently. The example I will give is that my sister had a bed-pan chair and, when she had had a bowel movement, we were interested in having it dealt with sooner rather than later but really didn't need immediate care. Over the two weeks, we became too scared to push the button for these, and other similar cases, because, even when the nurses were trying to be diplomatic about it, we were being given the truthful message that we were taking resources away from more urgent matters. Since we have no way of knowing what else is on their radar at the time, we have no way of being more polite except to put up with the un-met needs (even a large juice spill or a foul bedpan) until the next "check-in"
  
• Colleagues have challenged me to see my idea through to resolution - be that development and adoption or full comprehension of why it should not be implemented.
  

Thanks,

Aylene

Yes, I am Aylene - please don't kick me off the forum for not being a nurse. I really want to hear the nurses' perspective.

[chrisrn24]

In theory it's a great idea...but when you actually work as a nurse you will realize those people who say "I hate to bother you" or "don't rush" are few and far between. Most everyone thinks their needs are primary and above others.

You also run into the problem of patients confusing the buttons. They have chest pain but they click the wrong button, or they just need you to refill their water pitcher or they have to urgently use the toilet and don't click the urgent button so when you finally come they get upset.

[loriangel14, RN]

Most of my patients are too confused to follow the idea of 2 bells.Like chrisrn24 said, very few patients think their needs aren't very urgent.

[decgrad]

Aylene,

My step mother was in an ICU in AZ that had a multiple button system. There was a yellow button to push for needing to go to the bathroom, a pink one for pain and the typical red one for calling the nurse. I also learned that this system was very expensive, so only the ICU had it. The nurses had a love-hate relationship with this call system. On one hand, when the pee light came on, they knew it was okay to have the CNA answer the light and help the patient. On the other hand, they had to keep track of which patients were able to use the system and which ones were too confused or unable to see well enough to use it properly. So for one room, it was great, but another, any color was a nurse color. So yes, it is a great idea, but in use it still needs progress.

[martymoose, BSN, RN]

most patients I know feel their needs come first above all others, and therefore it IS an emergency to them.

although the idea was a nice one.

[OCNRN63, RN]

If I have to answer a call bell, I'd rather deal with it and be done. Otherwise, if it's a bell that's a non-urgent call, I might not remember to get to it. It's hard enough for nurses to answer one call bell let alone two, three...

[brithoover]

We are in the process of trying to get a call bell system where when the call bell is pushed is rings directly to the nurses individual phone they carry around with them. It's a peds unit so most rings will be from the patent. Very expensive though..

[dandk1997RN, MSN, RN]

Here is my email sent to a patient advocacy department at an Ottawa Hospital. It would be good to get nurses' views on this very early in the process.

Hello xxxxxxx,

Thanks for taking my call and agreeing to pass on my suggestion to xxxxxx xxxxxxx. My daytime numbers are as follows:

Office +1 xxxxxxxxxx

Mobile +1 xxxxxxxxxx

I look forward to seeing what can be done to fully explore this idea and, if appropriate, track it through to pilot and possible adoption.

Recap on the idea:

[*]Secondary button to call nurse with the intended interpretation “Please visit me when you have the opportunity as I have a non-urgent request that would be best addressed sooner than your next scheduled patient check-in”

[*]Have this button further away than the emergency button such that it is not accidently used when the intended message is that there is an urgent situation requiring immediate care.

Background on the idea:

[*]I just spent 2 weeks at the foot of my sister’s hospital bed (not here in Ottawa) and realized that we were annoying the nurses with these types of needs that, by nature of the button, necessitated them to respond under the assumption of urgency but were, in fact, not as urgent as the care they were attempting to provide to other patients at the time. I could understand their frustration and yet our needs were of a nature that we should not simply wait for the next ‘check-in’ by the nurse which may be not anticipated for quite some time, especially if they had visited us recently. The example I will give is that my sister had a bed-pan chair and, when she had had a bowel movement, we were interested in having it dealt with sooner rather than later but really didn’t need immediate care. Over the two weeks, we became too scared to push the button for these, and other similar cases, because, even when the nurses were trying to be diplomatic about it, we were being given the truthful message that we were taking resources away from more urgent matters. Since we have no way of knowing what else is on their radar at the time, we have no way of being more polite except to put up with the un-met needs (even a large juice spill or a foul bedpan) until the next “check-in”

[*]Colleagues have challenged me to see my idea through to resolution – be that development and adoption or full comprehension of why it should not be implemented.

Thanks,

Aylene

Yes, I am Aylene - please don't kick me off the forum for not being a nurse. I really want to hear the nurses' perspective.

I commend you for trying to improve the process. For reasons others have mentioned.

, I don't think in practice this would be very successful for many patients.

That being said. I would put out there that nurses and other staff aren't the only people who can clean up spills or empty bedpans. You can do these things as a family member as long as you are sure that a sample isn't needed and output isn't being measured. You can clear this with the nurse. You can also find out if you may go to the patient kitchen and being your loved one drinks, Etc. Within those parameters, we welcome outside help.

[Meriwhen, ASN, BSN, MSN, RN]

As others have said: good idea in theory, bad idea in reality. That's because the patients--and their families'--definitions of what is an "emergency" usually vary widely from nurses' definition. To some, not having a can of soda is tantamount to crisis.

Neverminding that half the time, it's the families who are jabbing the bell and making the demands. This is not directed at you, OP. But that's how it frequently is.

[dandk1997RN, MSN, RN]

Meriwhen, that last statement is so true. Last night I was so frustrated because I had just assessed my pt- no pain at all- 10 minutes prior to the pts family member insisting that I bring in pain medicine for the 8/10 leg pain from spinal stenosis (chronic) which apparently popped up out of nowhere and which the pt had to be reminded she had. As I was leaving the room the first time, the pts family member kept trying to talk the A&O pt into taking meds she didn't feel she needed. I'd love to have been a fly on the wall as the family convinced the pt that instead of no pain, she really had a lot of pain.

The only time I heard from that room the whole night, it was the family member and not the completely A&O pt. But yet they DIDN'T call me into the room when the pt got OOB the first time post-surgery despite verbalizing understanding that I personally had to be there when that happened. Go figure.

OP, best of luck in your effort to improve the process- even if I personally see issues with this particular plan, I do appreciate you advocating for a better approach.