I'm not answering call lights

[imintrouble]

At least not as many as usual.

I'm getting memos from pharmacy and management about charting that's not getting done. The nurses who follow me are finding me the next day, and reminding me to take care of forms I failed to do on my shift. At my age, I'm afraid these oversights will be attributed to my advancing age, and my feeble mind. Instead of the truth, which is I don't have time to be the aide and the nurse both. I'm helping patients to the bathroom instead of crossing my t's and dotting my i's.

Where I work, they staff decent for nursing, but are eliminating the CNAs. Because I can do both jobs.

So. I'm letting that call light sound. Just because I'm sitting down, doesn't mean I'm doing nothing. I'm not stopping and filling ice pitchers, delivering coffee, or fetching warm blankets unless my nurse job is caught up. My fellow nurses have no problem letting their lights sound for 10-15 minutes. Neither am I.

If I'm to be reprimanded, suspended, or (shudder) fired, it's not going to be because I didn't waste that Dilaudid. It'll have to be because I didn't fluff a pillow. I can explain the pillow, not the Dilaudid.

[imintrouble, BSN, RN]

Sometimes I think the cnas would be of more use if they were assigned a task rather than a patient load. For example: one CNA is in charge of toileting and just goes room to room knocking on the door and asking patient if they need to use the washroom or changing the patient in bed. Another CNA can be in charge of turning all patients and just goes around the floor turning/repositioning everyone. Another can be in charge of stocking and water.

I wonder if this would actually work....I came from a large floor so it could easily take 2 hours to get through the entire floor.

I love that idea. Unfortunately we usually only have one CNA for up to 20 patients. The nurses fill in the holes.

[Pangea Reunited, ASN, RN]

Sometimes I think the cnas would be of more use if they were assigned a task rather than a patient load. For example: one CNA is in charge of toileting and just goes room to room knocking on the door and asking patient if they need to use the washroom or changing the patient in bed. Another CNA can be in charge of turning all patients and just goes around the floor turning/repositioning everyone. Another can be in charge of stocking and water.

I wonder if this would actually work....I came from a large floor so it could easily take 2 hours to get through the entire floor.

Interesting idea, but what happens when you're turning a patient and they ask for water? Or you're getting them water and they ask for a bedpan? And who decides which CNA does all the toileting and which one just fills water pitchers and stocks? I'm guessing it wouldn't take long for a fist fight to break out under that sort of system.

[schnookimz]

Interesting idea but what happens when you're turning a patient and they ask for water? Or you're getting them water and they ask for a bedpan? And who decides which CNA does all the toileting and which one just fills water pitchers and stocks? I'm guessing it wouldn't take long for a fist fight to break out under that sort of system.[/quote']

Yea, honestly I'm not sure, but I would hope you wouldn't be asked for water when you're toileting bc the water CNA is doing their job and the patient has water. The system depends on people doing their parts. And you're right it may cause fights, but what doesn't? And if you're on poop duty one day then you could happily know that there's other days at work you'll never face poop!

[BrandonLPN, LPN]

Interesting idea, but what happens when you're turning a patient and they ask for water? Or you're getting them water and they ask for a bedpan? And who decides which CNA does all the toileting and which one just fills water pitchers and stocks? I'm guessing it wouldn't take long for a fist fight to break out under that sort of system.

Well, they could take turns. One night Sally-CNA is assigned to toiletting and Suzy-CNA is assigned to stocking/passing waters. Next night they switch.

And if Sally-CNA is toiletting room 201 and they ask for a water, she can just tell them Suzy will be in shortly. And then keep on with her toiletting room to room.

Sounds more efficient to me. Everybody keeps moving and the flow isn't disrupted.

Plus, if the CNAs are constantly going room to room performing their tasks, ther'll be less call lights going off overall.

[Caffeine_IV]

I agree call lights are important. I do not ignore them at all. But the questions they ask kind of set us up for failure. "How often did you get help as soon as you requested?" (Or some similar wording)

Obviously people want help or their request attended to immediately and it is not always possible. But always is the only answer the receives reimbursment.

Last night I worked (no pcts on night shift med surg floor) , I had 2 of 5 patients who required about 30minutes of my time for toileting so if another pt needed my assistance..they had to wait or hope another nurse would assist in my absence.

What good is a bed alarm if no one is available to answer it?

[THELIVINGWORST, ASN, RN]

As a new nurse and former CNA for five years, this is a touchy subject. Mind you, I work on a busy neuro med/surg floor, constantly I go to these rooms and they want pain meds or breathing tx, etc. it's the worst when a nurse goes into a room and leaves to come get me so I can change or toilet a pt even though they spent more time finding me, than they would've if they had taken care of it themselves. Don't even get me started on scd's!

[ICRN2008, BSN, RN]

When I worked the floors I found that rounding every 15 minutes to half hour cut down on the number of call lights for things that could wait, by at least 80%. I also made it a point to chart on the mobile computers near the patient's rooms instead of at the nursing station. We had one nursing assistant for the entire floor, which meant that each nurse got help for one out of his/her five patients It was insane.

[4give&4getoften]

True, that could happen. How we handled this was when a call light went off answer, at the station and if a pt had to go to the BR we tried to high tail it in their because we were an ortho floor and had many pts just start to get up and go. Now if they needed someone else we would get in there asap but we would never not answer a call light.

[brandy1017, ASN, RN]

This is the dilemma we are expected to be both nurses and aides and we can't physically be both and get our nursing tasks done on time when we are being distracted by the aide work. It isn't fair, but how can we just refuse to answer lights when our patients need help going to the bathroom. Even if you are lucky enough to have decent staffing and good aides one person can't be everywhere at once. I was just thinking this today as I was trying to get my nursing tasks and orders etc done while the call lights were going off and I knew my patients needed help. I ended up answering the lights and staying overtime to finish the real nursing work they pay us for and we are licensed for. But it is a matter of dignity and humanity to the patients that they get their physical needs met, not just medical!