New charge nurse - needing advice!

[bluebirdflyx]

I would appreciate some feedback on how to get nurses to help answer call lights. I work on a med-surg/oncology floor. I alternate working both the floor and also as charge nurse. Our ratio is typically 5-6 and we have 1-2 CNAs. We have a paging system at the UC desk so we can page back into the room and ask the patient what they need. If the UC is not at the desk (they leave at midnight) and a call light goes off, I have a select few RNs and some CNAs who WILL NOT get up and answer the light. They will not go to the phone to what the patient needs nor will they go directly to the room. I mean they will not budge from their seats. Whether or not it's their patient doesn't seem to factor in, they will let them go and go.

It doesn't seem to be an RN vs. CNA problem; it is made very clear at our facility that answering call lights is everyone's responsibility, but some of these people turn into Helen Keller the second an IV starts beeping or a call bell rings. I am not referring to nurses who are busy with other patients, reviewing orders, calling docs, or any of the other tasks that bog us down. I am talking about nurses who are sitting at the nurse's station playing on their phones, talking with other nurses, etc. I feel they are blatantly taking advantage of those of us who cannot sit by while the lights and alarms go off as they know we'll answer them eventually. It's not an option ignore the lights in return because only the patients will suffer.

Does anyone have any advice on how to facilitate a change and get these nurses off their behinds?

[Ruby Vee, BSN]

Have you tried speaking up when the call bell goes off or the alarm starts beeping? "Hey Jill, that's your call bell." Or "Tom, do you hear an IV pump? I think it's coming from your room." If you're Tom or Jill, it's embarrassing to have someone call attention to an alarm you're not addressing. (I know this because I've been guilty of failing to hear my own IV pump alarming -- not ignoring it, just not hearing it.). I'm pretty sure if you're consistent about doing this, most of the nurses will be more vigilant.

CNAs, if they aren't actually assigned to specific patients (as in our unit) can be politely asked if they'd mind getting that call light. If you're charge and they refuse, then they have to talk to the manager about insubordination. That is never a pleasant experience.

[kristinc312, RN]

As long as someone continues to answer those lights, they will be content to "wait it out", knowing that if they ignore it long enough, you or someone else will do it. You need to address them with this issue directly. If it continues to be a problem then disciplinary action should be started.

[Been there,done that, ASN, RN]

Why is this a question? Lights going off... direct the nurse or the aid to respond. If they do not.. get the nursing supervisor to the floor stat to observe and write them up, each and every time, when they refuse.

[bluebirdflyx]

I guess I should clarify that from the nurse's station we only have a visual on a few rooms. Often times when a light starts ringing no one can see what room it's coming from so it makes it difficult to direct a particular nurse. At this point it seems to become a standoff to see who is going to get up and see who's calling.

[Been there,done that, ASN, RN]

I guess I should clarify that from the nurse's station we only have a visual on a few rooms. Often times when a light starts ringing no one can see what room it's coming from so it makes it difficult to direct a particular nurse. At this point it seems to become a standoff to see who is going to get up and see who's calling.

. So there is no central locator at the desk? My mind is boggled at that . Everyone just hears bells in the air??? THAT would be a patient safety issue that you need to document, report,and remedy STAT .

In the meantime, YOUR direction is even more urgent. Get off your duff, identify what room is calling.. and direct the appropriate nurse/ aid. OR when you hear bells in the air.. direct anyone you designate to answer the dayum bell.

[NurseGirl525, ASN, RN]

I guess this is pretty simple. We don't have a. central thing that goes off. If a call light goes off, I look to see what room it is, if it's mine, I answer. If it's not, I look at what room it is and where the nurse is. If the nurse is busy, I answer. If they are at the station with me and it continues, I say, is there something I can get for so and so room for you? 9 times out of 10, they didn't realize it was their room. If it they did, at this point, they run and answer it. It's not hard.

[Cowboyardee]

Simple. You're charge nurse - so when a call light goes off, pick a nurse or CNA who doesn't often answer lights and say, "Hey, _______, get that light please." Don't say it angrily. But no pleading either. It's a directive, plain and simple, and your tone should say that you expect it to be obeyed.

It might piss em off, but you can rest assured that the nurses who regularly answer call lights while they sit around will appreciate you for it. If they balk at the order, repeat it once just as firmly, and then report any continued insubordination to your unit director.

[bluebirdflyx]

Thanks everyone for taking the time to respond. There are lights above the doors, and at one desk you can see on the paging system what room is calling, but from a majority of the seats unless you get up you cannot see which room it is.

I will start being more vocal about delegation. I'm new to this role and in addition I still work the floor so I have to work alongside everyone. I think before the next shift starts I will have a huddle and tell everyone up front they need to step up their game and help distribute the workload.

[TriciaJ, RN]

I guess I should clarify that from the nurse's station we only have a visual on a few rooms. Often times when a light starts ringing no one can see what room it's coming from so it makes it difficult to direct a particular nurse. At this point it seems to become a standoff to see who is going to get up and see who's calling.

Then pick out whoever is being the most irritatingly oblivious at that moment and say "Susie! Please answer that light."

[Been there,done that, ASN, RN]

Thanks everyone for taking the time to respond. There are lights above the doors, and at one desk you can see on the paging system what room is calling, but from a majority of the seats unless you get up you cannot see which room it is.

I will start being more vocal about delegation. I'm new to this role and in addition I still work the floor so I have to work alongside everyone. I think before the next shift starts I will have a huddle and tell everyone up front they need to step up their game and help distribute the workload.

I commend you on recognizing the problem, and trying to correct it. A new charge nurse has limited authority.You need to direct this issue to management.Where ARE they? You and the patients..need support from above.

A huddle MAY change things for THAT shift. YOU need to call a meeting with management and all charge nurses to correct this mess. There are helpless patients , lying in bed waiting for a response. Does management give a rat's patooty about HCAHPS ?

[SmilingBluEyes]

As a charge nurse, you are gonna have to learn directive guidance and communication. As said before, you don't beg, plead or get emotional. You say, "Mary I would appreciate your answering that light".....or "Joe I hear an IV pump alarming, I would like you to go check that out now".

Notice you did not ASK anyone to do anything. You told them to, in the most polite and non-confrontational way.

You are going to have be a leader, so act like one. No, it's not easy when you are new, but you have come out the gate confident and strong. People won't like you; you won't please em all. That's the way it goes. If you are strong and fair, you will be respected, even grudgingly.