We are currently trying to convince our nurse manager we need a new system to handle the number of phone calls we handle each day. We feel we are used too much for hospital information, general health information, physician referrals and "nurse calls" in which the caller is basically is requesting us to give them the "OK" to come in and have their runny nose evaluated. Even the calls to ask the waiting time are currently ringing in the Trauma section of our ER.
We are wanting an automated answering device that would basically say " We are unable to give medical advice over the phone if you feel you have a medical question please call your primary care doctor, if you have a medical emergency call 911." Our main number is published in the phone book, above the hospital information number and in larger print than the main hospital number, and cannot be changed until next JUNE!!! My question for you all is how are your phone calls handled.
Do you have an "ask-a-nurse" number, and does the public have easy access to the ER as a referance for everything?
Any thoughts would help. We currently are tabulating the number of calls we take a day and how long we are on the phone each time as proof we need a change.
There are several problems that have to be addressed Todd. First, legally we cannot give out medical advice over the phone. If you feel you need to come in, then come in. Second, I am sorry your father was told to try the next town over for help. That would never happen here, and shouldn' t happen any place as if someone requests medical care in an emergency room you have the legal right to receive the care. Calling ahead to see if the ER is busy in the future will not help your situation. If you have ever worked in the ER then you know we can go from no patients to 45 patients in a matter of minutes, so if I tell you "we have no wait, come on in we will be with you right away and treat you within minutes", then you bring your family member in after 15 ambulances have arrived along with 20 people at triage and you have to wait. I bet you are not happy with the fact I told you to come in. Another thing, there NEVER IS a wait for a true emergency.
My intial question was intended to figure out a solution to the number of calls that the nurses have to take, while at the same time caring for patients in a timely matter. If you have suggestions for my issue please let me know. I would love to be able to tell people what home remedies work, and if their illness will be OK until they see their PCP, but as ER nurses our hands are tied with legal ramifications.
Some of these answers disturb me. My dad's wife drove him (88y/o) to the ER one morning at 0200. After sitting and waiting to be seen for 1 and a half hours he was told he might want to go to the hospital at the next town as they were quite busy. His problem was serious enough that he spent 3 days in the hospital. He thought he might call next time if he has to go to the ER to avoid this happening in the future. Guess I'll print some of these responses out and give them to him. Sheesh.
as jj pointed out, there is NEVER a wait for a true emergency in our ED. not everything that comes through the ER doors is a true emergency. not every condition needs on the spot attention. that does not mean, however, that those people do not need to be seen at all.
I guess what bothers me is telling someone that calls there is a 4 hour wait when in fact there is no basis for telling someone that. And according to the posts, more than one ER does this. I don't know why they call and ask that question, but they must have some reason? It's just as easy to say, "I am unable to give you a specific time." As for *true emergencies,* my dad had a TIA. I'm thinking the first hospital was just not good and it is probably good he ended up at another. Hey, when it comes to ERs, I'm just as ignorant as joe/jane public.
While I'm posting, I want to state my distain for these automated phone systems. They are a tool and are only as good as the people using them. Here's my health care experience. Go the dr, he gives me rx that I take in the next day. He wrote it for a dosage that doesn't exist. Pharm faxes problem and asks for clarification. No answer so fax again. No answer again, so I call clinic. Listen to recordings that mean nothing to me, punch all the numbers and finally get a live nurse. My dr and his staff on vacation. Explain problem to nurse, she says, "Hold, I'll transfer you." She gives me his voice mail with the message he is on vacation for 2 weeks and will return call at that time! (Bang head on wall!) So I go down in person. Another dr takes care of problem. I ask what happened to all the pharm faxes. "We put them in the drs "in" box for when he gets back!
sorry about your dad, todd. terrible luck to have been put off with something like that. not making excuses in any way for the treatment he did/didn't receive but i have to wonder what else that emergency room had going on at the time.
and as a general rule, i agree with you about automated calls. i hate calling and getting the "please press #3, etc. ect." that's not the type of automation i am talking about in regards to our ED. i'm talking about a line that picks up ED calls and informs the caller that under no circumstances will patient information be given over the phone. it explains that no one will tell the caller if the patient is even in the facility much less the condition of that patient.
and the problems with patient's calling and asking wait times are these:
1. they will hold you to it! "well, i called 5 min ago and so and so told me i would get right in and i've been waiting for 3 hours!" never mind that their toothache could have been taken to urgent care. never mind that 5 squads pulled up outside with everything from MI's to OD's to multiple system traumas as soon as you hung up the phone with that potential toothache pain. that brings me to ......
2. within 10 seconds, the entire atmosphere of the ED can change. every patient in rooms can go from normal sats, great pressures, and walkie/talkie to crumping right before your eyes.
3. and it still stands to reason, if you have time to call the ED to inquire about wait times instead of phoning 911 or hopping in the car to "come on down" then it wasn't a true emergency to begin with.
In our ER, we used to get a lot of nurse advice calls, now we route the calls that want to speak to a nurse to an Ask-a-nurse service who will then tell them 9 times out of 10 to come to the ER! It saves the staff nurses from having to tell people that we can't give medical advice to anyone over the phone. It cuts down on the secretary being tied up answering phones too.
On rare occasions someone gets through but are either forwarded to the AAN service or told we can't give out medical advice. We never tell anyone what kind of wait there is because as stated above, that could change within 30 seconds!
My frustration is when floors call wanting to know if we have any possible admits for them. Another case of "not right now, but five minutes from now, who knows?" It's usually the chest pain floor or surgery so I usually try to yank their chain a little and tell them that we have an ER full of patients just waiting to go to them! Sometimes they just don't see the humor!
I don't like the "if this then push that" for myself personally, but I sure don't like to answering a constantly ringing phone either.
JJFROG
100 Posts
There are several problems that have to be addressed Todd. First, legally we cannot give out medical advice over the phone. If you feel you need to come in, then come in. Second, I am sorry your father was told to try the next town over for help. That would never happen here, and shouldn' t happen any place as if someone requests medical care in an emergency room you have the legal right to receive the care. Calling ahead to see if the ER is busy in the future will not help your situation. If you have ever worked in the ER then you know we can go from no patients to 45 patients in a matter of minutes, so if I tell you "we have no wait, come on in we will be with you right away and treat you within minutes", then you bring your family member in after 15 ambulances have arrived along with 20 people at triage and you have to wait. I bet you are not happy with the fact I told you to come in. Another thing, there NEVER IS a wait for a true emergency.
My intial question was intended to figure out a solution to the number of calls that the nurses have to take, while at the same time caring for patients in a timely matter. If you have suggestions for my issue please let me know. I would love to be able to tell people what home remedies work, and if their illness will be OK until they see their PCP, but as ER nurses our hands are tied with legal ramifications.