Nurses/patient care/cell phones

[snuggles49]

What is so hard about a nurse carrying a hospital assigned cell phone on her shift so she can be more accessible to doctors, staff, for ED report. I constantly hear " we are not going to answer the phone in the patients room, that is rude" BUT these same people have no problem answering their own phone or checking their text messages.

The premise to not answering the phone in the room is "it is rude". What happen to excusing oneself explaining to the patient that it is a work related call and step into the hall or another part of the room. The ED would like to call the nurses assigned cell phone to give report an admissions. ED usually calls the desk to speak with the nurse and usually she is not around or says she will call back and delays calling back to stall gettting the admission. Which in turn backs up the ED when they are busy.

What do other hospitals do re nurses and cell phones ?? Also, some nurses feel if they are on break they should not have to answer the cell phone esp. to take report or speak with a DR. they may have paged prior to going to break. Granted break is a time to be relieved of your duties re patient care but I think you could accept a call.

Looking for input on what other facilities do with cell phone use. Thanks

[TigerGalLE, BSN, RN]

Well we are required to carry a cell phone and I absolutely hate it. Yes it is convenient for the secretary but extremely inconvenient for the nurse. I hate having doctors, family members, and/or other disciplines transferred to my phone. I mean dang sometimes I'm sitting on the toilet... or in an isolation room... or in the middle of educating a patient. How horribly annoying it is to have to excuse yourself from the patient you are currently with to answer a question for a family member calling about a completely different patient. I usually just have to tell them I'll call them back b/c I can't give them any information in front of another patient.... It is so annoying and I hate it.

I do like having a phone so I can call others from the patient's room... but it should be against policy to transfer any call to the nurses phone unless the nurse is aware of the transfer before hand.

I mean how is a nurse going to take report on an ER patient while she is in the middle of an extensive dressing change??

Edit: And I never get a break b/c my cell phone rings constantly during lunch. Now how fair is that? I never page a doctor and then leave to go on break. That is just common sense. But to have to talk to a family member while my mouth is full of my cheeseburger? Hardly fair.

[Virgo_RN, BSN, RN]

The work flow is different on the floor. While I was not in the "it's rude to answer the phone in a patient's room" camp, and would take calls because I never knew if it was something urgent, I did notice a "Murphy's Law" type of phenomenon with the phone, in that it would invariably ring the moment I was elbow deep in a patient's bodily fluids, packed wound, pannus, or fresh groin puncture.

If I was expecting an admit from the ED or the cath lab, I would hold off on my meal break until after I had received report. If the patient sounded like a quick tuck-and-run, I could ask the nurse breaking me to do it. If the patient sounded a bit more involved, then I would stay and get them settled before going on my meal break.

There were many times where the ED or cath lab would try to call report, and I'd tell them I needed five to ten minutes to finish what I was doing and that I'd call them back, only to have them call me back literally two minutes later. Or, they would make some noise on the other end of the phone to vent their frustration. Or, if I couldn't answer my phone because I was holding pressure on a groin puncture, changing a sterile dressing, inserting a foley, cleaning up poop, starting an IV or whatever, they would continue to call and call and call and call and call and call until I finally answered. This was especially true in contact isolation rooms, where I'd be gowned and gloved from head to toe, my phone in my pocket under all my isolation garb where I couldn't get to it anyway.

You can't delay care until after the ED has called report, because you never know if it's going to be in ten minutes or an hour, and you just don't have that kind of time to wait, so you go about your duties and hope they don't call when you're in the middle of something.

We do faxed report now, and what I hear is that the floor nurses don't care for it too much because the report is not detailed enough. But it sure has cut down on the friction between ED and inpatient unit as far as phone tag goes.

The phone was a huge source of annoyance for me when I worked the floor. There were nights where I felt like all I did was answer the phone. It rang whenever a bed alarm clear on the other side of the unit went off. It rang with family members asking questions I could not answer over the phone. It rang with family members wanting to know why Grandma wasn't answering her phone. It rang with dietary confirming diet orders, with lab asking about lab orders, it rang and rang and rang. Constantly.

[mom4josh]

I agree with the previous post. We just started carrying phones this year, and many times it really sucks. The other thing I can add is that they are bulky and way too heavy to have to keep in a pocket... along with pens, markers, sharpie, scissors, alcohol preps, blah blah blah. Plus, all of the clips we had to attach to the phones to a pocket were broken within a few months.

Also, there are those nurses who leave their phone on their desk all the time. They are the ones who are impossible to reach, never leave their nurse locator lights on so you can find them, and never return calls. Ugh!

When I leave the floor for a break, I leave my phone at the desk or with another nurse. I have someone cover my patients. If I leave to go to the pharmacy or other work-related place, then I take my phone.

Oh yeah, the other thing is that our call light is located at the main nurse's station only. The halls are 12 very large rooms long on each side of the building. But when one of our patients call or an emergency light goes off (i.e., bed alarm, toilet call, staff assist), then every phone goes off. How annoying is that at 2 am when you sneak into a patient's room to hang an IV bag and all of a sudden your phone blasts them wide awake!

I vote to ditch the phone!

[Virgo_RN, BSN, RN]

I also want to add that in the ED, we take our breaks when they're given, even if we're in the middle of something. The nurse breaking us jumps in and does whatever needs to be done with our patients while we're gone, whether it is discharging them, transferring them to the floor, drawing labs, doing mini caths, or whatever. We do this because we have a designated break nurse, and you go at your time because there are other people waiting to go at their designated time, so you don't want to make everyone else late for dinner. Some nights we don't have a break nurse and have to get each other out, but even then, you go and whoever is covering is expected to do stuff with your patients.

On the floor, it is not like that. You have to get to a good place to be able to take a break, because the nurse breaking you has a full team as well, and will not have time to do anything with your patients, other than maybe give a PRN or help them to the BR. So, you get your head to toes done and documented, your med passes, your treatments, then go on break when you don't have anything pressing that needs to be done for the next half hour. The nurse breaking you may not have time to take report and tuck in an admit from the ED, because they may have a really busy team. It is highly likely that the nurse breaking you will never lay eyes on any of your patients while you are gone. If you are at a good place to take a break and starving, and the ED expects you to take report right then, this can be frustrating, because that might have been your one chance to go eat all night.

[Sewbusy~RN]

We are required to carry a phone, its not optional in any way. We even get written up if we forget to sign in (phone number attached to nurse and assigned patients). I always answer when I can, but they have caller ID so I can call back if I can't pick up for some reason. Our charge nurse can even send texts to us. I do give up my phone when I take a break. We can put our phones on vibrate or low tone so they won't wake our patients if we remember/have time to set them up. I guess I never really questioned it because its all I've known. The only thing I don't like about them is how dirty I know they probably are. One of the first things I do when I start a shift is wipe that sucker down with some antiseptic wipes!

[Virgo_RN, BSN, RN]

How annoying is that at 2 am when you sneak into a patient's room to hang an IV bag and all of a sudden your phone blasts them wide awake!

I vote to ditch the phone!

The first thing I do when I receive my phone at the beginning of the shift is set it to "vibrate" and make sure it has a full battery. If you want to see me jump about three feet, call me when my phone is on "loud".

[RedhairedNurse, BSN, RN]

I'm not going to answer that darn cell phone when I'm in a patients room with gloves on changing poop, or if i have my gloves on doing an assessment......It's just NOT HAPPENING. If they ring me when I'm available to answer, then I will. Same goes with my personal cell phone. They are very rude when it starts ringing when I'm talking to my patients, I absolutely hate them. And most the time, the phone call is regarding, "oh, pt in room 5 needs ice water." I took off my gloves and stopped my assessment for this??? IT's not happening again!!!

[Virgo_RN, BSN, RN]

Just wanted to specifically address these points:

ED usually calls the desk to speak with the nurse and usually she is not around or says she will call back and delays calling back to stall getting the admission. Which in turn backs up the ED when they are busy.

Make no mistake, it is busy on the floor, and I know of no nurses who ever stalled an admission just for their own convenience. Maybe that does happen, but I have never seen it. I have had to delay admissions because the room wasn't clean, I was busy with another patient who needed one on one care, the poop was hitting the fan and the hall was lit up like a Christmas tree with bed alarms and call lights, there was a code, I was pulling a sheath, etc. I am in the ED now and I am well aware that when a patient is admitted, we have to move them out in a timely fashion, no ifs and or buts (our goal is within 30 minutes of room assignment). The longer the patient takes up a bed in the ED, the longer someone else is waiting to be seen, and those nights where the ambulances keep rolling in one after the other make it even more critical to keep the flow going.

Granted break is a time to be relieved of your duties re patient care but I think you could accept a call.

Break time is a time to be relieved of ALL duties, including phone calls. If you are not fully relieved of duty, then it is not a break and you are entitled to be paid for that time. It's the law. The floor nurses are entitled to their meal breaks, and those meal breaks are precious. However, I don't think the floor nurse should go to their meal break without making provisions for someone to take report on their admit. It could be their break buddy or their charge nurse, or they could delay their break until after getting report. Another option is to be proactive and call the ED for report, and find out the ETA for the patient.

[cardiacmadeline, RN]

Cell phones are all I have ever known and I really like them. Absolutely hate pagers! We don't have to take our cell phones on break, because we hand our phones off to another nurse. Calls are not transferred to our phone. the US calls us, tells us so and so is on line ----, if we can take the call, fine, if not the US takes a message and we call them back. If I am busy or in the middle of cleaning up a mess, I don't answer and call them back when I get a chance, not a big deal. If I go into an isolation room, we try to let the US know we won't be able to answer our phones. If the nurse isn't available for something urgent, that's what the charge nurse is there for. If I get a call in a patient's room, I have no problem saying "excuse me, I have to take this call" and step out.

[swifty1031]

We were required to carry cell phones at a hospital I once worked for. It was very annoying. The secretary would put through family members that just wanted to check on pt but didn't have time to visit, doctors with tons of questions and of course you had no chart with you, and the most annoying call of all the tele secretary calling to say "there is a lead off in room 2". I know these are all important however like most nurses I am not sitting around with my feet up waiting to be called into action. Thank goodness we don't have them at the hospital I work at now:)

[Virgo_RN, BSN, RN]

My absolute, most hated phone call was the ubiquitous "Mom's not answering her phone" call. Well, she could be sleeping, she could be in the bathroom, she might have turned off the ringer because she doesn't want any calls, and NO, I do NOT have time to go check!