Questions? Questions?

[jaredumas]

How do I manage a patient who is constantly pushing the nurse call light in a professional and reasonable way?

Is this possible?

[juliaann]

What are they asking for? Are they just pushing it for fun/to see how long it will take you to respond? Or do they have legitimate questions/concerns/needs?

If they're just pushing it to push it, I think it's okay to say that the call lights are for communicating with the healthcare staff, and to ensure that the nurse/CNA/whoever can give quality and *prompt* care to all his/her patients, it is to be used only when needed.

If they have questions/concerns/needs, I personally would just take a chunk of time and sit and talk with the patient/resident about their concerns and questions, explain the routine the nurse and CNA and doctors have, when they can expect meals, bathing, tests, meds, etc., make sure they are comfortable and know how to work the bed controls and TV, everything they need is within reach, and tell them when you'll be back next to check on them - and then do it. I've noticed that if patients know what to expect and that the staff follows through on rounding and doing things about when they say they will, call light usage goes down.

Now if they're confused or disoriented and neither of the above works, maybe that patient needs a 1-1 sitter, to reasure them, reposition them, meet those needs and answer questions immediately so the rest of the staff can tend to other patients?

I'm sure a lot of what I would do would depend on the patient, the facility, the staffing situation, etc. But I've found that needy patients either need to be reminded that you have other patients (y'know...professionally, not in a "I don't have time for you" kind of way), or actually need to have those needs fully adressed, and usually the situation resolves itself.

I've gotten more frustrated than I care to admit about specific patients (especially the up ad lib, fully oriented woman who would push her call light every 20 minutes to have someone adjust the elevation of her head or foot of the bed...grrrr...if you can push the darn call light, you can push the button right next to it that elevates your HOB!) overusing the call light...it's tough.

[nursesaurus]

I agree with juliaann whole heartedly. Also does the patient have any visitors? Maybe they are really lonely and need a little extra attention as hard as that is to give.

[canigraduate]

A couple of times, I have flat out told patients that responding to constant call lights is an ineffective use of my time and takes away from the very limited time I have to care for them. Then I ask them to try to keep a list of what they need and call me for it all at once so that I will be able to meet their needs better.

I haven't been bitten in the butt for it so far.

[brownbook]

Very dificult situation. Assuming that they are basically mentally and physically "stable" tell the patient they must only use the call light for urgent needs, but that you will check on them every 1/2 hour (barring emergencies with another patient, ideally no more than a peek in their door to say hi.) Give them some reassurance and or hope that they won't be left alone. The "theory" is that once they know you are checking on them without their calling they are reassured and the 1/2 hour checks can be stretched out longer.