Take that, cell phone!

[nursej22, MSN, RN]

I knew this day would come, but it took longer than I thought.

All of our RNs and NACs are required to carry a hospital-issued cell phone that allows us to be called any time as well as being paged about call lights. They are heavy and bulky and generally ring constantly. I think they have become pretty standard as well as a general dissatisfier to nurses and patients.

Well now the number and length of calls we are getting is so bad that MDs and the monitor techs are complaining that they can't get ahold of RNs because their phones are busy! So we are looking for ways to cut down on calls. Uh, we told you this 4 years ago when you insisted we needed these stupid things. I would say that half my calls are from neighbor Bob or Aunt Sally just wanting an update. "I am unable to give info over the phone, would you like to speak to them directly? Oh, no I don't want to bother them":angryfire. Ya know you can't call your neighbors PCP and get an update on how their latest appointment went, why do think you call the hospital? And when I call an office nurse I always get her voice mail anyway.

Or the call that really burns me "this is Nellie in pharmacy, can you ask Mr. Jones in 503 if he took his warfarin today?" Hmm, every pt has a phone in their room. Why don't you call them and ask them yourselves? Because I am starting an IV, wiping a bum, consoling a grieving family, trying to calm a dementia pt, i.e. busy.

Surely others have to deal with this. Any creative, effective ideas?

[MikeyBSN]

The charge nurse and a few other select nurses carry phones, and I understand your frustration with them. However, I do find having one of the phones useful at times. Most of the time, someone needs to be transferred to a portable phone and they call the main number first. My biggest issue is that much of the time I'll get a call for a patient that I don't even have. In my facility, I think the clerks need to screen our calls a little better. A person doesn't need to be transferred to a nurse if they are asking about whether they should come in for their cough. The clerk can tell them the same thing we can, "We can't give medical advice over the phone, if you feel you are ill and want to be evaluated you can come to the hospital or call your doctor." Or, "We can't give patient information over the phone." You wouldn't believe the range of dumb questions that get transferred to my phone when I'm in charge. Actually, you probably would because you probably get them in your facility as well.

[rn4babies63]

Several years ago our hospital got a hospital-wide Vocera handsfree answering system. At the beginning of the shift you log in and it can be worn around the neck or clipped on your scrubs. Although it can be annoying at times (IE while you're in the bathroom), you can be paged at anytime. You have the option of ignoring calls if you are in middle of something that requires your undivided attention and can page that person back. I think it is much more useful that walking up and down the hallways trying to find the person you are looking for. Maybe your hospital should look into this.

[wooh, BSN, RN]

With a good secretary, this shouldn't be a problem. It's like a secretary answers a call light. "I need to see my nurse." Some secretaries just say ok, send nurse in to find out they just needed a towel. Which could have been done by the tech, or AT LEAST the nurse could have known and brought the towel with them, saving a trip. A good secretary will ask, "Can I tell the nurse what you're needing?" or similar.

When I get calls from families/friends/whatever with the "How are they doing?", if I know someone's in the room that can answer the phone, I just say, "I'll transfer you into the room so you can talk with them" and transfer before they can say otherwise. Avoids the whole phone info argument.

But it really sounds like the biggest problem is secretaries not screening better, and making sure everyone is doing the kind of anticipatory planning that keeps call lights down, asking the patient if they need something and getting it before they call you 5 times for it.

[smileedee]

"We need nurses at the bedside!" BLAH! BLAH! BLAH! Sure, on a phone kissing everyone's ass while the patient's choke to death in front of you because you are appeasing Great Aunt Mable for the 13th time today. Give me a break! What is next?

[RNKPCE]

I wonder how germy those cell phones get and then you are holding them to you your face, eweee.

vocera's are a nice alernative. They can be used hands free, under an isolation gown and like the previous poster said you can opt to not take calls if it is at a bad time. We also never get outside calls from family members of patients.

[cardiacmadeline, RN]

We use cell phones and I love them. I think they work great for us. The US calls us for a call light and can tell us what the patient wants. It makes it easier to prioritize when you are busy if you know what the patient wants. If we have a call from a family member, the US calls, tells us what line they are on and if we are busy they take a message. I hate pagers, if you get two calls at one time, how do you know which patient is having chest pain and which patient just wants a pillow? Cell phones do have their advantages.

[nursej22, MSN, RN]

Thanks for your replies.

We did trial Vocera several years ago but it seem to have trouble understanding staff voices. Our manager says she might trial it again hoping that the technology has improved.

I would love our unit clerks to screen calls and direct more to patients but this will require a huge culture shift. They have been trained to send any call regarding a patient status to the nurse. They are just as busy as the nurses between multiple phone lines ringing, dealing with visitors coming to the desk, answering call lights, and processing orders. We are a busy cardiac telemetry floor with 50-90% patient turnover per 24 hours, that equals lots of admits and discharges to process. I personally think they need more help and I hesitate to add to their load at the present.

[RNKPCE]

Yes vocera isn't perfect. Especially hard in your live in a part of the country that is a melting pot with lots of different accents. But you can spell names when you call people, assuming you their name isn't very unusual.

[husker_rn, RN]

We carry the phones too. On one hand they can save steps; we can be told what someone needs to save time. But....the darned thing always rings and rings and rings when I am drawing blood, or putting in a foley, or taking someone to the bathroom.

[GadgetRN71, ASN, RN]

I feel your pain..I have to carry a cell phone and I circulate a room at the same time as being in charge. I made it very clear to th PTB that if it's between the stupid phone, and my helpless pt on the OR table, helpless pt. wins hands down every time. If you call me while I am checking blood, doing counts with the scrub, moving a pt off of the fracture table etc that sucker is going to ring until I am finished doing the IMPORTANT stuff. And no, DR X calling to nag me for the 5th time about why he can't start his case is not my priority right then.

[mcknis]

I do find that cell phones have their advantages and then there are those other times... Like others have mentioned, if I am wiping a butt, inserting/removing a foley, inserting an IV, pulling a line, assisting an MD with a sterile bedside procedure, then the phone can ring. Their are other RNs who are perfectly capable of answering a phone and taking a message, as well as the unit clerk who can get a name and number. Truly ticks me off when grown ups don't understand how to take a simple message! It really isn't that difficult people. We also have to carry pagers that ring for everything from call lights our own call lights to all the monitor alarms on every pt on the floor (about 15-20 at a time) argh. I think vocera had an idea, but it just wasnt researched in the most idea settings. In food service or construction, maybe, but when you are coding a pt...probably not!