When was the last time you heard a nurse yell while on the clock? It may happen more frequently than you think.
When you think of "traditional communication" in a hospital, pagers, overhead paging and private branch exchange phone systems likely come to mind. But there is one mode of communication that is most traditional of all.
"Yelling is almost always in the top three forms of communication for nurses, across all hospitals," says Rhonda Collins, RN, Chief Nursing Officer for Vocera Communications. The Vocera Clinical Assessment survey, which is for nurses across all departments of a hospital, asks participants to identify their top three forms of communication. Vocera surveyors added the option "yell" because it came up so often. In the last dozen surveys, yelling held its spot as the No. 1, 2 or 3 form of communication.
In the heyday of mobile devices and other sophisticated technology, why are nurses still sticking their heads out of patient rooms and yelling down the hallway for assistance?
"They may not have the right technology, or what they need in that moment," says Ms. Collins. As a registered nurse for more than 20 years, Ms. Collins draws on a number of real-life scenarios where nurses are not always able to use certain technology. An emergency room nurse has a combative patient he is restraining, making it impossible to take his cell phone out of his pocket and dial for assistance. For immediate action, the nurse yells. "But with Vocera's hands-free, wearable badge, it's a quick double-tap and you can open up the entire system to say, 'I need help immediately,'" says Ms. Collins.
In another instance, a nurse is wearing sterile gloves and placing a peripherally inserted central catheter line (PICC) in a patient when her phone rings. She ignores it and continues the sterile procedure. The phone falls silent and then rings again, almost immediately. The nurse begins to think this is an urgent call she should take the call, despite being in the middle of the PICC line. Then the phone rings a third time.
The nurse removes the gloves and answers the call, leaving the patient in some degree of pain or discomfort. If the nurse opts not to answer, she is likely yelling: Can somebody answer my phone, please? "It's disruptive to the patient, the family, to everyone," says Ms. Collins. "If you're a patient, you're thinking, 'Does my nurse need to care for someone else right now?'"
Ms. Collins has a concise slogan: Communication is your problem; a smartphone is not your answer. Too often, smartphones or mobile devices are upheld as silver bullets, but nurses are first to know there is no such thing. One solution is not enough for the urgent, physical and unforeseen situations they find themselves in day after day.
Even calling a physician is a multi-step and time-consuming process. If a nurse needs to increase a pain medication dosage for a patient who is reporting 8-out-of-10 pain levels, the nurse must leave the bedside, go to the nurses' station, find the physician's number or call the hospital operator to leave a message for the physician. "Then the physician has to call back, give the order, and the nurse has to put the order in — this can take 15 to 45 minutes," says Ms. Collins. "Meanwhile the patient is still in pain, and one minute can feel like hours." In fact, according to Nursing News, only 20 percent of a nurse's time is at the patient’s bedside, equaling only about 15 minutes per patient during an eight-hour shift.
"Doing the right thing for patients and staff in the hospital is selecting a secure platform that accommodates any form of communication you need," says Ms. Collins. "Want to use your own personal cell phone? Absolutely. Need it hands-free because you're in direct patient care? Yes to that, too. Want a hospital-issued cell phone? Again, absolutely."
In this digital age, nurses should no longer have to yell. Secure text messaging capabilities let nurses send messages from their smartphone or handheld device directly to a physician, meaning they can receive an order in 5 minutes. In addition, when a nurse uses the Vocera enterprise system, the actual digits of the phone number are not apparent, maintaining the physician's privacy.
"Nurses have an incredibly difficult job trying to coordinate communication for the patient’s care. Anything we can do to make it easier is what we should do," says Ms. Collins. "It's difficult no matter what. I don't believe adding technology makes it easier to be a nurse. I think it makes it more reasonable, makes the workflow better and it can certainly improve safety or outcomes for patients when the nurse has the tools he or she needs."
To learn more about clinical communication that is efficient, supports patient satisfaction and fosters collaboration between nurses and physicians, register for the June 9 webinar "How the 'Five Rights' of clinical communication puts nurses back to the bedside," which will feature Ms. Collins and Mary Beth Mitchell, CNIO of Arlington-based Texas Health Resources.