Sunday, August 16, 2009

Paging Etiquette

I have intermittently worn a pager since since 1981 and finally somebody has put down what I have been thinking all these years.

I will print it out.

Rules for Paging Properly:

1) If you are going to be allowed to page me incessantly, then you should be required to wear a pager so I can return the favor.

2) If you page me, please wait 5-10 minutes for a response before paging back. Heaven forbid I be answering another page, seeing to an emergency, walking in a hallway without a phone, or sitting on the john. I am very conscientious about returning pages and really try hard not to make you wait, but sometimes it's unavoidable.

3) Please attempt to coordinate your pages. Having 2 different nurses page me about the same patient within 30 seconds of each other (indeed, I received page #2 while I was on the phone with nurse #1) is a little annoying. Especially when said patient isn't actually dying of a heart attack or writhing in severe pain, but "just wanted to talk to the doctor."

4) I know mistakes happen, but please attempt to look through the medications before paging me to say Ms. so-and-so needs a sleeping pill. If I stop what I'm doing and pull up the chart only to find Ambien in their list of meds, it's a little irritating.

5) Blood pressure of 135/anything does not excite me and I do not need to be paged for this, unless it was 220/190 5 minutes ago (in which case, why are they on a psych floor?).

6) The primary team arrives around 8 am M-F. I do not need to be paged at 7:20 (while I'm trying to check out and leave) for 2-day long sore throats or potassium of 3.2 drawn 4 days ago. I appreciate your incentive and that you are trying to help care for your patient, but it can wait.

7) When possible, please page me to an extension you'll be easily reached at. If you page me and I call you right back, only to reach someone who puts me on hold "while I find out who paged you", I get a little irritated, especially when this happens frequently.

8) Perhaps most importantly, when I call you back, please introduce yourself and state the patient's name clearly (perhaps even spell it) before rushing into the story of how the patient has an urgent foot rash. I have some hearing problems--not your fault--and I will have to interrupt your story to ask you to repeat the name, spell it, and wait while I access that patient's chart in the computer before you get going again. Also, if you have a non-American accent, it is going to be difficult for me to understand you over the phone, especially if you speak rapidly.

9) On my end, I promise to keep trying to answer pages promptly, identifying myself clearly when I call back, being really nice (or at least non-snarky) when I answer, and trying to educate the people paging me about appropriate paging. (Hey, I said "trying", didn't I? Stop looking at me, swan!) I know I fail at this frequently, but I really do try, I swear. I don't like paging people only to get yelled at, so I don't want to be the person yelling.

We are now in what I call the "Cult of Availability". With pagers and cell phones so freely available and widely used, there is now a tendency for people to call somebody instead of trying to solve the problems themselves using the resources available.

My mother was a nurse until she got married in 1951 and had to quit (that was the rule then no married nurses!). Back then doctors had only a single land-line rotary dial phone in their house or office. I highly doubt most doctors sat by their phones waiting to be called. They had a life outside of medicine plus some of them did housecalls. I asked my mother once, what did they do when they couldn't find the doctor. She said she didn't remember. She probably didn't remember because it was never an issue. The nurses back then probably were able to think independently and did what they could to solve the problem with the resources they had.

Like the blogger above, I try to answer my pages quickly and I don't know how many times I have answered the page, to be told, "it's okay we've solved the problem." The question I always want to ask is "why the hell didn't you try to solve the problem before you interrupted my supper/TV viewing/sex?" But of course I have learned from sad experience never to say what I am thinking on the phone.

No comments: