Call Bell Crazy? 6 Tips for Taming Overuse

Posted by Dr. El - September 22, 2011 - Communication, Resident education/Support groups - 10 Comments

“Tired CNA” posted a comment on my blog, saying she wished there were something that could be done about alert residents who ring their call bells 30 times a day.  And there is.  Here are some suggestions:

  1. Residents who ring their call bells frequently are often anxious, needing what seems like constant reassurance.  Quell their anxiety by visiting with them at the beginning of each shift, telling them who you are and when you’ll be by again next.  Check in on them when it’s relatively convenient for you so they don’t have to call and interrupt you when it isn’t.
  2. Answering the call bell right away reduces resident anxiety and decreases the frequency of calling.  Ring, answer, ring, answer, even if it’s to say that help will be there in ten minutes.  Then show up in ten minutes.
  3. I used to wait tables and there’d always be that group of diners who would wait until I’d returned from one request to give me a second, and then a third when I returned from the second.  I learned to ask “Is there anything else you need right now?”  Try this.
  4. I provide “Call Bell Education” on the theory that the residents, most of whom have never been in a nursing home before, have no idea how much bell-ringing is considered “too frequent” by the staff (and some of them don’t use it when they should).  It’s better to do this in a calm, informative manner when the residents first arrive rather than waiting until everybody is aggravated.  As a CNA you could give them a ballpark figure of what’s considered reasonable during a shift, while assuring them that you’re there to meet their need for care.  Part of the education process is helping them to identify when it’s important to let the staff know they require assistance (for example, they need oxygen or to be changed) and when it might be better to “group” requests (for example, if they want the window closed and the TV station switched, and meds are coming in ten minutes, they might as well wait for the nurse).
  5. If a resident continues to need a lot of assistance, consider moving them to a room closer to the nursing station, where staff members are more likely to pass by easily rather than having to walk all the way down the hall.
  6. Consider a referral to the psychologist.  My residents know they will see me each week and can ask me for assistance with a wide variety of matters.  This significantly reduces their anxiety.  This week someone said to me, “I don’t know what I’d do without you.  I really feel like you’re listening to me, taking my concerns seriously, and getting things done to fix them.”  And I am.  Include the psychologist on your team, and any other staff and family members you can enlist to improve the situation.