Commentary: “If you need anything just use the Buzzer…”

Firstly, I would like to say thank you to Tasha for her thoughts on call buttons. I think this is a very important topic in terms of understanding patient need and attainable levels of comfort.

There is a reasonable amount of research out there exploring patients’ perceptions of the ‘busy nurse’ and how this changes their willingness to ask for support as well as what they value in nurse-patient communication (see McCabe, 2004 for an excellent introduction).

I think it is always worth keeping in mind that what may seem trivial to us might be something that is far from trivial to our patients. Taking your slightly colder water jug scenario – to a mobile individual who can get up to get their own water whenever they want and who feels relatively in good health it may be rather trivial to want colder water. But to a patient who may be feeling nauseous, overheated, uncomfortable and is currently bed bound – that cold water may mean a great deal. I realise that it was a comment made in jest but I also think you hit on something: patients are in an unfamiliar and ultimately uncomfortable environment and this discomfort will manifest itself in different fashions and lead to different patient responses.

Hospital stays take patients out of their own environment and place them in close proximity with other patients at a time when some or none of them may be feeling particularly well. Then to add insult to injury we ask them to do things such as have personal conversations about their care and condition or use a commode with nothing but a thin curtain between them and a dozen other individuals. As much as we try to preserve the dignity of our patients and attend to making their experience positive, I can’t help but think how excruciating I would find being admitted to hospital myself. Add to that the fear of upsetting a nurse who has labelled me as calling ‘unnecessarily’ for an ‘outrageous reason’ when my world has been reduced to revolving around the next mealtime, managing my pain and whether I need the toilet or not.

Of course there will be times when we realise we are dealing with a patient who is calling for an element of attention rather than just water. But maybe that attention is just as important in terms of the nursing care that we can provide. Have I reassured my patient sufficiently? Have I answered all their questions? Have I promised to do things previously and then forgotten and hence lost some of their trust in me as their nurse? Have I fully taken their immediate psychological health into consideration as one of my nursing goals for their care?

I would say that there are things we can do during our not-so-busy moments such as making a point of checking in on them rather than waiting for a call button to ring. That little bit of extra support may alleviate some of their concerns and decrease their use of the call button – thus leaving us in a position where we can trust that if the button goes off we know it will be something more serious.

McCabe, C. (2004) Nurse-patient communication: an exploration of patients’ experiences. Journal of Clinical Nursing, 13(1):41-49.