The Patient Call Light: Is the SLP responsible?

Every med SLP has gone through this dilemma. You’re already behind and have two days of patients left for the afternoon. But the light is on. It’s not that bright, but it’s shining right through you. “Should I answer it? What if it’s important? If it’s important then one of the 6 other people standing by the room should have answered it, right? What if the person is suffering? But then I’ll be late to see my patients. What do I do?!” There’s no easy answer, unfortunately, but let’s discuss each side of the debate so we can look at the whole picture and see where we land.

It’s everyone’s job 

Most administrations make it clear that answering call bells is everyone’s job. It’s a part of healthcare. If everybody is keeping an eye out for lights then, in theory, they will be answered promptly. Nursing, on average, answers a call bell every 6 or 7 minutes. That’s about 10 per hour. Even if attending to the call bell only takes 2 minutes for each patient, that’s about 1/3 of the day answering lights. This is on top of the myriad of other tasks the nursing staff is responsible for. If the whole interdisciplinary team (IDT) takes responsibility for answering call bells, this spreads out the burden and, theoretically, leads to a more efficient system. Most importantly, answering call bells matters. Doing so quickly will lead to a reduced risk of falls, incontinence, and injury. 

If it’s everyone’s job then it’s nobody’s job

We, as trained speech pathologists, were hired for a role. That role involves taking care of patients with speech, language, voice, or swallowing disorders. Nothing more and nothing less. It’s not that getting somebody a blanket is below us, it’s just that we simply don’t have time for it. It sounds harsh, but what if we spent our entire day getting caught up by call lights. We’d never see all of the patients we were hired to see. They’d go without the necessary services we provide (picture a patient who is NPO all day and night because we weren’t able to make time for them). Or, we’d have to stay late and work after punching out for the evening (which is illegal) and sacrifice the time we have with our families (which is non-negotiable). We’d do it all if we could, but time is a finite resource. Plus, if the staff who were hired to answer call lights expect us to help too, they themselves may be less likely to answer the light. This creates a vicious cycle of confusion, finger-pointing, and neglected care.

The verdict

As you can see I can see both sides. This is why making a stance is so difficult. But here I go... I do feel it’s important to answer call lights as an SLP.  Besides the obvious ethical considerations (taking care of patients quickly is the right thing to do), it makes a statement within the IDT. We are all in this together. Taking time to help a nurse’s patient by getting them an extra pillow may lead the nurse to give you an extra minute or two of their time when you need help repositioning a patient for PO trials or feeding a patient during a FEES. Not to say you’d be helping the patient with selfish motives, but... PR is important. Yes, there are downsides to this approach as discussed above, but I believe the pros outweigh the cons. And, to be honest, it’s just hard for me to walk past a door with a light on. I like sleeping at night and skipping this on a regular basis would make that difficult for me (yes, again, I’m being selfish…I know).

The bigger issue that requires 6 other blog posts to unwrap is that many facilities are understaffed. If there were enough nurses and aides, this would be a moot point. CNA turnover is high, especially in skilled nursing facilities. We are short on nurses and CNAs and the problem is not expected to get better any time soon. Yes, we all want more staff, but that doesn’t change the fact that we don’t have it right now. So we do what we can. With what we have. While using ongoing patient needs to leverage more flexibility with our own caseloads (lower productivity requirements please). Because nobody wants to walk past that door and we shouldn’t feel like we have to.

Have an opinion on the topic? I’d love to hear from you! Comment below.