The call buzzer and me

“Just buzz if you need anything.” That is the all too familiar sentence from a nurse as they leave your room in hospital. You hear that instantly recognisable sound of the call bells almost engrained in the air when you walk on to a ward. (It is less apparent on a really well run ward in my experience.)

I have spent the equivalent of nearly four months of my life as an in-patient, yet I have probably only ever pressed my buzzer maybe five times.

Why my reluctance to ask for help?

Firstly I think it is intimately connected with my fierce independent spirit and desire to maintain this for as long as possible. By pressing a buzzer it somehow feels like I am giving in to the patient role together with its associated dependent state.

Secondly I fear the reaction of whoever answers it. When in doctor role I have observed nurses and HCAs reticent about the patient who buzzes all the time. I will always remember the first time I ever pressed my buzzer in hospital. It was a couple of days into my first admission to the Gynaecology Unit and I woke up with excruciating abdominal pain. I was in proper agony. The reaction I received from the staff nurse was one of indifference. I think this experience has conditioned me to be an infrequent buzzer.

Thirdly there is the uncertainty of who will answer your call. It might be a student nurse, it might be an HCA, it might be a Staff Nurse, it might be Sister. Some of the problems and complications my cancer causes are really embarrassing and the thought of having to repeat yourself as you go up the chain of command is horrid, in my mind anyway. I would much rather venture out to find the correct person who can sort out whatever the issue is.

Fourthly is my professional understanding of how busy nursing staff are. Even when I am in a side room I will usually have an awareness of what is happening on a ward. Perhaps there is a very sick patient or there are numerous admissions, which I will prioritise in my own mind as more important that me.

So my reluctance to press the big round orange button and ask for help gets me into a pickle sometimes. I have laid in a hospital bed crying in pain many times during the night because I don’t want to ask for help. I have also left other serious symptoms too long before telling anyone. I think sometimes I am just a bad patient. We all know doctors make the worst patients but sometimes I wonder if ‘lay’ patients share my feelings about the big orange button…

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32 thoughts on “The call buzzer and me

  1. My wife felt the same last year as she recovered from surgery to remove bowel cancer. She was treated with indifference when she eventually plucked up courage and asked for something to deal with the pain. She was given something but with no empathy from the staff which made her even more reluctant to ask a second time. Busyness is no excuse for rudeness. Thankfully, the hospital has listened to my complaints and is doing something about improving this situation.

  2. There is also the fact that a lot of nurses just ignore the bloody things. Quite how many patients die because a buzzer has gone unanswered I shudder to think.

    But I’m with you Kate. I try and manage as much of my condition as I can myself. I hate giving up control. But I’m a little OCD on that – perhaps that’s why I’ve survived the NHS so far… J x

    • I can’t imagine how frustrating it can be to be a patient in pain, needing the toilet, a drink or requiring something and waiting while no one comes but I don’t believe nurses ignore buzzers. They just don’t have enough staff and the recruitment problem is worsening. I moved to itu from a ward as I couldn’t do all I wanted to for all the patients I was expected to care for on a ward. Until the nhs is given enough funding to adequately staff all wards with caring compassionate staff and the image of nurses in the press improves so more people want to join the profession this problem is not going to be solved. I’m not naive enough to believe all nurses are angels but I think most go into the profession wanting to care but the reality of life on a ward is very different to how they would wish to work.

      • I’ve been an inpatient twice over the last couple of years. My impressions confirm your Dec 14 post..
        My second stay was in a ward with a room per patient, all in for ASCT and chemo, so imuno-compromised and requiring isolation. The staffing levels matched the number of patients, and care and response to the buzzer were pretty good. Moral was good among the nurses, and this made a difference to us patients.
        But my first stay was on an open ward, with a fair sprinkling of dementia patients and other problem cases – who shouldn’t have been there, but simply couldn’t be sent home. Often a shift would come in to find that staff numbers were short, and there would be a swift round of bargaining to bring in support from elsewhere. I’m surprised how many nurses remained cheerful in spite of all this, but quite a few were struggling – sullen, miserable. And, yes, sometimes buzzers would go unanswered.
        The scary thing is, I don’t see it getting better – there’s a downward spiral (positive feedback would be the technical term): the worse the conditions, the less nurses will volunteer for these wards, and so conditions will worsen further. And the press will rage and scream, further demoralising the NHS staff (not that I’m suggesting the press should ignore NHS problems, but I could wish coverage was a little more nuanced).

  3. Hi Kate and hope the beast gives you some respite over Christmas.Can empathise so well with fear of the buzzer.Totally different scenario but 35 years ago woke in agony a couple of hours after my daughter was born,didn’t want to wake the doctor (I was a GP at the time) .Fortunately pain overcame sympathy and my 4 pint pph was dealt with and I survived to become a grandmother but it was a close call.You are a very brave lady and I wish you all the very best,just hope eventually you find some peace.

  4. I think I *was* the one who got the rolled eyes for ringing the bell too often. Fortunately I haven’t had many hospital stays, but after my first birth, a traumatic one, I needed frequent help and was quite often met with indifference. I had a baby with a sore head who was hungry but didn’t want to feed and just screamed and screamed. Being the only new mum on a ward of 4 with the only baby who cried all night was horrific enough, but whether it was my state of mind – traumatic birth, PPH, 70mins in theatre after for stitching, lots of morphine which made me lose all sense of reality, or just new mother cluelessness – I did ring the bell quite often. Mostly for help feeding. The midwives would shove his (sore from forceps) head onto me then go away. Often as not, he’s bob back off within 30secs and resume screaming. Due to previous brief, not hugely interested response, I didn’t always dare ring again. I wish I had, as I feel huge guilt for not meeting his needs well to start with and it took a long while to get over the traumas of it all.

    Fortunately my faith was restored with birth number 2 (yup, mad enough to do it again despite all that…). Different hospital. Different feel. Better birth, so maybe less need to press buzzer, but the odd times I did, they came. They cared. They were chatty. They waited until I was happy before they went. They just seemed to give that bit more. I’m very thankful I had the second experience to realise places weren’t always like the first one.

    Lots of love to you, Kate. X

  5. I was in hospital a couple of months ago having had joint replacement , felt rough on morphine and being sick. Had to ring buzzer because of the sickness but felt uncomfortable for disturbing the busy nurses.

    Some nurses were kind and showed great empathy but not all the time and I felt that I was a pest.

    Being 40 years old, I should of been seen and no heard.

    Jane
    X

  6. As an ex nurse I find these comments upsetting and disturbing. I hope I wasn’t like that in my day. But I guess when you’re really busy as a nurse and you’ve got lots of patients needing help it would be hard not to seem brusque occassionally.
    Now being the patient I will do anything not to press the buzzer because of maintaining my independence but in the occasion I have done the nurses have always been delightful, apologising if they didn’t respond straight away etc.
    I thought maybe it was because they were oncology wards but I did stay in an extremely busy acute medical ward and the care there was amazing to me and my surrounding (sometimes extremely challenging) patients.
    Maybe these wards were better staffed than normal? I don’t know.
    Thanks for another thought provoking blog Kate.
    Lindy x

  7. As a palliative care nurse and recent patient, I have also been reticent to ring the call bell. I assumed that every other patient was more needy than myself, despite being post op and obviously having the same needs as everyone else!? I put it down to a mixture of the professional ‘I am a nurse, I can fix this’ attitude & perhaps a greater awareness of busy staff & not wishing to add to their load. For my patients, it is crucial that they have the confidence to call for assistance if they need my help. I have always said the same- ‘call me if you need me’- but then gone back to check everything is alright, even if they haven’t rung the bell. There is always something that I can do for them- that is what being a nurse is all about. Sadly, there are some who seem to have forgotten this.

  8. As a Coroner’s Officer I am worried about the thought of someone’s buzzer being deliberately ignored, as a human being I am saddened by some of the reasons people have given for not ‘buzzing’. Whilst I imagine there is nothing worse than having a constant buzzer, surely that should never influence your attitude towards every buzee. People are in hospital, one imagines, because they are poorly and unable to do things for themselves?
    Get buzzing and face up to any wrath with a steadfast resilience.

  9. I’ve spent too long in hospitals, mainly orthopaedic, and always the pain relief has been so good that I’ve never had to press the buzzer once. BUT, then I got cancer, and after TAH/BSO, omentectomy and lymph node bx, I was given an epidural. I could write a book about that b***** epidural. It wasn’t working properly, and I spent days writhing in agony, my husband increasingly furious with the nursing staff, the anaesthetist, etc., all of whom insisted the epidural was working perfectly. They were wrong. A CT and subsequent spinal MRI demonstrated that. God knows how many times I pressed the buzzer, fruitlessly. I pleaded, cajoled, ended up yelling at them: ‘Now look, I am the patient here, and when I say I am in pain, I am in absolute agony. For Christ’s sake, take the f******* thing out NOW!!!’
    They did and, surprise surprise, suddenly I was 200% better. I used to think that horror stories about pain relief were invented by professional patients and gullible reporters. Now I know that sometimes, they are true…
    If you are a patient, never feel bad about asking for help. Would you feel good if you knew a patient wasn’t comfortable, but wasn’t comfortable with telling you that???

    • Was it Florence Nightingale who said ‘ Every patient who enters this hospital shall be treated as an honoured guest’ ?The caring is just as important as the technology. Thoughts and prayers Kate

  10. Pingback: The call buzzer and me | drkategranger | All Things Palliative - Article Feed

  11. I am a student nurse and I have seen patients reluctance to press the buzzer many times.. I try to reassure them that we are there to help them and there is no shame in asking for help. At one stage a patient said that when people answer the buzzer, they say they will do something but it never gets done. I felt really sad for this patient, but I told him that at times some may be busy and genuinely forget to come back and address his needs, so it’s ok to press the buzzer to remind staff of what he needs. He said I wish everyone felt like that…however I would rather be reminded than allowing someone to suffer in silence, or not get their basic needs met. I do worry though that as a student I have more time for patients, and once registered time will be restricted, leaving me unable to care for patients as I hope to

  12. As a nurse in a surgical receiving unit, I am rarely out of my room and when I am I hope my patients never feel they can’t use the buzzer – in fact I encourage it. But I have worked in areas where there is judgement about people who ‘like to buzz’ – sometimes it is the pressure of trying to be in 5 places at once, sometimes people simply don’t have the attitude to their work and the people they work with and for that they should, and sometimes it is because of the treatment that we receive at the hands of some patients who can be derogatory, abusive and selfish about staff and other patients (and unfortunately these people are not the exception to the rule, there has been at least one on every shift I have ever worked in 15 years as auxiliary and nurse). I think sometimes people don’t buzz for fear of being seen in the same light.

    But at these times it is up to the nurse to look after her patients. I breastfed my son and was taught to look for cues of times to feed before the wailing began. As a student nurse I was also trained to look for signs of need in my adult patients before it went on too long. I won’t say I’m always successful, but I write notes in the bay, I check on my patients while others are making every bed in the ward before the doctors round (causes many raised eyebrows that one) and if someone I am looking after is doubled up in pain, I consider that I’m not doing my job properly. I’m not a supernurse, most of the people I’ve worked with do the same, or try to, but we need to work with people, to de-stigmatise the buzzer for patients and staff, and to find times when we can be about and visible so we can respond to need quicker.

    PS I’ve never worked in or been a patient on a nightingale ward but I wish we could bring them back, imagine being able to see everyone pretty much all the time and have somewhere to write notes etc instead of perching on a plastic chair beside the toilet?

      • Thanks so much Jonathan, although be warned, my post-op patients always end up telling me to go away before they burst their stitches laughing and my silly jokes and anecdotes 🙂

  13. As a Matron I find this both disappointing and moving to read. Today I will share Kate’s thoughts with my team and see how we can change the patient views about buzzers x

  14. I think it’s the staff’s views about buzzers that need to change, not the patients. Get that right and patients will happily use the buzzer as intended…

  15. Over here in the states, we are training nurses to address the “4 ‘P’s” before exiting a patient’s room: Potty, Pain, Positioning, and Personal belongings within reach. That covers a majority of needs, prevents excessive call lights, and overall improves “call light fatigue” for staff.

  16. I have followed your story for some time now from the US. Like you, I am a terminal cancer patient but a bit older at age 52. Last January, my doctor attempted the most radical surgery known as a pelvic exenteration. They had to abort the full surgery since my cancer had spread too far. They did a hysterectomy and sewed me up. After I came to still struggling with the surgical pain, I was told they had to abort and I was terminal.

    I was alone in my room and my nurse cane in for a brief check. I just looked at her and said “I don’t want to die!!” God Bless that sweet angel. She stayed with me for an hour talking and soothing me as best she could. I know she had other patients but was so touched by her kindness in my darkest moment.

  17. recently i spent some time in hospital, as there was a shortage of nurses the nhs had ”banking” staff on duty. I found these nurses very lazy, one of them was on her phone texting all day, as she couldnt get a signal she ”hid” behind the curtain next to the window. I didnt see her for at least 20 mins !!!!!

  18. I would just love to be your nurse…..may your days be filled with richness, joy and fulfillment
    thanks ever so much for your generosity….sharing your story, your truth and your spirit is a gift to me, for sure…and, undoubtedly many, many others! you’re a doll!

  19. I’m a student nurse, and I like to think that I’ve never made a patient feel bad for buzzing. In fact, I’ve had many patients tell me that I’m too chirpy if anything! My philosophy is that you wouldn’t buzz unless you needed me. I’ve been buzzed to pass the remote control, or to pass a chocolate bar that’s closer to the patient than the buzzer was or to ask what the time is. They might seem to some like silly reasons to press the buzzer, but I try to look behind it, and see that they probably just want some reassurance, and to see the nurses face. Or even a little bit of attention, and who can blame them when they’re in hospital! And the more time you spend with your patients, the less they press their call bells. Funny that…

  20. I was in Aberdeen RI for High dose chemo and SCT 18 months ago, in a tiny room in isolation for 5 weeks. I know exactly what you mean about being reticent about buzzing. Like you Kate I suspect it was due to a reluctance to admit to being dependent, when in normal life I’m the one doing the looking after (kids, home, dog….). I also think there is a bit of not wanting to cry wolf, ie I’ll wait till I’m really desperate for help rather than buzzing too much, otherwise they might get fed up of my red light and stop coming – totally irrational, but its hard to be rational under those circumstances and with a head full of chemo drugs! I should add that with one or two rare exceptions I got all the care I needed and more, and some really genuine, non-patronising sympathy from the great nursing team.
    PS You were fantastic on Womans Hour, thanks for ‘going public’.

  21. I work for the NHS (not as a nurse, but in the medical diagnosis field) and have been a patient many times in recent years (cancer treatment and the fall-out and related issues of chemo). I have answered the buzzer for patients in the same ward area as me when the nurses have been busy, simply because the patients have been desperate at times and have needed help which was simple to give (but they were unable to manage by themselves). I wonder whether I am covered for Health and Safety issues in this day and age, but ‘what the heck’, people are precious and some are very vulnerable in the hospital setting and I would hope someone would come to my rescue in the same situation; however, like most people on this page, I am reticent to press the buzzer unless I absolutely have to and then you would probably find me in some irretrievable position trying my hardest to rectify the situation by myself (as a fiercely independent soul).
    There are good nurses and there are not-so-good nurses (in the same way that there are people people and those not so good at compassion) but I have to say the good outweigh the not-so.
    By the way, it’s not just doctors who make bad patients but anyone medical, especially those who can self-diagnose, including me!
    Keep your chin-up, keep smiling, keep writing; there are people who care very much for you and who can empathise with you.

  22. I have been a nurse on a very busy orthopaedic trauma unit and an elderly care unit a stroke unit and EAU, I am sadend that people feel we ignore buzzers…. Walking down the ward yesterday there were 8 buzzers going, I have 8 staff 30 patients, all of a high dependency required help with majority of care needs, dementia patients wandering and becoming aggressive, ward rounds, relatives who are clearly distressed and anxious who all want updates about their loved ones, we do our upmost to assist all patients with a friendly welcoming manner, I promote and try and get all my staff to think what’s it’s like to be on the other side, we role play so they are aware of how terrifying an experience it can be, where your not always in control of what is happening around you or with you. How would you feel if it was your relative, child, mother?? I sometimes think it’s very easy to get caught up in another day at work…… But I people (not all if I’m honest but most) do not go into this profession unless they want to Make a. difference and care. We face some extreme challenges and quite often have sleepless nights but despite everything I love my job and wouldn’t do anything else, i work as hard as I can to make every patients/relatives stay as easy and pleasent as it possibly can be for being in hospital. Nursing is a wonderful profession it just needs some help and good promotion….not the bad.

  23. I have been fortunate not to be an in-patient but I am a paediatrician and unfortunately, despite generally better staffing levels, I have seen buzzers ignored. Alarms though are very promptly responded to. I have gone in to see my patient in pain, nauseous and vomiting, needing cleaning and parents wringing their hands because they buzzed once and no one has come yet. Knowing how even one sick complicated patient can keep several nurses busy, I tend to lend a hand and provide what I can OR go hunt up the nurse if the need is outside my capabilities. Something I have noticed is the door buzzers…people come in and out in a constant stream, each one needing to be buzzed in. Guess who has to answer that buzzer too? The already overworked nurses and HCAs. The NHS definitely needs more (less expensive non-bank) nursing staff

  24. Hi Kate and firstly thank you for your courage in sharing your journey with everyone. I’ve been a nurse for twenty seven years and was admitted to my local hospital in February.
    The nurses were lovely but with minimum staff pain relief was precious to say the least. I and the other patients in my bay had to wait for up to an hour and a half for analgesia. I’ve never yet used a hospital buzzer but those patients who did still had to wait excruciating lengths of time before a nurse eventually came. I genuinely felt embarrassed to be a nurse -and that’s a very unpleasant experience!

  25. All are sympathetic and empathetic but should understand one thing if there is sufficient and limited patient these things will work out. Or else if they are ignoring the buzzers and doing there other work means they have a lot of things to do in a limited time schedule and there will be shortage of staffs as well. consider they are human being not machines..

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