Nurses' perception of beeper calls. Implications for resident stress and patient care

To describe beeper calls made by nurses to physicians and to compare the nurses' ratings of the urgency of the beeper calls with the physicians' responses to the calls.

Nurses were asked to complete beeper logs for all calls made to physicians. Nurses also recorded the physician's response to the call. Nurses assessed each call as routine (answer needed in 12 to 24 hours), urgent (answer needed soon to accomplish patient care), or an emergency (patient assessment needed immediately).

A university-affiliated children's hospital in Salt Lake City, Utah.

Nurses recorded 849 beeper calls. Of this number, 30 (4%) were judged to be an emergency, 275 (32%) were perceived to be urgent, and 471 (55%) were considered to be routine. The recorded physician response for 597 calls is as follows: 60 calls (10%) resulted in physician assessment of the patient; 211 calls (35%) resulted in verbal orders given over the telephone; 136 calls (23%) resulted in other action taken; and 190 calls (32%) resulted in no action taken. While calls that were judged to be an emergency were more likely to result in physician assessment of the patient than were other calls (nine [45%] of 20 vs 49 [9%] of 541 calls) (P < .001), nearly half (43%) of the calls that resulted in physician assessment of the patient had been judged to be routine. Calls that were perceived to be urgent or routine did not significantly differ from the percentage of calls that resulted in no action taken by the physician (52 [27%] of 193 vs 118 [34%] of 348 calls).

Nurses' ratings of the urgency of beeper calls are not good predictors of physician response to the call. Unless nurses' and physicians' perceptions of the urgency of beeper calls are similar, delaying response to routine calls cannot be assumed to be a safe and effective way to decrease unnecessary interruptions to resident activities.