Words Are Hard

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Tag Archives: nursing

I’m just calling to give you a heads up…

There is no other phrase that I hear while working that makes me cringe quite as much. There are times it’s fine, but most of the “heads up!” calls amount to the caller waking someone up at three o’clock in the morning for no good reason. This is especially true if the deceased is at a facility with access to a morgue.

Most of the time when I get “heads up!” calls, it’s because the nurses will call before they even arrive at the home of the deceased. They want to save themselves some time because they don’t want to wait around for the removal people to show up.  They’re trying to time it so that the removal people show up about fifteen minutes after the nurse does. To the best of my knowledge this is rarely, if ever, successful and is only really appropriate in the following situation:

  • The funeral director will be making removal personally.
  • The funeral director is more than an hour away from the home and will be traveling there themselves instead of calling a more local funeral home to make the removal (otherwise known as a trade call). This is common in very rural communities.
  • The nurse is less than an hour away from the home, will be there early enough to get the paperwork done, and has made sure that the family is ready.

That’s it, really. In that case, by all means, get the director up and moving. If, however, the director is local, or they’re using a local funeral home or removal service, then chances are you’re waking them up to say: “Hey I’m going to be calling you later about this one body that hasn’t even been pronounced yet.”

They can’t do anything in that case and, chances are, they’re just going to go back to bed, grumbling under their breath and calling you names. Many places I answer for have instructions in place that say if the body isn’t ready (and if it hasn’t been pronounced, it isn’t ready) that we don’t even bother calling it out until it is. The only exception to that rule is if the family wants to talk to a director, but if you’re not at the home, how do you know if they do or not?

A lot of the time I’ll hedge when I get these calls and say something like, “Well, I can take the information now and get it to the director, or we can hold off until you get to the home and everyone is ready…”

Every time.  Without fail.  The nurse will (obviously not thinking this through) have me wake up the director who will then growl, “Okay,” and go back to bed.  I’m getting the impression that the nurse thinks the director doesn’t go back to bed, but I can assure you, when we get the second, “Okay ready now!” call, I’m waking them up again.  I know this because just waking up people have a distinct, groggy tone in their voice and a tendency to go “Mrfff,” “Grphf,” and “Fffstphk.”

Any hospice nurse worth their weight in student loans should know that a body cannot be moved from the place of death until it has been pronounced. In fact, five seconds with Google will tell you the same thing. Guess what can’t be done if you’re not there to do it? Right.

I also notice that a lot of nurses who do this (call before even getting to the home) will just sort of assume that the body will be ready shortly after being pronounced. Never mind any family members that are coming from a ways away that want to view the body before the funeral home arrives. Never mind any religious or cultural concerns. Never mind a husband or wife who just wants to spend a few more hours with their dearly departed for whatever reason. Never mind actually bothering to ask the family any of that. Just come and get the stiff!

This often ends in several calls back and forth saying the body is ready, then it’s not, then it is, then it’s not. Trying to jump ahead in the queue often leads to things getting messed up and wires getting crossed. It’s unprofessional. It makes the director look unprofessional and it puts a couple extra bucks in our bank account because we charge for every call we take and every one we have to make.

…On second thought, go ahead and make all those calls. Momma needs a new Playstation.

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How not to call a funeral home at midnight

I mentioned on Monday that I work for ten hours a night answering other people’s telephones.  This is true.  I’ve been doing this for almost three years now, and working almost exclusively at night for over two.  What this means is that when dealing with the funeral home accounts that make up the majority of our business, I’ve talked to my fair share of nurses.

Let’s be blunt.  Nursing – especially hospice nursing – is a very difficult, and mostly thankless career and you definitely don’t get paid enough for it.  About 95% of the nurses I talk to are nice, professional, and know exactly what needs to be done and when.  They may not like being called out at 4am to pronounce a patient, but they are wise enough not to shoot the messenger.  To these nurses I say: I love you.  You are, in every sense of the word, a hero.

To the other 5% I say: How the hell did you graduate from nursing school?

Seriously.

I have spoken to hospice nurses who didn’t know what the phrase “next of kin” means.  Who didn’t understand why I would ask for something as silly as a contact number for the next of kin.  Who didn’t understand what I was asking for when I asked for the time of death.  Yes.  Those nurses.

So for the 5% who need a crash course, stick around and I’ll try to make it informative.  If this all seems like common sense, I agree with you.  Go ahead and enjoy the complementary wine and massage by our very own cabana boy, Antonio.

Pour vous.

What to do when reporting a death to a funeral home.

  1. Stop being annoyedLook, I get it.  Nobody likes being woken up in the middle of the night (or day, in my case).  In the middle of winter it’s cold.  It’s miserable.  Some poor bugger has died and the family is upset.  I get that.  So when I ask questions it’s not because I want to make your job harder.  I realize you want to get off the line asap so you can go home.  Here’s what you can do:
  2. Know where you are.  This is probably the most important bit.  If you are at a facility please for the love of puppies don’t tell me “they know where it is!”  That is not what I asked.  I asked for an address because records.  If I don’t ask for an address, it’s because we don’t need one.  Please have the address of the facility ready before you call.  If I can Google it faster than you can look it up or ask someone (which you should have done before you called!) then we have an issue.
  3. Know where you’re calling.  Several places I answer for have more than one location.  I am going to ask you which location the family wants to use.  When I ask you that question I don’t want you to tell me where you are.  We’ll get to that!
  4. Hey!  Listen!  When I ask you for a room number please don’t give me the phone number.
  5. Have all the info ready before you hit dial.  If you have a face sheet, get the face sheet.  If you are at a hospital or facility where charts are a thing, please have the chart handy.   If I ask for a piece of information you don’t have immediately the magic words are: “I don’ t have that information.”  or  “I don’t know.”  Do not waste my time and yours by digging through stacks upon stacks of paperwork to try and find a social security number when your facility/office doesn’t even keep those on record.  Note that this does not apply to information like addresses and phone numbers.  These things are pretty easy to find.  No excuses there!
  6. Let me ask the questionsI have a computer template that I use and isn’t exactly easy to jump around on super fast.  So when you’re throwing date of birth and time of death and next of kin at me in rapid succession and all out of order I’m going to have to ask you to repeat about half of it.  There is no set order every time.  Every funeral home is different and while the questions may all be mostly the same, with some places asking for more info and some places wanting less, they come at different times.  You will save time, get off the line faster, and we’ll both be a lot happier if you just let me do most of the talking.
  7. I am going to verify everything.  That’s my job.  Getting information and making sure it is correct is my job.  So yes, I am going to spell last names back to you using phonetics and yes, I am going to repeat every phone number and address.  Don’t interrupt me, and for the love of everything do NOT (seriously do NOT) wait for me to finish spelling back the name and then proceed to spell it again using a different set of phonetics.  Just say yes or no.  If no then at that time you can go ahead with the phonetics if you need to.  It’s not hard.  You know when I won’t spell things back?  When you use phonetics the first go-round.  That makes it very clear on my end and I will be very grateful.  I will have to double check all the numbers though, sorry.
  8. Please hold.  For some reason, and I don’t know why, death calls always roam around space and time in packs, waiting for the moment when we get one to drop four more on us.  Depending on the time of night there are anywhere from two to three of us here (the day shift gets a whole lot more than that, but they’re a lot busier).  Trust me when I say I hate putting you on hold as much as you hate being on hold.  I can see the counter and start twitching at the one minute mark.  This is why it’s very important that the ducks are all lined up in a nice row before making the call.  Chances are it’s not just me you’re making wait.  The faster we can get this done, the less time people have to wait listening to our awful hold music.
  9. Area codes are important.  Every time someone gives me a phone number without an area code a fairy doesn’t get its wings.  I don’t care that “everyone knows” what area code you’re in.  Most places we answer for have locations in multiple area codes.  Just gimme the freakin thing and stop rolling your eyes.  I can hear you doing that.  Also remember the template thing?  Yeah, phone numbers are required to have area codes.  If you don’t give me one it slows us both down because I have to correct the formatting.
  10. I don’t want to talk to the family.  There is absolutely nothing I, myself, can do for the family.  I am not a director.  I’m a messenger.  If the family wants to talk to a director I can certainly have the director call.  Always.  It is never a problem.  But I don’t want to talk to the family myself, because asking them how heavy their loved one happens to be is rude and a question you, as a professional, should be answering.  As a note: there is one (just one!) city that shall remain nameless whose hospitals are notorious for making the family contact the funeral home to arrange pick up from the hospital.  I have been told that this is because families will often tell the hospital one thing and then change their minds in the morning, making things messy.  Since this city seems to be the only city ever to have this problem forgive me for raising an eyebrow and thinking your nurses and staff are just really [explicative deleted] lazy.
  11. Nine times out of ten we want them in the morgue.  Every funeral home is different but the majority I work with will prefer to pick up from the morgue during business hours if at all possible.  In fact, there are several who have “tough luck pal” policies.  Morgue is full?  Too bad.  In many cases they use removal services (I’ve noticed that it’s mostly the ones located in larger cities) and night time removals cost them extra, so they won’t unless absolutely necessary (and sometimes not even then).  However, every funeral home is different and some change their minds depending on the phase of the moon so if you aren’t sure please ask.  If I don’t know (and I often don’t) I will have a director call you to let you know what they would prefer.  Pretty much all funeral homes will make removal from homes 24/7.  I have yet to run across one that won’t.
  12. When to ask for an ETA.  ETA in this context stands for Estimated Time of Arrival (yes, I’ve had to explain that so hush).  At the end of every death call my exact question, no matter what is, “Is there anything else I should let the directors know right away?”  That is the time to ask for an ETA.  If I have one, I will gladly give it to you.  Otherwise I will make a note in my handy-dandy “additional info” box and let the director know you’d like a call back.  Do not wait until I say “Thank you.  I’ll get this information to the director.  Good bye!” to interrupt me before I hang up and ask for an ETA.  Just don’t.  Chances are I’m not even in the template anymore because I’m digging up the contact instructions for the on call.  Note: That is also the time to tell me the family would like to talk to the director ASAP, or the deceased will need two people for the removal because they’re on the second floor or they’re heavy.  Anything additional that’s important.  MRSA?  That is very important (for non-nurses: don’t Google that if you don’t know what it is).
  13. If you want an ETA please ask for an ETA.  Self explanatory.  Most places won’t call you back unless you ask them too.  Some are nice and will make courtesy calls.  Don’t expect them all to.  And don’t get mad when they don’t.  Just call us an we’ll page them.  Problem solved!
  14. Be honest.  Is this your first time calling to report a death?  Is your computer/smart phone glitchy and running slow?  Don’t have the chart because the supervisor and/or doctor ran off with it?  Are you outside with a bad cell connection and no paperwork because you’re at Zombie Apocalypse Ground Zero and your patient ate the paperwork?  No problem!  Just let me know.  We can work with just about anything.  Don’t have a piece of info?  Don’t panic!  Just let me know upfront.  Things will go so much smoother and I won’t get mad at you.  I promise!  My patience is pretty infinite in those situations.
  15. Know your lingo!  Time of death is pretty self explanatory.  What time did you pronounce?  If you can pronounce the death, then there’s not much excuse for not knowing what I mean, right?  Generally speaking I want the pronounced time anyway, but if you give me that and the actual time that’s fine.  Chances are I only have room for one though, so unless the account says differently, it’s the pronounced time I go with (I know, I know the death certificate wants both depending on what state you’re in…).  Next of kin is convoluted, but generally giving us the closest able family member (spouse or kids usually) will suffice for the immediate future.  They can figure it out in the morning but they need to know who to call.

That’s it.  See?  It’s not hard.  You and I are both professionals.  I enjoy my job so help me help you and we can help make a very difficult time for a family just a little easier.

Congratulations on passing the course!  Antonio will now see to your needs:

…Ladies.

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