Texting and cell phone use are becoming more common in hospitals

The cell-phone is a wonderful device. Even I, somewhat Luddite about certain technologies, find it delightfully useful for things like calling my wife when I lose the grocery list, calling my wife for directions and calling my wife to remind me of what I was supposed to be doing. I’m not really a fan of texting, though my wife and oldest son seem to communicate that way quite effectively. It’s like having two telepathic alien species, who talk to one another across the ether while the rest of us are stuck in neolithic spoken tongues.

I understand the appeal of those little devices. Sometimes, though I really don’t need it, I find myself coveting a ’smart-phone.’ The younger physicians I meet have instant access to what is, apparently, all of the medical knowledge since Galen; whilst I’m stuck with my rusting cerebrum, and am constantly calculating drug doses with that old-fashioned brain.

Nevertheless, cell-phones are a bane to my practice, and to many others. Even MacDonalds and other fast food restaurants have signs that say, ‘no cell-phone use in the drive through.’ Maybe it’s like the time Jan and I were parachuting in Anderson, Indiana, and were receiving messages on our head-sets from the local Burger King, alternating with messages from our instructor. ‘Pull the riser to the left, gently, and look for the large grassy….fries with that, and a large vanilla, no chocolate, no, vanilla shake and Whopper…watch out for that F-16, and you’ve drifted towards a massive power…no, diet Coke, please and I have some coupons from last year, is that…TURN, TURN, TURN…’ OK, not that bad. But I was getting hungry listening to the orders.

I think, though, the main problem is inattention. My patients frequently hold one finger up while talking on the phone in the ER. And I have previously addressed my feeling that, if you’re on a back-board after a car crash and are busily texting despite immobilization, your trauma-score will probably suggest survival. Science may prove me wrong, but I doubt it.

The thing is, it’s frankly rude to speak to someone in a room while someone else on their phone or blue-tooth is loudly saying, ‘yeah, Clarice, the doctor is finally here. What? Sure, Lasagna will be great.’ And it’s worse when it’s the patient who will NOT put down the phone so that I can address the reason they are in the ER. And really, from now on, most of us will simply walk out if given that ‘finger.’ No, not the middle finger, the ‘wait a minute,’ finger.

I’m convinced that if my some of my patients were on fire, they would tell me ‘just a minute,’ and text, ‘doctor says I’m on fire,’ to all of their friends.

Almost as bad is walking down the hall past a patient room as a family or friend walks up to me, presses a cell-phone into my hand and says, ‘it’s my Uncle John, he’s a neurosurgeon at Mayo Clinic and he wants to talk to you.’ No one says, ‘would you mind?’ They just hand me the phone. Or tell me I must talk to their sister the nursing assistant, who is concerned I’m not doing the right thing; from her perspective in Guam.

Equally nefarious is the practice of patients recording audio or video, or taking pictures of doctors and other patients, while in the ER. Every hospital should come to terms with the fact that those uses of electronic devices constitute major HIPPA violations, and have to be forbidden.

And yet, there are times. A few days ago, I cared for a little boy with a rare cancer and low platelets. His mom furnished him with a lap-top, on which to play and watch movies while we 1) obtained the platelets he needed and 2) infused them, all at a glacial pace. She was wonderful, and arranged for me to speak to her child’s oncologist in Atlanta, using her own cell-phone. Paging and call-schedules are much harder to navigate than a concerned, meticulous mom with speed-dial. Everything was smoother due to the connection.

I suspect that cell-phones, smart phones and computers probably decrease perceived ER wait-times; of course, that’s just supposition, not science. But it makes sense. I really don’t care if someone is texting, playing a game or even talking, so long as I can talk to them when I need to. And frankly, it’s hard to judge them as our wait-times creep ever upward due to increased acuity and volume. Staring at a wall is mighty boring stuff.

(For years I’ve advocated pay-per view movies and video-poker in the waiting room, with a payout in Lortab and work-excuses, but apparently cell-phones have trumped me in patient entertainment!)

So, there you are. Cell-phones, blessing and curse. But one thing is certain; no matter how much they may make physicians and nurses crazy, they aren’t going away. So we’ll all have to adapt.

And hopefully, we’ll all learn to be more respectful to one another along the way.

Edwin Leap is an emergency physician who blogs at edwinleap.com.

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