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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  • http://paynehertz.blogspot.com Paynehertz

    You seem to have answered your own question. Patients use cellphones to deal with the boredom of long ER wait times. They may also use them to calm their anxieties, reassure loved-ones or even say goodbye in what may be a moment of acute distress for them…such as after a car accident. Ability to use a cellphone is not a measure of how severe a person’s problem is. A person with his legs crushed under a car can use a cellphone to call for help.

    Holding up the finger is a polite way for someone on a phone to acknowledge your presence and ask for the quick second or two it takes to politely end a call. I can see getting annoyed if the person takes 3 minutes to terminate a call, but not at “getting the finger” if it is followed by a quick goodbye.

    It is unreasonable to keep people waiting for hours and then expect them to instantly drop what they are doing and be prepared to deal with you the second you unexpectedly enter the room. Have you never spent a half-hour in call waiting for tech support or customer service at some business or other, listening to crappy music, only to be suddenly interrupted by the voice on the other end and find yourself fumbling for words as you try to remember what it is you called about?

    A little politeness and understanding on your end might go a long way too.

  • Francesca

    I try not to use mine as much as I used to. I recently read a story in a Catholic newspaper about the state of Maine putting warning labels on cell phones. Some studies have linked excessive cell phone usage with an increased occurrence of brain tumors.

  • http://www.MDWhistleblower.blogspot.com Michael Kirsch, M.D.

    Of course, cell phones are essential. But, so is quiet time. It is increasingly difficult to find a sanctuary from them, even in my own house. So many of these conversations are either elective, or don’t have to take place at all. We didn’t use to have them, and somehow we survived. When we were in the car, for example, we suffered by looking out the window or having conversations with each other.

  • Ryan

    In most of the hospitals I’ve worked in, cell phones are banned because they can potentially interfere with the operation of life-saving equipment. Just sayin.’

  • http://Therapists.PsychologyToday.com/rms/48698 Jay E. Korman, LCSW

    Cell phones and texting have also become the bane of psychotherapist’s existence. The varieties of violation of the “analytic frame” are many. The patient who has to finish the conversation before leaving the waiting room to start the session or talks all the way into the consulting room and then still continues once both of us are seated. Most patients don’t turn off their phones or put them on “vibrate” during sessions and the ringer is always loud and disruptive to our work. The other major variety of mobile phone impingement on the session is the person who takes out his/her mobile phone and is talking while looking for his/her checkbook at the end of the session.

    On the other hand, since I work in psychoanalytic psychotherapy, everything is “grist for the mill,” whether it’s why someone can’t separate from the person with whom they are speaking to why they imagine they would want to interrupt the flow of the session. It’s a double-edged sword because of the nature of the work. The question is going to be raised because it speaks to something going on in my patient that needs to be addressed. Maybe not at that exact moment because it’s dismissed out of hand, but it’s going to return and the underlying motive, presuming there is one, will be sought (and, hopefully, found.)

  • http://www.academicobgyn.com Nicholas Fogelson

    >> Jay E. Korman, LCSW

    Sadly, sometimes even the therapist is in on it. I worked with somebody who took calls during a session on a number of occasions, which ticked me off.

  • http://www.consentcare.com Martin Young

    Some hospital trusts in the NHS have banned cellphones for worry of interference as Ryan has said above.

    I use my cellphone in theatre and ICU all the time, and we (our hospital) have no reason to believe there is any danger.

    Is this another myth?

  • http://boneandspine.com Arun Pal Singh

    Whether they interfere with the life saving equipment or not, they do interfere with the mind and focus of the one.

    Cellphones in theater and ICU are unnecessaryintrusion and I make sure I keep mine in locker.
    There is no point in talking when you are scrubbed or monitoring an intensive care patient.

    If it is not safe to drive with cellphone on, it is not safe to work on patients with buzz and rings around.

  • Jen

    I’ve still never seen cell phone use allowed by patients in an (Ontario) hospital that we’ve been in. It would be nice to use them on occasion- it’s not fun leaving a child alone in emerg while you run outside to arrange babysitting for other kids.

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