WhiteCoat

Cell Phones in the ED

OK, I couldn’t take it any more. The rant of the day is cell phones, ladies and gentlemen.

It is a pet peeve of mine when I am in a room with a patient and someone answers their cell phone. Don’t get me wrong, my phone is often on vibrate if I am in a meeting. Unless someone knows the secret code for emergency, I’ll wait until I am out of the meeting or will sometimes look to see who is calling and then put my phone back in the holster. Ed McMahon never seems to call me when I want him to. I rarely if ever answer my cell phone when in the presence of someone else and if I do so, I excuse myself and leave their presence.
More than 90% of the people in emergency rooms just pick up their cell phone and begin blabbing as if nothing is out of the ordinary. “Yeah, mom’s blood pressure is 70/nothing and the doctor is about to stick a funny looking tube down her throat. Who are you going to the dance with next winter?”
There was a doctor I worked with a long time ago who used to carry her cell phone around with her when she saw patients. The nurses told me that one time she got into a shouting match with her boyfriend on her cell phone in a patient’s room … during a code.

Our hospital has signs up all over the place stating that cell phones must be turned off. Even though they probably aren’t accurate, we quote the studies stating that cell phones can interfere with medical equipment. A specific case was reported by the FDA, but I’m a little leery about quoting anything the FDA says right about now.

Despite the signs, I have had family members talk so loud that I can’t even obtain a history from the patient. At first I stop talking and stare at them, but some people don’t get the hint. They just keep chatting away. Then, depending upon my mood, I will either ask the family member to leave the room or, in a louder voice, I will tell the patient that I cannot understand what they are saying because their family member is talking too loud … on their cellphone … which is supposed to be turned off in the emergency department.

Some family members have pulled a John Madden on me. When I examine the patient, they give the person on the other end of the line a play-by-play of everything I am doing. “He is listening to her lungs now. He is making a face. Wonder what that means. Oops, probably nothing. He just itched his nose. Now he is listening to her heart. Mom had problems with her heart as a kid, you know. Now he is pressing on her stomach. Ooooh, she just moaned in pain. That had ta’ hurt. I wonder if he is going to give her any pain medicine…” I have always wanted to end that type of conversation something like “Now the doctor is walking toward me. He is grabbing the phone out of my hands. He is throwing it against the … [Disconnect].” Kind of like this.

Patients can be just as bad as the family members. I understand that sometimes people have to wait a long time and they talk on the phone to pass the time. But if it is busy, when I finally do walk in the room, I would hope that the patient would want to talk to me instead of someone they’re going to see an hour later if they get discharged. Some times I guess people just find me boring.

A few days ago, there was a young guy who was brought in by ambulance for chest pain (yes, he got his EKG on arrival). I walked in the room about 30 minutes after he arrived and he had his cell phone to one ear and the hospital phone to his other ear. He was alternating talking into one phone and then the other. I walked in and told him “Sorry about the wait, I’m Dr. WhiteCoat. What can I do to help you?” He just kept talking into his cell phone as if I was not there. I waited about five more seconds for him to finish his conversation and it appeared that he had no intent of doing so. I then told him in a loud voice “I will be back when you are off of your phone.”
I went to see a couple of other patients, admitted someone, and then came back in the room. He was still on his cell phone, but as soon as he saw me walk through the door, he said “gotta go” and hung up the phone. He ended up being an OK guy, and, after reviewing his old records and normal stress test, his chest pain appeared to be from his stomach and not his heart.
I was talking with our lab technician while the patient was over and the x-ray department. I had mentioned the issue I had with the patient on a cell phone. We commiserated over some peoples’ lack of cell phone etiquette.
Shortly afterwards, the patient was wheeled back into the room by the x-ray technician. The lab technician went into the room literally 30 seconds later to draw blood. He was in there for a few minutes and then came out with a smile on his face.
“When I went in the room, he was already on his cell phone. As soon as I opened the door, he hung up the phone. Then when he saw it was me, he opened the phone back up and made a call. He told me ‘I thought you were that doctor again. I didn’t want to him to make me wait another hour before he came in and gave me the results of my tests.’”

If anyone ever invents a portable device to make someone else’s cell phone disconnect a call remotely, I’ll be the first in line to purchase it. Price is no object.

15 Responses to “Cell Phones in the ED”

  1. Carteach0 says:

    The thing about all those signs in the hospital telling everyone to shut their phones off……. is that most doctors and nurses
    seem to have an active one on them at all times.

    Some doctors look like walking electronics suites, with multiple cells phones, pagers, PDAs, etc hanging all over them.

    I have had a med-tech in the hospital telling a friend he could not have his cell phone on, at the same time the tech was talking into his!

    That said, I agree whole heartedly on the manners issue, as well as the rudeness issue. I have no problem at all telling people about it when they cross the line.

  2. rlbates says:

    I don’t enjoy this issue either. I have had patients answer their cell phone during a consultation with me–”It’s the school. I need to get this.” Damn, what can you say to that. Their child may be hurt.

  3. Patrick says:

    Ahhh….that 36 second YouTube clip was the most beautiful thing I have seen all week!

  4. My phone is constantly going off in clinic. I just don’t answer in the middle of a consultation. It’s just rude, at least in my book. If the patient doesn’t share my values, what’s stopping me from answering my phone? Come to think of it, if I’m waiting for a patient to get off the finish their call, I might as well check in with my wife.

    What’s good for the gander is good for the goose…

  5. WhiteCoat says:

    I like that one. Might have to just add that to my repertoire.
    “Hi, honey, just checking in. Walked in the room to see a patient and he wouldn’t get off their cell phone, so I figured that I would call and see what’s up with you.”
    Well, maybe not. Then the patient complaints would start rolling in that the “rude” doctor wouldn’t get off the phone.
    Can’t win …

  6. Nurse K says:

    Worst family ever today in one of my rooms. I could fill 2 pages with all the rudeness, inappropriateness, and mistreatment of me and the rest of the staff. They did the “play by play” on the cell phone, only with the worse addendum of, “And THE NURSE is here and SHE WON’T GIVE HIM a FLU SHOT (nevermind the numerous explanations of how that could be done as an inpatient etc) and SHE WON’T GIVE HIM his home medications (nevermind that his bp was 60/40 and his home meds were bp meds, diuretics, and coumadin), so I’m going to have to hang up with you and talk to HIS CARDIOLOGIST to get him in here to DEMAND he RECEIVE his HOME MEDICATIONS right now. All she said is an INTERNIST was coming, and OBVIOUSLY an internist can’t handle this case but SHE DOESN’T SEEM TO CARE.”

    I told someone that I was “about to decompensate”. Later on, I went in the back room to hide and eat my lunch and not more than 2 seconds into microwaving my food, the aide and the secretary came back and said they were throwing a fit because I had not told them how much insulin I gave and the patient’s lunch tray was what he ordered for diet, but he didn’t like WHITE BREAD and HOW CAN YOU GIVE SOMEONE WHITE BREAD IN A HOSPITAL AND HE NEEDS WHEAT BREAD AND RE-CHECK HIS BLOOD SUGAR RIGHT NOW.

    Meanwhile, the patient was alert and oriented and wasn’t complaining about his food at all, etc.

    It was a study in how to piss people off in a hospital, a farce if you will.

  7. Griffin3 says:

    Hrmm … here’s one for 130GBP, which is, I dunno $200 or so? Works up to 30 meters, no promises, I see … And is not particularly legal here in the states. But, wouldn’t the confused look be worth it?

    --> http://www.globalgadgetuk.com/rx9000.htm (many other similar gadgets on that site.)

    I also found instructions for a do-it-yourself jammer, big as a pack of cigarettes, if you are more mechanically inclined than electrocutionally inclined …

  8. Ten out of Ten says:

    I had a similar experience the other day — I walked into a room and a young woman was talking on her cell phone. I stared her down for maybe five seconds or so and then said “ok I’ll be back in a little while.”

    I stayed busy for the next hour or so and then went back and she was gone. I got real excited, peaked in the bathroom, and discovered she wasn’t there either. It was like Christmas morning.

    General rule of thumb — if you’re well enough to chat away on the cell phone your probably going to be ok.

  9. LF says:

    As a preface, I do agree — cell phone does need to be curbed in many situations — particularly in medicine.

    One of my dearest friends is the daughter of a very senior firefighter/paramedic in a major US city… she called him one day to complain about a teacher, and her dad actually answered the phone while he was performing CPR on a woman. At some point in time, the woman was conscious and asked who he was talking to — he told her it was his daughter (around the same time that he said “sweetie, I’m trying to do CPR, can I call you back later??”) and my friend heard the (nearly-dead) woman say “She sounds so sweet!”

    Really and truly, I couldn’t make that up…

    I, do, however, have to admit my own transgression (but, it *was* the first indicator that my mom was going to survive a possibly fatal head injury)

    Yes, I saw the signs as I walked into the ER/Trauma Dept that my mom had been life-flighted to (Ford Explorer rollover — if you own one, sell it. I know you don’t think you can afford it, but I promise you that selling it is cheaper than the medical bills you will incur when it decides to do somersaults down the interstate) Yes, I understand that signs are posted for a reason (FDA motivated or not). Believe it or not, I do have a significant amount of respect for medical personnel (my family tree includes a doctor or two — one might be my dad).

    Anyway, by the time I made it to my mom, I had her cell phone and my own in my possession and I was trying to keep track of my dad (he couldn’t go out of town with us that weekend b/c he was on call, so he was driving to meet us at the hospital she was flown to) Fast forward through a lot of gory (but really rather fascinating — and ultimately miraculous) diagnosis and treatment… Grandma (Mom’s mom) found out about the wreck. She called my mom’s phone first, and I didn’t answer. Then she called my phone, and I knew she was really worried. After a quick, nonverbal communication with my dad and then the nurse in the room, I moved over to the corner and answered. Grandma was very clear and concise — she wanted to know if my mom was a) alive, b) going to survive and c) if she was going to survive, whether she’d know her own name and be able to walk. My mother — in a drug induced stupor (but still beautifully rebellious, as expected for one raised in the Deep South) heard her Mom through the cell phone on the other side of a 12×12 trauma room and managed a “oh lord, please, not her!”

    At that point, despite significant head trauma, the doctors (2 of them entered during this phone call) were positive she was going to make a full recovery. And, for the most part, she has.

    In conclusion… while all too often abused, cell phones in the ED aren’t ALWAYS a bad thing!

  10. morethananelectrician says:

    We will turn off our phones and not answer them when we actually get to be seen for our 9:30 am appointment before 11 am. We have jobs and responsibilities and in my 10 appointments within the medical community, I have never been seen any earlier than one hour AFTER my scheduled appointment…hard to tell someone when you’ll be done if you never know when you are going to be seen. Then we don’t actually get to see the physician, oh…he peaks in head in the door so he wont be committing fraud when the paperwork is filled out to the insurance provider that he actually “saw” the patient.

  11. WhiteCoat says:

    Bwwwaaaaahahahahahahaha. I’m videotaping my escapades with this little beauty. Do they check for stuff like this in customs?
    If you’re from the FCC and reading this, I’m just kidding. Really.

  12. DevilDoc says:

    I had a young woman the other day who answered her cell phone and had a full conversation while I was doing a pelvic exam. She just nodded at me when I finished, as she was too busy setting up her schedule for the evening to discuss the findings. I gave her ample time to finish her conversation before I went back into the room. She’d started bugging the nurses to leave as soon as she got off the phone. It seems she had to leave right away to meet one of her friends. Her “emergency” pelvic pain she’d had for 6 months seemed to disappear once she had a party to attend. She did ask for some Percocet “to get through the weekend”. Umm…no. People never cease to amaze me.

  13. nocturnal rn says:

    Oh my! I loved that clip. I so wish I could do that sometimes!

  14. EEJ says:

    Just in from Techdirt:

    We’ve known for a while that mobile phone jammers were popular with places like hotels even though they were illegal. And while a US firm selling the devices is involved in a lawsuit claiming that banning the devices is unconstitutional, they’re still very much barred. Yet, as the NY Times reports this weekend, overseas sellers of the devices (including personal ones that you can keep in your pocket) are seeing growing demand from US users, including random people who just like to mess with mobile phone chatters around them. Of course, for those of you tempted to annoy those who normally annoy you with their chatter, at least recognize that the fine for getting caught using these devices STARTS at $11,000 (in the US).

    via http://www.techdirt.com

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