Not Nurse Ratched

Texting fetus, from splendidmarbles.com

Technology plays an increasingly interesting role in probably all walks of life, and hospitals are no exception. I already wrote about Facebook in the ER, and that kind of thing continues. “Hang on…I’m updating my Facebook status” or “Let me take a picture of that before they stitch it up.” I’ve seen a few cell phone photos of “my first IV” snapped and sent to Twitter, and I’m pretty sure I’m in the background of a few home videos.

People bring all kinds of gadgets with them to the hospital. Students bring their laptops to work on papers while they wait, and adult children bring theirs to catch up on work while they wait for their elderly parents to be admitted. Everyone has an iPod of some flavor (yes, an iPod; I’ve heard of other brands of MP3 players, but I don’t see them). Everyone has a cell phone. I’ve seen only one iPad, and its owner was eager to show it to me (I feigned amazement). My favorite gadget story is from a long time ago, though, when I was still an aide on the floor. I was helping a new admit get settled, and she was a fairly elderly lady. She pulled out her bag, from which I fully expected knitting to emerge, but instead she whipped out a Kindle. I’d never seen one in the wild before and asked her about it. The lady launched forth with full-on geekish knowledge and enthusiasm about Whispersync and wireless connectivity. (I decided I’d be her when I get old.) I see older folks texting their thumbs off all the time, and I see toddlers thumbing their parents’ BlackBerry keyboards, pretend-texting (this is particularly cute, obviously).

Speaking specifically of texting, it adds some interesting dimensions to ER life. The cops will bring you in for a psychological evaluation if someone calls them and says you sent a questionable or worrisome text. I held off writing anything about this online at first because I thought it might identify patients, but it happens so often now that it’s a generality. And then you have your texting injuries. You hear about them in the news, like the girl who fell through a hole in the sidewalk because she was texting and didn’t see it. I haven’t had a disappearing patient, but people do step off things and run into things. I’m waiting to see someone hit by a car because they were crossing the street while texting. And to have a car accident in which someone admits they were texting. Hasn’t happened yet, but it’s probably just a matter of time.

Staff-side, most of us have smartphones with varying degrees of usefulness for work. I use my iPhone fairly often, mostly for the calculator and the ratios program to double-check calculations (you never know when our [fancy computerized] IV pumps might miscalculate a heparin drip, do you?). The docs use theirs constantly to check formularies and I don’t even know what else. The hospitalists carry those waterproof, bulletproof netbooks around to do their CPOE documentation, and it’s frakking handy. They take them to the bedside and when they come out of the room you’ve got a complete order set ready to go. Our EKG machines wirelessly sync with our charting system so a copy of the EKG magically appears in the electronic chart. When you think about it, it’s pretty amazing.

It makes me wonder what things will be like in 30 years when I’m one of those old battleaxe nurses (I plan to be one). Will I still be an early adopter, or will I turn into one of the “back in my day” nurses? I suspect the former.