Facebook in the ER

Facebook is strangely interwoven with my job in the ER---like it or not (mostly "not"). There is the patient privacy/departmental policy sector. We are not allowed to be on Facebook at work, nor may we discuss patients on Facebook. I run hot and cold on the former. I feel the hospital should trust our judgment about whether or not it's dead enough that we can waste time online, but whatever. Their money, my time, I get that. The discussing-patients thing is a nonissue. Even before the hospital issued a "don't do that" e-mail I was a big PITA, messaging people "take that room number off! That's a HIPAA violation!" So mainly, Facebook involves my job through patients and THEIR Facebook accounts. They update Facebook constantly. CONSTANTLY. They have us take photos of injuries they can't reach so they can post the photos to Facebook. I am not making this up. "I want a photo of my hideously dislocated ankle/knee/shoulder but I can't move, so would you mind using my phone to take a picture for me?" And they keep updating and updating. I have actually said, "I'm about to give you a medicine that is going to render you unconscious immediately, so you should set your phone down." They commemorate situations that go in the category of "stuff that will keep you from being hired someday," like "here is a photo of me and my roommate when we got sooooo drunk we passed out in the snow in front of our dorm and had to go to the ER! Look, you can still see the vomit on our shirts!"

Facebook can have more oblique and bizarre effects. Example: I had an overdose patient (this story, obviously, has been scrambled like Reagan's brains) who had not been able to reach his therapist and continued to be unable to do so in the ER. You couldn't pry his Blackberry away. He was texting the therapist's receptionist. This apparently is how he customarily reached the therapist. Text. Text. Text. I watched his anxiety creep up. I watched him make phone calls and leave messages (enviously, because we iPhone users can't always do that whole voice thing). I could tell he was really freaking out, and who wouldn't be? I'm guessing that if you take a serious overdose, then whether you "meant it" or not and whether you're gonna die or not, you WANT your therapist to know, and you want to KNOW she knows. (NNR is not screwing with you. This does relate to Facebook. Keep reading.)

So the patient kept chillin' with me, 1:1, and behold! The sonar sound finally came. "She says she's not talking to me anymore because I unfriended her on Facebook." I'm talking about his therapist's RECEPTIONIST here. Not passing along messages because of Facebook drama.

My patient, puzzled, said he didn't unfriend her. The guy was actually tearful. I had a lightbulb moment on account of Facebook had just rolled out their new page design (the only from recently) and dropped a handful of MY friends, several of whom noticed and were upset, so I asked him if he just got the new design. He didn't know because he just had his Blackberry interface. We used a COW (computer on wheels) to check, and he had the new design. Mystery solved (see, being a geek CAN help patients!). He texted the answer to the unfriending mystery, and right after that he was transferred, so I don't know how it turned out.

But...really? These days you can't get a message to your therapist that you tried to kill yourself because her receptionist is pissed off that you unfriended her even though you didn't but she thought you did because Facebook jacked up its page-design rollout? Argh.