Recently, I was in a hospital elevator when three hospital employees walked up to it separately, all deeply concentrating on their smartphones. Their smartphones collided, and they looked up dazedly, sheepishly apologizing as they stepped on to the elevator. Then all three resumed communing with their smartphones. From where I stood I could see that at least two of them were not doing patient or work-related activities on their phones. I considered this research and not elevator eavesdropping.
By now everyone has heard of the dangers of cell phone and texting distraction while driving, although state laws banning or limiting cell phone use while driving seem to be scoff laws. Being a true Seattleite, I bike to work on our lovely Burke-Gilman bike trail. This used to be almost idyllic but now I have to watch for bikers on their phones, weaving as if they’re drunk. I am not a complete curmudgeonly Luddite: I own an iPhone, but I don’t use it while riding my bike, driving, or walking onto a hospital elevator.
A recent NYT article on distracted doctoring and distracted nursing highlights the extent of hospital personnel using smartphones, computers and other electronic devices for things other than work, including when they are doing patient care—even when they are doing surgery. (“As Doctors Use More Devices, Potential for Distraction Grows” by Mike Richtel, 12-14-11). A neurosurgeon reportedly was talking on his cellphone (using a wireless headset) during a surgery that got botched, leaving the patient partially paralyzed. An OR nurse in Portland was reprimanded for surfing an OR computer for airfares while she was covering a spinal surgery. And then for the truly frightening, over half of 439 technicians surveyed admitted to texting while monitoring heart bypass machines.
When my father was in the hospital last year, I noticed that his nurses spent much more time on the mobile computer stations outside of his room than they did in direct patient care. He had some terrific nurses, and they told me that they hated how much time they had to spend in checking and entering patient data in the computers. The legitimate use of technology in health care is all in the name of patient safety. But at what cost does it come in terms of the human interaction necessary as the core of all healing?
The angel statue in the photo is on a cellphone…
This drives me crazy too. I work on a med-surg/telemetry floor where most of the staff is half my age. On Christmas Day (my holiday to work), the 3 other nurses with whom I worked were playing Scrabble (or some such game) on their iphones. When I tried speaking to one of them, she continued staring at her iphone, saying, “I’m listening . . .” This made my day! This goes on all the time, and It’s so rude/infuriating — they’re compulsively addicted, and I can’t stand it.
I’m reminded of a comment I heard on MarketPlace Tech Report a couple of months ago by one of the authors of a recent report on Health Information Technology and Patient Safety sponsored by the Institutes of Medicine. The commenter (Dr. Ashish Jha) alluded to a downside to the adoption of Health IT systems: “Physicians started spending a lot less time at the bedside and they were spending a lot more time staring at the computer screen, and interacting less with nurses and interacting less with patients.”
The comment prompted me to blog about usability and confusability in Health IT: doctor-computer interaction vs. doctor-human interaction, speculating on really good or really bad design as potential explanations for the displacement of attention. Your post – and the articles it links to – suggests that this distraction and displacement may be more widespread than any problems associated with the use of Health IT systems.
The comment above by lisa janak reminds me of a post on Crafting my Own Safety Net that I just read at Pulse Magazine (“voices from the heart of medicine”) about one doctor’s encounter – as a patient – with another doctor (suffering from “a malignant case of overconfidence”) who did not listen to her when she returned for a second visit concerning unexplained symptoms. Since this story (by Dr. Nicola Holmes) does not reference technology, I suspect the problem is broader still, and that while technology – especially smartphones – can exacerbate problems of inattentiveness, it seems distraction may be a more general symptom of a more general problem of authentic engagement among various “participants” in health care.