I stopped to visit a friend in the hospital and had a chance
to observe some clinical workflow in person.
The Nurse walked in. She had a
large brick of a phone wrapped in a plastic case pulling the side of her scrubs
uncomfortably down. She began asking
questions as she prepared the medications. She reached into her pocket and pulled out an
Iphone……confusing…..then I realized it was her medication scanner.
As she was preparing to hand the medications to my friend
the brick rang…..loud….very loud…. She apologized as she reached down and
complained that the previous shift must have had the ringer turned up. (I was
there at 8am in the morning so evidently night shift likes to carry a mobile
alarm clock) She silenced it and went back to medication work. I asked “Do you like your phone” – she held up
her iphone and said “This isn’t used as a phone it’s just for meds and stuff.”
I laughed and smiled “No the brick wrapped in bubble wrap hooked to your
scrubs.” She laughed and said “No
Comment” as she finished putting the medication in the cup and talking to Holly
she looked at me and said “That thing interrupts me when I am trying to work
with a patient and it’s just rude to the patient. I don’t think it’s very
practical…..I like to be fully engaged when I am with a patient”
Ouch…every technologist who has designed a decentralized
workflow should wince when they hear that – this nurse is a young lady who grew
up with a cell phone in her hand wanted to be what? “fully engaged with her
patient” She wanted to walk into a
patient’s room and only think about what she needs to do in that moment. She wanted to focus on getting my friends
medications accurate, make sure she didn’t miss any aspect that could be a
warning sign…..crazy thing….she wanted to be a nurse.
As I worked on this post – I started writing about ideas for
fixing….pointing out that holding on to old technology only hurts your facility….listening
to nursing because they actually do the work….blah blah blah…..but then I
started think this isn’t just a hospital thing.
I was sitting in my family room – Noah (aka #4) on my lap
talking about his day and my phone rang…..in that moment I stopped engaging
with Noah and answered my phone…I tried to justify in my mind that I had tried
to get ahold of this person all day and needed the information….as I hung up
Noah said “Mom, can you just talk to me for a minute”….ouch…. As I began
writing this blog for “Linkedin Content” to promote my industry knowledge…..I
am pausing for a moment.
Our workflow design reflects our society design….the nurses
response is reflecting the shift in our society to tolerate interruptions. She recognizes that everyone would like a bit
of undivided attention, especially when they are in a new environment. She recognizes that the technology she had
been given was not serving her well and was making her less effective in her
job. She recognizes that – just like
Noah – her focus on my friend in that moment should be the most important part
of her day.
So this post should serve two purposes – rethink how you are
designing your clinical workflow and alarm design. Clinicians are fatigued because their
attention is constantly being split.
Clinicians are fatigued because we, as technologist, aren’t doing our jobs.
The second purpose – does your personal life reflect an
interrupt driven society? When will that become not ok for you?
Last night…..I left my phablet in the kitchen….turned the
ringer off….and enjoyed my family and some friends. It was probably the best night I have had in
months…..today…..the ringer is still turned off.
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Thanks for Posting on Clinical Transformation!
Kourtney Govro
kgovro@sphere3consulting.com