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How Technology Can Make The Doctor-Patient Relationship Impresonal

At work, we have Voceras.  They are little phones that we wear around our necks.  We use them to call each other, other departments, take phone calls.  They were a little annoying at first and kind of hard to get used to using, but now we all use them every day and I personally have found them to be really helpful.  Our unit is large, and instead of walking around trying to find Susie Q RN to tell her she has a phone call, we just click our Vocera button and can reach her instantly.  Easy.

They added a feature a little while ago.  The Voceras now tie in with the patient monitors.  I don’t know how it all works; for all I know, the unit secretary brings out a magic wand, chants a spell, and then the monitor and Vocera both know what patient I have that day.  This results in a couple of things.

First, when MY particular patient puts their call light on, in addition to hearing it throughout the unit, my personal Vocera makes a sound so that I know without looking around that it’s my patient who needs help.  Next, and this is pretty interesting – when my patient has an arryhthmia, my Vocera makes a “do-dunk” sound.  It kind of sounds like a knock.  I look at the little screen and it tells me which room is alarming and what the alarm is.  All very helpful when I’m in my other patient’s room.

So one day, I had a patient that wasn’t doing very well.  We were communicating with the patient’s family and trying to decide whether or not to make him a no-code, or withdraw life support altogether.  It’s an understandably difficult decision to make and the family was struggling with it.  As the day wore on, though, the patient was becoming more and more unstable.  The monitor started alarming, which made my Vocera start doing its “do-dunk” sound when the patient started having bradycardia.  The family still wasn’t comfortable with the idea of taking him off of life support though.

Then it came to be my turn to go to lunch.  We had a break nurse, so she could completely take over caring for my patient and only my patient while I was gone.  I brought her up to speed on the situation.  As I left, I could see the family coming out of the room to talk to the nurse that took over for me.

I went to the cafeteria to get lunch, brought it back to the break room, and started to eat.  I was talking with a coworker about our kids when I heard the familiar “do-dunk.”  But when I looked at my Vocera, it said, “Room 2-0-1-1 ASYSTOLE.”

And that is how I found out, over lunch and lighthearted conversation, that my patient had died.

I told my co-worker what my Vocera said, and without even looking up she replied, “You know, you can push that ‘Do Not Disturb’ button.”

Um… yeah.

When I returned from lunch, the break nurse started to say, “Your patient…”

I just said, “Yeah, I know.”

*This blog post was originally published at code blog - tales of a nurse*

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