By the time I walked into Mr. P’s room, I just wanted ICU rounds to be over. It had been a long week. I was tired and I really wanted to sit down and take a mental break.
Mr. P was resting in bed, and his son was talking on a cell phone. He quickly hung up, then apologized, “I’m sorry, I was just talking to my sister.”
“No worries,” I replied. “Would you like to call her back? Would she like to listen in on rounds?”
Mr. P’s son called his sister. Locked in her bathroom, to get a few minutes away from her two toddlers, Mr. P’s daughter instantly became an active member of her dad’s team. We passed the cellphone from her dad’s nurse, to his pharmacist, and then to his physiotherapist, social worker and doctor. She asked us great questions, while answering our questions about how best to manage Mr. P’s symptoms.
Mr. P has lived with a permanent disability for over 20 years. His daughter has been his primary care giver and medical historian for much of that time. She knows him better than anyone else, whether it be regarding his wound care, medications, pain management, or therapies.
The expertise she shared helped us improve the care we were providing. Personally, I was energized by the whole experience. The look on Mr. P’s face as he listened to his daughter teach us about his care was a mix of pride and gratitude. The fatigue I carried into his room was lifted.
I wouldn’t have thought to have a family member call in to an everyday bedside rounds if Mr. P’s son hadn’t been talking on a cellphone that day. I’ve done many planned family meetings via teleconference but never a spontaneous one like this. I was reminded of Mr. P and his children as I read some of the recent emails on the Canadian Critical Care Google group.
Last week a nurse educator posed a question to the 700-odd members, asking about ICU policies or guidelines about cellphone and wireless device usage in the ICU. Two camps emerged.
A few participants raised concerns primarily focused on noise levels in the ICU. A nurse wrote, “My concern with cell phone usage in the ICU is the potential for the place to turn into a zoo… All it takes is one relative in every bay and the noise level increases exponentially.” Other participants raised similar concerns about the noise that could arise if cellphones are allowed in the unit.
But I was heartened that more people spoke up in favor of patients and families using cellphones.
“Technology is here folks, I say embrace it. If you can bring comfort to an ICU patient by giving them some FaceTime with a beloved, distant relative or friend then yes, let’s do it.”
“My suspicion is that families will be respectful and it would be a rarity that they would be loud.”
“[Cell phone] use has been fantastic. I will never forget the young girl who was scared but she was texting her sister who couldn’t be with her – she was about to be intubated and it really helped her.”
I did a double take the first time I saw one of my patients texting while intubated. I’m used to critically ill patients sitting up, awake, waving at me from their beds. But texting?!
To those who are reluctant, I say try it! Use your QI skills and curiosity to do a quick PDSA examining the effect of letting patients and families use cellphones in the ICU for a week. Measure the impact. Ask families, patients, and nurses how the week went. Analyze what you find, then share the results as a comment to this post. I’m interested to hear about your experiences.
Photo Credit: IronRodArt – Royce Bair (NightScapes on Thursdays)’s