Communications Emergency In My Hospital: What's a Hospitalist To Do?

by The Happy Hospitalist

I've got to admit, it was probably one of my greatest mornings ever.  Not a single page until after noon.  I thought for sure my daily education with nurses regarding what's appropriate to call and what can wait until rounds was sure to be taking hold.  Then I learned the truth.  The pager system was down.

My fellow hospitalists and I are stuck on 1980's technology.  The pager.  I got my first pager in 1997, one year before my first cell phone.  I was a second year medical student.  I'm not sure why I got it.  I think having a pager back then was cool.  

And I swear, I'm still using the same pager technology today as I had 13 years ago.  No texting, no pictures.  Just a beep or a buzz and a call back number. That's how Happy gets notified by nurses.  That's how I respond to code blue arrests.

And twice a week at 10 A.M. our operators do a pager check to make sure they are working.  That day I happened to be one one carrying the test pager.  It was past ten and no page.  They called me.  I said I didn't get the test page.  They said they would look into it.

And that was that.  I assumed they got it worked out.  Still, no pages.  It was wonderful.  Then I got a text to my iPhone from my nurse coordinator.

12:30 pm
Nurse coordinator:  Where are you?
I called her 
Happy:  I'm rounding.
Nurse coordinator:  Your patient in withdrawal has been on the floor for over an hour waiting for orders.
Happy:  I guess I can't write orders if nobody calls me.

I'll be honest, it was the greatest five hours of rounding ever.  Not a single interruption for things that can wait.  Unfortunately, my patient was in alcohol withdrawal waiting for me to see them.  After I realized the pagers still weren't working, I had the operators divert all my calls to my cell phone.  

That worked until about 4 pm when my cell phone went dead, from all the unnecessary calls that could have waited to be addressed during rounds, or the next morning.  By now I'm admitting patients through the ER and fielding patient calls from frantic nurses wondering if I could write an order for some Colace.  

And how am I getting all my emergency and not so emergent pages by now?  They're paging me overhead.  For three hours that day, everytime someone needed to talk to me, I was paged on the overhead paging system.  I'm  sure I missed half of them.  This sounds like a hospital communication's emergency break down to me.

Perhaps it's time to upgrade the hospital's communication system.  Unfortunately, these types of capital improvements cost money, money that's becoming more scarce with every passing year.  I wonder what other hospitalists use to keep in touch with their ER and nursing staff when everything stops working.  Do you have emergency communications protocols in place?

Does your hospital provide you with cell phones or pagers?  Do you provide your own?  Which do you prefer?    What happens in your hospital when your communications sytem goes down