Qs regarding pages on call/nightfloat

[Barry Otter]

Hi all,

I realize this is going to depend a lot on specialty, program, rotation, and PGY level, but on typical call or float nights, do you have a significant number of pages that require traveling to a different part of the hospital to address, rather than taking care of over the phone? How many of those could be avoided if you were able to see and talk to the nurse or patient over video?

I'm a med school grad now in tech, and I'm trying to gauge how helpful an intra-hospital video app would be for reducing the number of such scenarios. Thanks.

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[cbrons]

Don't things like this already exist? I.e. skype

 

[ThoracicGuy]

Hi all,

I realize this is going to depend a lot on specialty, program, rotation, and PGY level, but on typical call or float nights, do you have a significant number of pages that require traveling to a different part of the hospital to address, rather than taking care of over the phone? How many of those could be avoided if you were able to see and talk to the nurse or patient over video?

I'm a med school grad now in tech, and I'm trying to gauge how helpful an intra-hospital video app would be for reducing the number of such scenarios. Thanks.

Rule #1. See the patient. A video conference call doesn't work. No need to video with the nurse... unless she's really hawt.

 

[BigSib]

Highly variable depending upon census, acuity of patients, types of problems, experience of nursing staff, and general daytime communication among all of the providers for each patient. # of pages ranges from a handful to 20ish overnight for our range of 12-20 adult inpatients. I don't feel having a video app would really benefit the situation because the calls are usually quick/dumb questions (tylenol isn't already ordered, patient wants to shower, patient can't sleep and wants benadryl/melatonin, etc.) that don't require a face-to-face. I always liked having the pager because I don't have to respond immediately when I'm doing something more important such as already seeing a patient or something. Nurses should be able to tell me over the phone what's going on; there are certain types of problems that need to be seen in person regardless as well.

 

[RangerBob]

I can't think of a single time I'd use video conference. I take home call at my program--if I'm concerned I come in and look at the patient in person, talk to them in person, and do an exam.

I think the usefulness of video conference comes into play more with outpatient visits/telemedicine.

 

[WinslowPringle]

Zero of my call pages would be avoidable by a video compared to regular phone. The patient is either fine and I don't need to see them or not fine and I had better be seeing them right away.

 

[Gastrapathy]

not relevant for use with house staff, but this is already available lots of places.

 

[Raryn]

When doing general medicine, either I have to physically lay eyes on the patient, or I can take care of it via phone/text/the EMR. I suppose there might be the rare circumstance if they wheeled in a camera to the patients room and showed him to me that may be helpful. The tele-ICU guys do it. But when doing general medicine, I'm in-house anyway, so it would be better to just go physically see the pt.

Regardless, in my current subspecialty, I can't think of any circumstance I'd have to physically come in in the middle of the night, so it doesn't matter to me.

 

[Barry Otter]

Thanks for the feedback, everyone. I had in mind an app that would do something like send dual pages to both pager and cellphone, so that housestaff would have the option of responding through the phone, or clicking a link in the SMS to start a video session with the person who paged. So that would've been a point of differentiation from other Skype or telemedicine app. However, from the responses here, it's clear that it would not be very useful for residents.

 

[Psai]

Thanks for the feedback, everyone. I had in mind an app that would do something like send dual pages to both pager and cellphone, so that housestaff would have the option of responding through the phone, or clicking a link in the SMS to start a video session with the person who paged. So that would've been a point of differentiation from other Skype or telemedicine app. However, from the responses here, it's clear that it would not be very useful for residents.

Responding to 2 pages? Hell no. Why would I want to video with the nurse? Like everyone else said, it's either something easy like a sleeping pill order or something I need to see the patient for. Video doesn't help either way.

 

[AdmiralChz]

Yeah, when I interviewed at Emory (I think?) last year they showed us their Tele-ICU where you can call a night covering MD with issues from the patient's room... extremely awkward. As an intern/resident you are best just going and seeing the patient yourself if you have any questions, or just replacing the damn potassium.

 

[caffeinemia]

Rule #1. See the patient. A video conference call doesn't work. No need to video with the nurse... unless she's really hawt.

The only instance i've seen of video conf is between attending at home and resident in hospital. Otherwise, always see patient. There are something the hands are more adept at detecting than the eyes. Also, there are somethings that nurses just won't do -- whether it's put in tubes or various sorts or pulling tubes -- in which case, you're **** out of luck and will still need to see patient.

 

[MediCane2006]

This is somewhat useful in Plastics when evaluating flaps/wounds (especially free flaps) and is in somewhat limited use in that context.

 

[backcountryrez]

IMO, video consults could be a novel approach, but it's hardly personal when looking at it from the patient's point of view. A local hosp (not academic) provides a telemed service for at-home hypochondriacs. Sure, it could be "personal", but it cheapens the profession.

 

[evilbooyaa]

My goodness. If you're already in-house you're either answering the call and that's the end or adding it to your list of people to see.

Two pages for the same thing and I have to talk to the nurse who can see me (so I can't roll my eyes)? No thank you.