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I'm not comfortable text-messaging physicians for orders. What should I do?

Friday August 24, 2012
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Question:

Dear Donna,

I am concerned about cell phone use at work. I have a per diem position in a rehab center and notice many nurses on their cell phones behind the desk, at their carts and around their patients. My biggest concern is when I called a physician to obtain orders for a patient, he instructed me next time to text-message him. I asked the nursing supervisor if we are supposed to text physicians with our personal cell phones to get orders. She told me that physicians prefer to be texted.

I do not feel comfortable texting patient information on my personal cell phone for a number of reasons: HIPAA, the doctor having my cell phone number and looking unprofessional on the unit. I want to bring this to the nursing director’s attention, but this appears to be the norm. All the nurses tell me they feel comfortable doing this. It has nothing to do with comfort; it has to do with patients’ rights and violations. I don't know how to handle this. I don't work there that often, but I feel that this will be a problem for me in the future if I have to contact a physician.

TJ in N.J.

Dear Donna replies:

Dear TJ in N.J.,

The situation you mention involves many issues related to confidentiality, ethics and legality, professionalism and appropriateness. If texting is being used, there should be a dedicated phone to be used by staff. The staff should not be using personal cell phones to send or receive texts for work. There also should be a clear written policy in place about texting, use of personal cell phones and so on. I'm assuming one doesn’t exist or it is not being followed.

This certainly is a matter you should bring up with your immediate supervisor and unit quality improvement coordinator, if you have one. If you don’t get any response or resolution, then speak to the next in command (e.g. unit or department manager, etc).

Here is a white paper issued by the National Council of State Boards of Nursing regarding use of social media by nurses: www.ncsbn.org/Social_Media.pdf. Scenario No. 6 (scroll down) relates to texting in the healthcare setting. You can find additional related information online. By all means, share this paper with your supervisor.

Best wishes,
Donna


Donna Cardillo, RN, MA, well-known career guru, is Nurse.com’s “Dear Donna” and author of “Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional” and “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career.” Information about the books is available at www.Nurse.com/CE/7010 and www.Nurse.com/CE/7250, respectively. To ask Donna your question, go to www.Nurse.com/Asktheexperts/Deardonna. Find a “Dear Donna” seminar near you: Call 800-866-0919 or visit http://Events.nursingspectrum.com/Seminar.