Do nurses at your LTC facility text the docs?

[inkydorei, LVN]

i had a nurse tell me the other day to "just text Dr. H and he will text you back the order" What??!!

i have not been told by Dr H or management that this is accepted practice, yet several other nurses have said 'oh yea, we do that all the time.'

Do you text your doctors for orders? Do you feel comfortable doing so? Is the response time shorter when communicating with the doc this way? Have you ever sent a text to a doc only to have him/her say "I didn't get it"?

i've been doing this for a long time---i will never forget the day i learned to use a fax machine! i think my biggest concern is sending a text to a wrong number, with all my patient's information, which would result in a HIPAA violation.

Any comments, advice, thoughts?

[mamamerlee, LPN]

There absolutely MUST be a policy about this practice. It just blows my mind!

[CoffeeRTC, BSN, RN]

Um...heck no. I like the good old fashion talking thing. Until this becomes policy and we have the equiptment in place etc. No.

Are they using their own phones?

[inkydorei, LVN]

i'm assuming they are using their own phones. There are no company cell phones available. i'm like you, Michelle, i want to talk to a live person. We had one doc who would fax us orders, and i didn't like that either. i was just wondering if this is acceptable practice in other LTCs.

[inkydorei, LVN]

oh, and for clarification purposes, when i said i have been doing this a long time, i meant working in LTC......NOT texting docs :)

[shiccy]

We have text pagers in our hospital (Level 1 trauma center). The only # I know is Trauma's pager, and they call back nearly instantly and give VERBAL orders. If you think about it, V.O. stands for VERBAL order, T.O. is typically Telephone order ... Never have I seen/heard someone TEXT orders back. There's too much at risk, you can't ask questions, etc.

Texting is NOT *NOT* a "secure" method of communication. It's sent in plain text, can be reviewed as plain text by anybody in the phone company, etc... HIPAA would have a field day with this one. The way *I* get around this is typing ONLY the room #. This way they HAVE to call back because you technically should have a double identifier when giving/getting orders... Nobody does it, but it's something that should happen. If you use a room number, this is NOT a patient identifier, thus you don't have to worry about HIPAA at all :)

[yadda_yadda_yadda, LPN, LVN]

Absolutely NOT.

A Text message shouldn't be considered a verbal, written or telephone order.

In my state, anything other that a written & signed order requires read-back for confirmation & clarification..which certainly couldn't be done via TEXT.

This is insane & illustrates the utmost laziness I've ever seen (or heard about) in health-care.

The only circumstance our cell phones are used for where I work is to communicate with our supervisors. They've voiced that they appreciate updates & changes via text msg, rather than a potentially rambling phone call. They can check their msgs @ when they have time, with little or no significant disruption to their time away from work.

But texted orders from MD's, PA's or ARNP's ..... ABSOLUTELY not.

What is heath-care coming to?

[cebuana_nurse]

If you use a room number, this is NOT a patient identifier, thus you don't have to worry about HIPAA at all :)

A preceptor of mine kept repeating the same thing to me when I was writing the room numbers down on who takes their pills crushed or whole. She said that anything that is related to patients is confidential information. Therefore if you write it down and take it home with you, it's a HIPAA violation. So, is this true or not?

[bluemartian, BSN]

Ive thought about the popularity of texting, it just seems to be a generational thing, but with that said I certainly can see the value in texting pending that proper nomenclature is used and never use abbreviations or text slang, no you have a whole new world of errors. I agree with one of the previous posters, a policy should be in place if this menthod of communication is used

[shiccy]

AFAIK room numbers are not HIPAA b/c they're not allowed per double identifiers to be used as a form of confirmation of identity. When you give meds, for example, room numbers cannot be used bc a room number is a fickle thing and can be different tomorrow vs today... a birthday, mrn, visit number, and (obv) name cannot change, thus those ARE. Also age is considered HIPAA as well, from what I've been told...

[CoffeeRTC, BSN, RN]

Don't cell phone companies keep a record of text messages? Not too much privacy in that, huh? What about an attorney getting ahold of them?

I don't mind a faxed order. Sometimes we fax things to the doc that might not warrent a call. (FYI doc, so and so got a skin tear and we are treating it per P and P) or when we fax the labs we might add a note to it (s/s, assessment of current condition) and the doc will fax back an order. ...I do beleive we have a P and P in place for this tho.

[red2003xlt, LPN]

Unguarded communication regarding confidential data is grounds for one helluva lawsuit.

A phone call or encrypted email would pass the legal test, texting doesn't.