How I miss my beloved text-paging

[evilolive, BSN, RN]

For the first 16 months or so of my current job, we had this glorious, convenient way of communicating with whatever in-house hospitalist was covering our unit - The Text Page.

With The Text Page you could send a nifty little message to Dr. to get a short and sweet message across. It especially worked well for when patients refused a medication - this way Dr. can get the heads up that LOL refused her Senna at 9pm, and you don't have to slow his roll if he's in the middle of an admit. Not like he really cares that granny refused her med, unless she's constipated.

Hey doc, can you please put in CVAD verification for Pt. XYZ? Five minutes later you can "officially" use the PICC that day shift began using anyway.

We could even request pain medication, let them know a DNR/I had to be signed, etc. etc. Of course we would call if something emergent requiring their help was needed, or if the situation was too long to be explained via text, or if the MD was taking too long to enter orders/reply to the text.

Some MDs made damn well sure that the night nurses communicated this way. It made life simple, sweet, and easy for everyone involved.

Can you see where this is going?

Of course all good things must come to an end. From what I understand, a Cardiologist at my facility made a HUGE stink, calling The Text Page a HIPPA violation. Per my manager, we are no longer allowed to use this method of communication at night. Because of this, I have truly had to DRILL into my nurses' heads what does/does not warrant a physician call overnight. DO NOT call to d/c orders like blood glucose tests that you did anyway, and aren't due until the morning. DO NOT call because your patient is refusing to drink contrast (per day nurse) and you haven't attempted to resolve the issue yet.

My question to all of you is, have you ever used a form of communication this way at your facility, and was it ever shot down by someone higher up the food chain? I say if text paging your unit, room number, and initials of the patient are a HIPPA violation, then the Bedboard/Transport beepers who use the patient's full name, MR#, attending physician and diagnosis are even more of a HIPPA violation.

At the end of the day, all of these beepers are for In-House use. What is the problem here?

[Fribblet]

The problem is that it was working and made almost everyone happy.

[rn/writer, RN]

If you know the person you are texting and it's done on in-house equipment and you aren't using names, I don't see how this is a HIPAA violation.

Next thing you know we'll be offering patients masks or bags to put over their heads so no one will recognize them in the hallway.

[K+MgSO4, BSN]

I would be lost without the text paging. We use it for everyone docs, porters. Is great cuts out confusion and ours is recorded on the system so if someone says I didn't get a page about X your manager can request the system to be searched to support you. Save me and a collegue a lot of drama about a porter denying he got paged when we had the evidence. He had left work & didn't tell anyone and we lost a unit of blood.

I don't understand HIPAA as I work in Oz but if it going from a work computer to a hospital pager then where is the issue?

[NurseBlueBear]

We still use text paging for a lot of things. The doctors and the nurses have them. We have a certain way that we enter pt information so it won't be a HIPAA violation, and they monitor ALL the pages to make dang sure that we do it right.

[shiccy]

We have text paging as well. We don't have computerized ordering yet in our hospital, so when we text page, what *I* would do is put a room number and the reason for the page. The PA's in house would make a decision on whether it was important or not to call back immediately or "asap". It creates less aggravation for them when they call back for something unimportant between stitches.

A room number alone is not a violation. Name, room, and MRN/DOB *is*, though IIRC txting is encrypted so unless the pager is lost it shouldn't matter.

[KyPinkRN]

If you are using this information for direct patient care... it's not a HIPAA violation. Perhaps that Cardiologist needs some more education on the finer points of that legislation. Or maybe you should start routing all night time calls through his personal phone... just sayin.

[glutton4punishment]

OMG, I wish we had text-paging. Geez, that would be sooooo awesome. Nope, it is 2011, and we are still doing everything on paper.

[RadBSN]

I love text page, I would be so sad if it went away! I don't understand how it's a HIPAA violation if the intended person is receiving the message and has a "need to know" this information.

[stefanyjoy]

I work in health insurance and it is not a HIPAA violation ... Does the sun rise and set on this cardiologist's ass? Why wouldn't someone who actually knew HIPAA educate this provider and let you all be on your merry way?

[anotherone, BSN, RN]

my facility uses text pages and i can't imagine not using them now. It would be insanity..... Esp for small issues the md and you don't have to spend precious time playing phone tag etc.

[belgarion]

If you know the person you are texting and it's done on in-house equipment and you aren't using names, I don't see how this is a HIPAA violation.

Next thing you know we'll be offering patients masks or bags to put over their heads so no one will recognize them in the hallway.

Covering a pt's face isn't that far fetched. At a hospital near me the chopper pad is about a half block down and across the street from the ER. One of the pointy haired managers decided that a sheet should be placed over the pt's face during the transfer from chopper to ER. You know, just in case someone in a passing car recognizes the person on the stretcher and decides to twitter the world about it. So now the rubberneckers all think they are hauling a dead body in.

In keeping with the law of unintended consequences HIPAA has grown from a simple little law that made perfect sense into a hugely subjective mess.