Wednesday, February 15, 2017

The Texting Issue

“Who in the world ever thought that typing vs. speaking the same thought would garner so much ire?” – Dr. Melissa Walton-Shirley,, February 8, 2017

As far back as 2015, according to an Informate survey (, texting surpassed talking on smartphones in the United States.  I can only assume that the use of texting has continued to rise, at least if I go by my own behavior.  I text WAY more than I talk on my iPhone – and I bet you do, too.
At the end of last year, the Joint Commission banned physician orders via text.  Again.  

Dr. Walton-Shirley brings up some very good points in her support of texting as a means of communication between nurses and physicians, not the least of which is the speed at which treatment decisions can be communicated and implemented.  You can read her full article here

Sure, there are privacy concerns.  There are ALWAYS privacy concerns and we’re kidding ourselves if we think that banning texting between nurses and doctors will protect confidentiality.  Another issue with texting is the lack of documentation in the medical record.  Texts can be screenshotted (is that a word?) and printed or emailed and put in the medical record, but, really, why?  If the order is considered just like a verbal order, then there’s very little difference between a text and a phone conversation.  I’ve yet to see the transcript of a recorded conversation between nurse and doctor in the medical record.  

Why is it so much easier to text than to talk on the phone?  It’s quick, it’s simple, and it doesn’t require that the person on the other end necessarily stop what they’re doing in order to answer.  It also doesn’t require waiting on a call back after a service notifies a physician that her or his attention is needed.  

Will the Joint Commission’s ban on physician orders via text stop nurses and doctors from texting?  I doubt it.  And if it is my treatment or my family’s treatment hanging in the balance, I hope that nursing’s long-standing tradition of doing whatever is necessary to make sure patients get good care does not end with a simple text.

What are your thoughts on texting to communicate about patient care?

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