A Tale of Two Phones

Volume 38 Number 6 | December 2024

Heather R. Parks, MS, MLS(ASCP)^CM, ASCLS Today Volunteer Contributor

Or shall I say, many, many phones. And phone calls.

While brainstorming about patient safety, I thought back to times when I (gasp!) have made mistakes in the lab. Usually, I did not hit save on the computer, I entered something wrong, and luckily, I caught my mistake. What was happening when I made these mistakes? Most of the time, distractions broke my concentration.

Curious how other people handle distraction, I turned to my favorite lab social media group and asked, “What are your biggest distractions at work? How do you deal with them?” Wow, talk about a lively discussion! Common answers:

• Self-distraction
• Co-workers talking and making excessive noise
• Instrument alarms

But by far, the hands-down winner was PHONES.

The first phone in this story is the work phone: that innocent-looking, crucial block of plastic. We use it to call critical values, answer questions, confer with pathologists, and question specimen integrity. But when they ring too much, they distract us.

In hematology, we field calls all morning from nurses ready to start chemotherapy. I know they are looking out for their patients. I don’t want the patients to wait, either. But constant calls during the morning rush can put us behind for hours, delaying care for other patients and resulting in errors.

We are not superhuman. We can get overwhelmed, exasperated, and pulled in many directions during these high-volume hours. People in my social media discussion mentioned excessive calls about:

• results when the specimen was just received
• status on blood products while working on massive transfusions and critical patients
• results that are already posted
• add-ons
• specimen collection requirements
• appointments (from patients transferred to the lab)

During these calls, I take a deep breath, remember I am part of an interprofessional team, and put myself in their shoes. Sometimes their calls are necessary to address lost specimens and patients needing transfusions.

According to Melissa Urban, author of The Book of Boundaries: Set the Limits That Will Set You Free, setting “clear and kind” boundaries is healthy for us and our relationships. After reading this book, I feel better about kindly (or firmly) expressing myself to the callers. I can say things like:

• I’m working on a critical patient right now; can you call back in 10 minutes?
• I am working hard to finish this, but the phone keeps ringing.
• We have an instrument down and are trying to fix it. Please expect delays.
• This is a complex specimen, and I need time to work on it to ensure accurate results.

To my management team, I can say things like:

• The phone calls from the infusion center happen too early and often. Can you talk with the manager and ask them to limit phone calls? Their premature calls are distracting and put us further behind.
• Let’s consider a small call center to buffer these calls. This was helpful at one place I worked (true story).
• Can you alert the emergency department that we are repairing an instrument and to hold phone calls if possible?
• The call volume is overwhelming and breaks my concentration when working on difficult specimens. Perhaps we can add a second person to this bench or enlist the help of a lab assistant.

Kindly and frequently alerting our managers to these excessive calls does help. I also try to remember that my calls may distract nurses. Our computer system, Epic, allows for secure messages to nurses. Have you ever called a nurse only to hear them out of breath and a patient vomiting in the background? I try to remember they may be busy, exasperated, and hungry, too.

The second phone in this story is the personal cell phone, which does not require much explanation. Many people answered my social media query complaining about co-workers on their phones too much: scrolling, playing, messaging. They are not only worried about the cell phone taking attention away from patient care (not to mention infection control risks) but also about teamwork being negatively impacted. While Worker A is playing on their phone, Workers B, C, and D could use help with testing and department chores.

Personal cell phones in the lab is a huge topic, and many of us feel they are necessary. What if your child gets sick at school? The schools have my work number, but only once has a teacher called it instead of my cell phone. What if I am on a floor for a bone marrow procedure and need my co-worker to bring supplies? Our procedure room has no phone!

When using cell phones, discretion, ensuring patient privacy, and consideration for the team are key. Most importantly, we need to focus on patient testing without distraction. Try powering down your phone and putting it in your locker for the first part of your shift. It may help you focus.

That said, I admit seeing a cute animal picture or cartoon on someone’s phone does boost morale and sets the tone for my shift. My friend Kenley modeled for the “cell phone use at the bench” photo. He is a good sport and joked that the only games he plays at work are games about being a better employee. Let’s make an effort to set healthy boundaries around phone calls and phone use. Professional discretion, respect for patient privacy, respect for our team, and, most importantly, minimizing distractions for accurate results are fundamental. Let’s do it for our patients.

Reference

• Urban, M. (2022). The Book of Boundaries: Set the limits that will set you free. Random House.

Heather R. Parks is a Medical Laboratory Scientist in the Core Lab at the University Hospital in San Antonio, Texas.