Friday, March 12, 2010

There is Superstition

I went to a medical staff meeting last night. It had been a while since I had gone to one and having attended one I realised why.

One item on the agenda which caught my eye was the hospital's reiteration of its policy towards cell phones. Based on document which it did not supply the hospital reiterated that while cell phones are welcome in certain areas of the hospital (mostly areas where administrators go with their hospital-supplied blackberries), use of them in most patient care areas including the ICUs remains verbotten.

It pained me to see the Hospital's chief executive officer (or whatever title they are using this month) stand up to explain this policy. She seems to be an intelligent lady, probably has an MBA and yet she has to stand up and repeat what is one of the biggest urban legends around: Cell phones can interfere with or reprogram delicate medical equipment.

Another way of looking at things is: You paid six figures for a ventilator, five figures for a monitor or 4 figures for an infusion pump and my little cell phone is capable of playing havoc with them. Maybe your purchasing department should have exercised a little due diligence when they were selecting which make and model to buy. It is interesting that the initial point of contact for buying medical equipment is usually a trade show at a medical conference. Who attends trade shows? Sales reps who are attached to their cell phone and doctors who are likewise attached. Think of the amount of radio interference going on.

It seems that whereas three hundred years ago intelligent people had lots of superstitions that seemed so irrefutable then, we still have superstitions that likewise seem irrefutable. Cell phones and medical equipment are one.

Other examples.


Nobody denies that washing your hands before and after touching a patient is a good idea especially before you make a large hole in his skin. Washing the skin before you make the large hole is probably also a good idea. Not wearing the clothes you put on at home is probably not a bad idea especially the tie you have had for the past 20 years and have never once washed. Not wearing the OR greens you slept in makes sense too. Wearing a hat to keep something from dropping off your scalp probably isn't a bad idea either. Cleaning the instruments makes some sense. Gloves of course protect you from the patient.

Beyond that just about everything else we do in the OR in the name of reducing infection is simply ritual and superstition.

The Case Room

The case room is a hot bed of superstition. Much of this centres around labour epidurals. Many nurses and obstetricians believe the epidurals slow labour. This of course doesn't stop them from requesting them early when they themselves are in labour. Fetal monitoring is of course about as scientific as sacrificing a chicken and reading the entrails.

1 comment:

burnttoast said...

Totally agree with you. Cellphone restrictions are utter rubbish. No one says a word about them though signs were posted. Everyone is addicted to them, including nurses so not likely to be a real issue. The administrators rarely venture into patient care areas, Don't look, don't want to be confused by reality, just let me believe the press releases.

My second most hated myth is what the nurses tell every shivering patient as they are wheeled into the OR. "It's so cold to prevent germs." It would have to be below freezing to significantly hinder bacteria.

My most hated myth is "Anesthesia". Used to explain any delay or failure of service by RNs in OR. Used to explain any postop complication mysteriously appearing anytime within 6 months of surgery. Hair falling out? Anesthesia. All your teeth loose? Anesthesia. Strange neuropathy after intrascalene pain pump? Anesthesia (EMG's showed it was surgery site specific.) If an MD doesn't know why something happens, well, it must be anesthesia, because the MD doesn't know anything about anesthesia either, and clearly there can't be two areas he/she is uneducated in!!