Authored by: Anonymous practicing M.D. in the Pacific Northwest
“The average ER doctor gets interrupted once every 2 minutes,” someone once told me as they were interrupting my order for antibiotics and fluids on a septic patient :-\
I laughed, “That’s all?!” and went back to trying to figure out the Vancomycin dosing that the pharmacy would inevitably correct for me.
But, let me tell you, it feels like a helluva lot more often than every 2 minutes. Whoever did that study needs to come to the average U.S. Emergency Department.
When you’re sitting at your computer trying to order a medication or talking to a patient about some key element of their complaint or running to pick up the callback from an important consultant you’ve been trying to reach about a critical patient, it never fails that someone will stop you. “Hey–can you sign this EKG? Doc–you see the repeat sodium in Bed 6? Excuse me–can Bed 10 eat?”
We learn to live with this frenetic, incessant bombardment sometime in residency. Multitasking becomes akin to a fun puzzle. Noise becomes soothing, almost.
Yet these interruptions are actually incredibly fatiguing and undoubtedly contribute to the feeling that you’ve just run a marathon, which sets in after many shifts.
Beyond causing mental exhaustion, however, non-critical interruptions break the train of thought for a doctor or nurse who is–quite literally–often making life-or-death decisions.
Details–missed. Orders–forgotten. Patient warm blanket requests–erased from the concentration stream. The majority of these interruptions are, unfortunately, inherent to hospital medicine, and most of us have adapted.
Except there’s one interruption that doesn’t have to be part of our lives: unnecessary (and most often false) alarms.
When I heard that well over 75% of the alarms from medical devices like heart rate monitors and pulse oximeters were erroneous, I wasn’t the least bit surprised.
Multiple times a shift I will be walking towards one room to check on a patient or talk to a nurse, and I’ll be sidetracked by that all too familiar–and tedious–beeping that I know has about a 2% chance of being legit.
But I still have to stop, take a few seconds to eyeball the patient, and then–more often than not–go back to whatever legitimate task I was trying to complete.
Just this one micro-decision, when added up over time has–without question–caused each of us in hospital medicine to waste hours/days/weeks/months/years forgetting what we were doing, for ZERO good reason. It’s a product of the suboptimal systems that allow for noise to be created even though a signal isn’t valid, such as a pulse oximeter that’s not even on a finger. Or worse, devices which alert based on generic parameters that no one with clinical knowledge of the patient in question has created, like a heart rate (HR) monitor beeping for HR > 100 in an Afib patient (duh) or (my favorite) a HR monitor beeping for asystole because it can’t read the pacemaker spikes of a patient comfortably eating a turkey sandwich.
Enter: CalmWave and smart alarm management to (finally) deal with a problem we never really knew existed, yet also ALWAYS knew, deeply inside, was there.
I, for one, can’t wait to watch the alarm interruptions dwindle away. Even just to get back those valuable minutes each shift when I can do something productive instead of saying, “Yeah, sorry these monitors are so annoying, lemme talk to your nurse about changing it.”