This is the 117th #WILTW
John has been admitted to hospital with pneumonia. He is on a bed near the nursing station on ward 22A. Around the station are a couple of doctors and nurses looking through the notes trolley. He watches the ward clerk stand up and walk off the ward to find some stationery.
The phone at the desk starts to ring. The doctors and nurses on the ward round continue their discussions.
The phone continues to ring. John watches a doctor walk past the station, look at the phone, look around the room and then continue to walk up the corridor.
The phone continues to ring. A nurse arrives at the station. She looks stressed. She sits next to the ringing phone, pulls out a diary, opens it, rolls her eyes and then walks away.
The phone continues to ring. Through the doors to the ward a consultant arrives with some medical students. They all look at the ringing phone. They look at doctors and nurses around the notes trolley and look back at the phone. They then move off to examine the patient next to John.
One of the doctors at the notes trolley then moves round to sit next to the ringing phone. He starts writing in the notes. He looks at the phone. The phone keeps ringing. He looks up at the remaining team around the notes trolley. He then continues to write in the notes.
The stressed nurse comes back to the nursing station, mutters something under her breath and then leaves the ward. The doctors and nurses around the notes trolley push it towards the patient opposite John. They are joined by the note writing doctor.
The phone continues to ring .
The ward clerk returns to the ward.
The phone stops ringing.
I had to call out our staff this week for leaving the phone ringing despite a number of people being quite capable of answering it. The act of picking up a phone seems an inherently simple task. Certainly to an external observer like John there seems no reason for someone not to do it. The assumption is staff are lazy, rude or completely uncompassionate. Imagine if John had been waiting for a phone call from a loved one with some important family news or maybe about his transfer home.
Some of the reasons are more complex than the assumptions though. A honest junior said to me once, “The problem with answering the phone is that the majority of the time you can’t help at all and get dragged into a situation where you become responsible for the problems/issues/concerns of the person on the other end of the line.” This doesn’t excuse not answering the phone but if you knew you could always respond with a yes or no I suspect answering times would decrease significantly.
The prompt for this muse comes from a powerful article by Dr. Ranjana Srivastava on professionalism and responsibilities in medicine. She questions why health care professionals ‘overlook’ potential poor or harmful practice by colleagues or in systems:
“So, while professional integrity is necessary, I think the question we ought to periodically ask all doctors is actually a far simpler one. “What kind of a person do you want to be?”
I want to be the consultant that sets a good example to the medical students. I want my juniors to understand how to prioritise tasks and I want nurses and doctors to realise that some jobs can be done by either professional.
This is really easy to say but much more difficult to put into practice. Maybe answering the phone is one place to start.
What have you learnt this week? #WILTW
Post release note:
#WILTW rarely produces responses and it is even less common for people to disagree (please see comments below). The topic of discussion is definitely in the grey zone though and I think it was a justified challenge. The tweet below perhaps was something I should have included within the blog.
@Damian_Roland Is the message here: never walk past an unanswered phone?
— M a T (@MatSilk) August 11, 2016
Answer: No e.g. emergency
— Damian Roland (@Damian_Roland) August 11, 2016