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Before the Signal Fades

Ravert, Robbie RN, RNC-OBhis

AJN, American Journal of Nursing: July 2011 - Volume 111 - Issue 7 - p 72
doi: 10.1097/01.NAJ.0000399320.10977.a0
Reflections

Patient and family cell phone use can seem intrusive in a hospital—until it's not.

Patient and family cell phone use can seem intrusive in a hospital—until it's not.

Robbie Ravert has been a labor and delivery nurse for over 35 years, and is currently a staff nurse at Evangelical Community Hospital in Lewisburg, PA. Contact author: rlravert@windstream.net. Reflections is coordinated by Madeleine Mysko, MA, RN, mmysko@comcast.net. Illustration by Denny Bond.

Oh no, here comes another dad with a Bluetooth.

My colleague and I roll our eyes at each other in frustration. Another self-important junior executive who must be in touch with everyone in the world while his wife labors unsupported, I mutter with dismay as I rise from my chair to greet our newest birthing couple.

I have to coach myself: Change your attitude. Change your attitude, as I weigh the mom and escort the couple to the birthing room. Dad-to-Be proceeds to spread out his equipment on the dresser in front of the window while Mom-to-Be, in obvious distress, changes into a gown in the bathroom.

It occurs to me that I'm getting too old for this, as D-to-B struts about the room, speaking into the air. I spend the remainder of the shift trying to find ways to engage him in the care and support of his wife. I'm only partly successful: I teach him to apply counterpressure for his wife's back pain, but even in this he works with one hand, keeping the other on his computer keyboard.

While strolling in the hallway pushing her IV pole or digging in the freezer for an ice pop, he speaks loudly into the air, gesturing to an unseen business associate. I draw the water for her whirlpool. If he only knew what he's missing. . . .

Communication technology has changed the culture of our birthing rooms in many ways. Consider the group of teenagers in the hallway, each one on a cell phone while their girlfriend labors; the new aunt with her feet firmly planted at the side of the infant care center while taking a picture with her cell phone; or the patient texting during a pelvic exam, while she miscarries. Consider the challenge of reviewing discharge instructions while all eyes go to the cell phone vibrating on the over-the-bed table, the educational opportunity vanishing.

By the end of the shift with D-to-B and his equipment, I'm thinking maybe we need to put up a new sign about cell phone etiquette. I'm even thinking we should ban cell phone usage altogether.

But one evening the patient is a young woman who's already been through three miscarriages and a stillbirth. Now, at 18-weeks gestation, she's bleeding and contracting. Her husband, a truck driver, is in the next state, at least three hours away. Her mother is frantically trying to contact him on the cell phone, while at the same time attempting to comfort her sobbing daughter.

Finally, the husband is reached. I'm told he's turned his truck around and is heading for the hospital. Labor is progressing rapidly, as I finish injecting a second dose of Nubain. The patient's mother is on the phone—as she has been almost continuously since she arrived. The patient begins to feel pressure. Her mother doesn't hang up, but she has to put the phone down momentarily so she can stroke her daughter's forehead and arm. One mild push and the tiny baby is in my hand, her heart beating visibly inside her tiny chest.

"She's alive!" her grandmother says.

I place the child's limp body on a towel and gently lay her on her mother's abdomen. In a second, the grand-mother is back on the phone; I watch in tearful disbelief as she puts the phone next to the baby's head.

I can hear the child's father repeating, "I love you, Daddy loves you," to his newborn child, from somewhere along Interstate 81.

I'd be lying if I said the sight of a Bluetooth doesn't start the growling in my head, or the chatter of several cell phone conversations outside a birthing room doesn't make me want to shut the door. But despite the irritations of communication technology, I have to say I'm thankful for the meaningful connections it sometimes does make possible.

© 2011 Lippincott Williams & Wilkins, Inc.