Can Text Help Nurses Be More Efficient? by Raj Chand, MD
Thursday, January 14, 2010 
Raj Chand, MDAt 5 am, the charge nurse began making calls. Two nurses called in sick for the day shift, and at the height of flu season, we needed all the help we could get. Throughout the years, I have watched charge nurses follow the same approach of making endless calls every time there is a need for more support. I often wondered if there was a better way to reach ED staff.
While email groups are common, they do not allow immediate access to staff. On the other hand, most people have cell phones with text capabilities. Text messaging monitors elections in nascent African democracies, improves compliance with childhood immunizations in England, and alerts coastal residents of impending tsunamis. Why not use it to increase efficiency in American healthcare?
Enter Tatango.com — a startup web based text messaging service. While it won't solve the nationwide nursing shortage, text messaging can help us tackle the mini-crises our Departments face each day.
I have no connection to Tatango; I found them during a 4 am Google search as I pondered the questions posed above. Prior to signing up for the service, we surveyed the ED staff (RNs, techs, secretaries) and 94% of respondents (49/52) could receive text messages.
We started using Tatango in November 2009. As word spread amongst the staff, 70 people signed up. People took an immediate liking to the new system. For charge nurses, it translated into time saved making multiple calls for additional coverage. For the staff nurses, it meant less interruption of personal time with phone calls and voicemails. The simplicity of text made an age old tradition of phone lists and multiple calls obsolete overnight.
You might be wondering if people actually come in after receiving a text. From our experience, the answer is a resounding yes. It is unclear whether this response is motivated by the state of the economy, PRN staff looking for shifts, or just a willingness to pitch in and help out. So far it seems — if you text, they will come.
After all, if text messages sent by elephants can save crops, we can use text to be more efficient in healthcare.
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Reader Comments (6)
This is a remarkable use of a service. One of my clients recently integrated a 2 part tool I helped with it's text and phone blasts. Staff can decide if they would like a phone call or a text who needs etc.. a reply to the call (press 1 or 2) or a reply by text let's the organization know they are available. All a greta idea and great work Raj.
Thanks for the post regarding Tatango. This is an amazing use of our service, very cool to see! If you are any of your followers need any help with Tatango, please don't hesitate to contact me.
Best regards,
Derek Johnson
CEO, Tatango, Inc.
Mobile: 206.334.4012
Office: 206.274.6599, x6
I had the chance to meet (and interview) Derek w/ Tatango. Great company/people to work with.
Quick question on logistics. When someone fills the opening to you retext the group to inform them?
My husband works as a paramedic and his mom as an RN. They've been getting mass memo texts from work for years now. This is new?
We also do this with our physician group using the hospital's internal paging function. The lead in our communications department was able to set this up such that a page to a particular number fans out to the entire group's text page number. We use it to find docs to help with surges. We do have an obligatory on-call doc but sometimes another wishes to come in and pick up extra hours (and the necessary call-in bribe).
Thanks everyone for the great comments!
Here's a few thoughts:
Molly - I agree that many EMS and physician groups have had similar systems for many years using text paging. Most ER nurses are not given pagers and certainly do not carry them 24 x 7. The cell phone is the one object most of us keep with us at all times. If your husband's and mom's employers are using web based text messaging, then they are definitely ahead of the curve.
Tom - Great idea about using this with docs as well. Our docs no longer carry pagers and everyone has agreed to be available by cell phone when on call. Again, I think text messaging has a role to play.
Steven - Currently we do not send a second text saying the shift has been filled. Although, I like the idea. Mostly our texts ask the staff to call in and speak with charge nurse. If the shift gets filled, then secretary updates anyone else who calls in to offer and help.