Technology – The Answer,* Part 1

Let me start with this … I’m a bit of a technofile.  I’m not always the early adopter but I’m an early follower and eager adopter once ‘version 2’ comes out whether that be a new mac, iphone, ipad, kindle, etc.  I regularly hit Gizmodo and Wired.  I like this stuff.  A lot.  Since entering long-term care profession this tech love has turned into a love-hate relationship.

An example of why I love it.

This is an admittedly low-tech example … here’s how a conversation has gone that I’ve had many times with groups of nurses & CNAs:

Me: How many times during your shift do you have to ‘look for someone to help?’  Whether it’s another CNA to help with a transfer or another nurse for pain meds or whatever.  How many times do you ‘look for someone to help?’

Them: 10.  20.  15.  25.

Me: Ok.  Let’s say about 15 times.  Now, think about how long it takes you to find that person.  Sometimes they’re right outside the door.  Sometimes they’re in the middle of helping a patient and you need to find someone else.  Sometimes they’re hiding in a quiet place to get their charting done.  Sometimes they’re in the employee break room.  How long on average does it take?

Them: 3 min.  10 min.  5 min.  7 min.  Etc.

Me: Ok.  Let’s figure out how much time you’re wasting during your shift (time that could be used to care for patients but instead is being used to ‘look for someone to help.’


  • 15 times looking for help x 5 minutes = 75 minutes/shift
  • 75 minutes x 10 (# of nurses & CNAs on a shift) = 750 minutes or 12.5 HOURS/shift of wasted time
  • Multiply that by 2 to cover the other 2 shifts (by 2 instead of 3 b/c the other shifts don’t have as many people as the first shift) and you arrive at a hidden, staggering number:

25 hours of care givers time per day that is not used for care giving.

When the nurses and CNAs see that math on the white board in front of them, jaws drop.  DONs are disgusted.  People shake their heads in frustration.  How do you fix that?

Here’s what we did … we noticed at luxury hotels, some restaurants, even at OfficeMax something they use to improve the speed of communication.  We called them Secret Service Radios.

Secret Service radios in nursing homes

As I researched it, I found out that what looks pretty sophisticated with the sneaky ear piece, but in reality is very low-tech.  You have a small 2-way radio that connects to a ear piece-microphone cable that you wear underneath your scrubs.

My staff’s response was, for the most part, positive.*  They welcomed a way to relieve the 25 hours/day pain that was no longer hidden.

The impact both to our culture and to our care and to our census was significant.

Culturally, the staff, families, and patients saw an outlay of money for one purpose with no financial ROI expected.  That message is powerful.  We’re spending this money to make your jobs better.  To make care better.  Period.

The community ate it up.  The case managers and doctors at the hospital loved it.  We played up the ‘secret service’ angle with corny lines like, ‘if it’s good enough for the President of the United States it’s good enough for our patients and residents.’

We identified a problem.  We looked outside our industry for a solution.  It looks high-tech but is actually low-tech analog.  You might be tempted to do this too.  If you did, you very well maybe throwing your money down the toilet.

I’ll explain in Part 2 of this topic why that is.

*A couple of my CNAs doubted my motives.  They thought I was trying to be big brother so I could always monitor exactly where they were at all times.  So, just between themselves, they came up with a code word to alert each other when I was on the floor so they could look really busy.  “7-11.”  One of them would say, “7-11.”  Others would repeat into their radios, “what?” with no reply.  The code word was only meant for the other person who knew what it meant.  Pretty hard for something like that to stay quiet.  So, when I found out about it I invited one of them into my office.

Me: How are the kids?

Him: Good.

Me: Good.  Everything going well?

Him: Yes.

Me: Great.  Hey, really quick … how did you come up with the code word 7-11?

Him: (Deer in the headlights.  Long pause.)  I don’t know what you’re talking about.

Me: Oh.  My mistake.  Let me just take a minute and talk to you about why I invested $5,000 in the secret service radios.  (I did the math with him.  I shared success stories of better, faster care.  10 minutes.  I excused him.  2 weeks later he quit.  Perfect.)

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