An old adage in medicine says that "the dose makes the poison." In other words, even the most benign substances can be toxic in the wrong doses. The same can be said for countless other tools we have, where the same device can have incredible utility or highly destructive power, depending on how it's used.
Cellular telephones are no different. Perhaps no other device in modern American society has changed our daily lives so significantly. Cell phones provide almost limitless communication, are relatively cheap and have virtually uninterrupted coverage, and almost every person between ages 12 and 80 has one. But, as with all tools, there are negatives. Cell phones are the cause of accidents due to distracted driving, they can be expensive, and they can be a major factor in the information overload many people experience.
Policies regarding carrying personal cell phones while on duty vary from an outright ban at all times to virtually no controls at all. I submit that an outright ban on carrying personal cellular telephones is an unenforceable policy and is therefore bad management. As with all tools, personal cell phones have utility if used properly.
First, considering that virtually every one of your current employees probably has a personal cell phone, I doubt that a policy banning carrying it while on duty would be successful. Some of your staff will flatout disobey the order and secretly carry their phones anyway. Moreover, a policy like that will surely create ill will and unhappiness in a much larger group of employees.
Second, there is utility to a personal cell phone. Besides the obvious benefit to staff members of being able to keep in touch with family, the phone can also be beneficial to the EMS system. Cell phones can provide a backup method of communication when other systems fail. The cameras built into most cell phones these days can be used to document mechanism of injury. Some cell phones are also powerful reference devices, able to carry protocols, scheduling, phone lists and medical references.
Given these realities, I believe the utility of carrying a personal cell phone exceeds the downside. However, strict controls must be put in place so this utility is not overshadowed by the possible problems personal phones can cause.
I am willing to concede that individuals can and should be allowed to carry their personal cell phones while on duty, and even while on a call. However, personal calls should be prohibited while on an emergency. This starts at the moment the unit is dispatched and ends when the unit is available again. There is a significant negative public image in EMS personnel talking on the phone while they should be taking care of a patient. Additionally, responders should not be distracted from patient care by their phones. There is no problem that cannot wait until the response is over. If a cell call comes in, it can go to voice mail until the EMS call is finished.
Next, consistent with many laws, there should be no driving while talking on your personal cell phone. Many places now require that a hands-free device be used to operate a cell phone while driving. Considering the other distractions involved with driving an ambulance, and the size and complexity of the vehicle, there is no reason to talk on your personal phone while driving. Pull over, switch drivers or simply wait until you reach your destination. Many of the "hands-free" laws have exceptions for public safety personnel, but those exceptions should be for work-related use, not personal.
Last, and perhaps most important, there should be absolutely no photos, video or audio recordings made under any circumstances while on duty without the prior express approval of management. Of course, this should also include the use of digital cameras, video cameras and even simple film cameras. Granted, there is some potential benefit to patient care and provider education through real-world photography or video recordings, but the potential to violate state and federal patient privacy laws is too great.
The ease of posting files on Internet sites makes it all too likely that those training photos or videos will end up in the public eye. The last thing you want to see is your department in the news because someone posted a video involving a patient. If you think you can control this issue, then create a policy where supervisors or educators can take photos or videos under certain circumstances, and have all files go directly to management. Make it a policy violation to retain a copy of those files on an individual's computer or cell phone without permission, or to distribute those files to anyone under any circumstances.
All of these policy elements should be strictly zero-tolerance. You get the privilege of carrying your personal cell phone on duty, subject to restrictions, but if you're caught violating any part of this policy, you're fired. With great power comes great responsibility, as the saying goes.
EMS Magazine recently conducted an online poll of departmental policies regarding personal cell phone use. More than half of the respondents have no policy whatsoever, and only a fraction have policies that address photo or video recording. This is simply unacceptable. It's bad management not to address this issue. Take a look at your system, and shut this barn door before the horse escapes.
Matthew R. Streger, JD, MPA, NREMT-P, is an associate at Kern, Augustine, Conroy & Schoppman, P.C., in Bridgewater, NJ, and a paramedic at Trinitas Hospital in Elizabeth, NJ. He is a graduate of Seton Hall University Law School, Clemson University and John Jay College of Criminal Justice. He has more than 20 years of EMS experience and is a member of EMS Magazine's editorial advisory board.