There is a phone on the counter in the ER. This is a very special phone. Patients use it to call social service agencies. All they have to do is pick up the phone, dial 2 numbers and they’re connected directly to the agency. There is a list of places to call with the numbers –  most are drug treatment programs and the Department of Human Services (DHS.) Every night patients use the phone to call DHS because they are homeless. DHS has a van that comes out and picks up our homeless patients and takes them to shelters around the city.

We social workers love this phone  because we don’t have to call and be on hold forever to make a referral. I can’t imagine what it was like before the special phone. Probably the patients would have used the phone in the social work office and there would have been a steady stream of traffic in and out.  No way! Or the  social worker would have had to make all the calls, not the best use of our time.

It’s a lesson in the effects of poverty to watch patients use the phone.  Because so many of them have lived on the streets for years, a phone can be a strange thing. It’s been a long time since they have seen or used one. They pick up the cradle and don’t quite know what to do. They aren’t used to navigating  voice menus that ask them to make choices, or how to leave a voice-mail which is kind of a moot point because there is no call back number. They aren’t used to being put on hold and waiting; they get frustrated. They put the phone down and seem perplexed. Usually I stand next to them in case they need help. With my patients that are severely mentally ill I make the call –  from my County-issued cell phone.   

The poor and the homeless are out of the communication loop. We live in a society obsessed with communication and connection – at all times – and yet we have a group of people who are utterly unconnected and out of touch.  The universe of cell phones,  Blackberries, iPod Touch, ipod phones, camera phones, web cameras, computers, laptops, Skype doesn’t exist for my patients. When they see these technological devices they are in awe in the way a country bumpkin sees the skyscrapers of Chicago for the first time.  

But there is something else about this phone – I never touch it. Unless I am cleaning it. No doubt the phone is coated with the germs of hundreds of hands, many of them homeless hands. It’s hard to be clean when you are homeless.  Those hands also belong to people who are sick. Sometimes patients try to hand me the phone especially when the DHS worker asks for my name and phone number. I quickly tell the patient the info and they tell the person on the other end of the line.  I write my name and number down on a piece of paper and tape it to the counter, too.  Never touch that phone if  you can help it! I try to clean it every shift. I go to phlebotomy and get a castile soap towelette and alcohol prep pads. I wash that phone down good, every part, the cradle, phone, and dial pad.

I remember during my orientation that the nurse epidemiologist stressed the importance of hand washing. The woman counseled: when you wash your hands sing happy birthday twice and that is enough time to remove all the germs.  At least 30 seconds, you have to scrub for at least 30 seconds. And you need to create suds. The suds make the surface of the hands slippery and the water makes the germs slide off. This is serious business. There are dispensers of hand sanitizer, soap, and lotion  all over the ER and hospital.

I’ve become a bit obsessive about the hand washing. County gave me OCD – obsessive compulsive disorder….

And thank the goddess of social work for that phone!