I am a new grad - on week 3 out of 6 of my orientation on a very busy/heavy resp/tele unit. I am orienting on day shift, but will eventually switch to night. There's a chance they might keep my on days, but I am so scared because I know I will need to go to rounds and doctors will be there more often.
One of my biggest fears right now is how and when to talk to the doctors I've worked 7 shifts already, only called the doctor once. 99% of the time my preceptor just go ahead and talk to them then let me know what happened, often time I am not there when he speak to the MD or I didn't even know he was planning on calling them - because he think talking to doctor is the "easy thing" I should focus on not being behind d/t charting or giving med.
My preceptor tell me, whenever you see doctor - go listen to them talking to your patient, or if you see them on the floor, just go talk to them about your patient. He made it seem so easy, and kept on saying "it's not scary, you just talk to them."
1. "Just talk to them" - talk about what exactly and how? How do you initiate the conversation about your patient after "Hi Doc, how are you?"
2. If I want to find out what's the plan for the patient - how do I ask the doctor? or how to find out what's on their mind after they speak to the patient.. I feel simply walking up to them and say "Hi doctor, so what is your plan for Ms. _________?" sounds.. just awkward, yet I am not sure how to break the ice or make it flow better. Would they think -- why don't you go read the chart after I put in the order?
3. I often see a doctor in the room but I don't know their name, what their specialty is, if they are the primary, or specialist? I really want to find out but I also don't know exactly how? I mean I introduce myself all the time to people on the floor, PT/OT/RT, but when I know it is a doctor it's like I lost all social skills all the sudden somehow... what do you do in situation like that? What exactly do you say and introduce yourself and find out who the doctor is? I feel I will sound stupid if I go, "Hi Doctor, my name is ____, I am the nurse for _____ -- what if your name? and what is your specialty?" I feel I should know!!
4. When doctor come into the room they ask "how is the patient?" what do they want to hear? I often don't know what to say, I feel it's either I'm caught off guard sometime or I just gave them useless information that they don't seem to care at all from their look. L
Sorry if this is a stupid question, but I really am frustrated with myself about this problem, I feel speaking with doctors is something I should know how to, since it's big part of nursing, but it's really scary for me. asking my nurse with the answer "just talk to them, they don't bite" didn't help me much..
I know each doctor has different personality and preference to be talked to, but I really appreciate if you could help me with more specific information such as give me examples on exactly how you would speak to the doctor? like a sample conversation of when you see the doctor on the floor, or what you say when you see a new doctor, how to ask about what's their plan after they see the patient? Because sometimes I don't always get to stay in the room to listen or sometimes I simply didn't catch what they were saying...
Oct 4, '12
When I talk to the doctors at my work its more or less a very easy convo. You want to have a good trusting relationship with the doctors. So when I pass them it's a simple hello! " how are you doing today?" When a doctor comes in for a patient and they start writing in their charts I just ask tue doctor if there is anything new the staff should be aware of. I would also at this time inform the doctor of anything that would be importance regarding the patient. At my work I call the doctors or fax them if I notice anything unusual or have any questions regarding mediations. If I transfer a patient I would also inform the doctors.
Oct 4, '12
4) they want to hear the truth.
- any behaviour issues
- any thing that is abnormal
- drugs being refused
- weather or not the person had any problems voiding / eating
If they have a fever or what exactly has happens in the past 48 hours that would be an importance that they might not already no.
Oct 4, '12
Client is on a new antibiotic and her blood sugar had a reading of 22.3 so I called her doctor and her came in to see her -let's call her Jane doe
- Dr. Pintcher , how are you doing today?
- I'm doing well thanks, yourself?
- good, Jane Doe is just in her room,
- so I understand her bs was 22.3 at 0800 hrs? What was it at 1700?
- it was only 11.8 it seems to be really high in the morning and go down as the day goes on.
- she's on 8 units a night right?
-she sure is. She has been taking her antibiotic at. 2100 hrs with her 8 units, that wouldn't effect it would it?
*** this is when he started talking to the patient and assessing them.
- I'm putting her on a novorapid sliding scale. Keep giving her, her antibiotic but keep monitoring her bs. If it goes over 20 again fax my office and I will adjust her units.
- I will chart this an pass it on to the other staff. Thanks
- your welcome, I'm also here to see mr. Brown in room 201?
- yes he's right over here, follow me. He's been expecting you.
Oct 4, '12
one communication tool that is widely used now is the use of SBAR when communicating with doctors or any member of the healthcare team , Situation Background Assessment Recommendation (SBAR) is a standardized way of communicating. It promotes patient safety because it helps individuals communicate with each other with a shared set of expectations. Staff and physicians can use SBAR to share patient information in a concise and structured format (What is SBAR? | Situation Background Assessment Recommendation | What is SBAR Communication? - Safer Healthcare
every hospital facility and every unit at that hospital has certain policies/procedures or even standing orders from the physicians, we have to do everything we can as nurses and be able to relay or communicate with doctors when situation calls for it (Ex: on following a Sliding Scale Insulin for diabetics - there is a range as to how many units of insulin you will give the patient for a certain blood glucose reading - if blood glucose reached a certain degree - lets say for blood glucose of 400 mg/dl give 16 units of regular insulin and notify MD) ... it will also help to ask your colleagues when in doubt - there is no harm in asking for assistance... mentoring doesn't stop after your orientation - that is my personal belief... hope this helps!
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