Quote from jenniferhelene
I'm wondering the same thing... when do you call the Dr. during night shift? It seems the experienced nurses think I should wait until my pt is crashing before calling a dr. overnight. For instance, I had a pt with a moderate pleural effusion. CT scan two days later called it a "very large" pleural effusion and picked up a small pericardial effusion. Since it was 1 am when the results came up and my pt was relatively stable (a little short of breath, satting 92% on 2L, cardizem gtt to keep her rate controlled) the nsg supervisor said to wait until the morning. I'm a tele nurse, not in the unit. So I go against my gut and wait it out. Then the day shift nurse nearly has a cow when I tell her I just paged the Dr. this AM, not last night. I feel like I can't win...
This is why I stopped working tele years ago. I found myself in that position far too many times, and tele patients can become icu patients very easily. It isn't just tele or your hospital though, that type of attitude "don't call the doctor at 1am exists in a lot of different places.
Okay, so what to do. First I commend you on a lesson learned--you have a great gut:spin: .
Second, I wish someone would have told me to take as many continuing ed classes as possible. The reason is because, you can learn tons of great information for everyday use in the CEU classes. Since you are working on tele, by all means attend the Critical care certification classes. Oh my goodness, did I love that class.
I am a med-surg nurse. I love med-surg. I walked up to the teacher explained these 2 facts to her and boy did she gear that class to help me too.
Third, please don't be like some of your colleagues. Perhaps they may not have sensed the urgency with the patient or understood all the symptoms to know this would turn into a problem--like cardiac tamponade with a "small pericardial effusion." At the aforementioned class, I learned that increases in intrathoracic or intraperitoneal pressure can cause heart arrhythmias.
Fourth, continue onward with your growth and learning. Sometimes the mds may be grumpy at 1-2am calls but, know that you did the right thing.
Finally, is there a way that disrespectful behavior by physicians is handled. We actually complete forms for this type of behavior and things are dealt with during their medical meetings.
I hope this is helpful