Calling MD's per patient request!!

  1. What do you experienced nurse's do when a patient or family member is insisting that you call the doctor in the middle of the night for something that could wait until morning. Of course, they see it as important, and it may be, but just something that can wait. (for example...med questions, or ordering a med that they take in the am but did not get ordered yet) The family and patient are looking at you like you are a bad person because you do not want to call. How do you handle this, what do you say? Our facility has very relaxed visiting hours and this seems to happen a lot. A family member will show up in the middle of the night and want answers NOW!!!!
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  2. 23 Comments

  3. by   HARN
    I just explain to the family that this can be taken care of in the morning. If they are insistant upon calling I call. Most patients family whom want to get ahold of the Dr with persistants are well know to the Dr & the Dr has understood. But like I have written if it can wait & is not something I have to deal with at that moment I leave it until the Dr comes in the morning. I don't let families decide when I call, I make that decision upon the situation.
  4. by   susanmary
    First problem -- relaxed visiting hours. Your facility should not allow visitors to come in any time during the middle of the night -- you need to enforce visiting hours. Fix this and you will essentially fix the problem. I would tell them that visiting hours are _____ to _____.

    Regarding patients/meds -- I'd tell the patients that their doctor would be rounding in the morning, and that you will write a note on the front of the chart regarding the med questions. I would explain that often medications are changed/adjusted while a patient is in the hospital (for example -- po meds may be changed to iv, etc.) -- and you will follow through with this. If a family member insists that you call -- and you or your charge nurse can't troubleshoot, then can you call a resident -- or whoever is actually in-house on call? You can always give the family member the doctor's service -- let them make the call -- just document that the family member requested the physician's number. I have never refused to call a doctor at a patient's request.

    Talk to your manager about visiting hours. Talk to him/her about these issues -- you really need a staff meeting -- if this is repeatedly happening -- I'm wondering what is going on ...
    Last edit by susanmary on Jul 3, '03
  5. by   Hellllllo Nurse
    I have told families that the docs won't return calls from the hospital unless it is an emergency. I have then given family members the doc's phone # and told them they can call if they would like.
  6. by   ceecel.dee
    Originally posted by susanmary
    I'd tell the patients that their doctor would be rounding in the morning (if they do) and that you will write a note on the front of the chart regarding the med questions.
    If a family member insists that you call -- and you or your charge nurse can't troubleshoot, then can you call a resident -- or whoever is actually in-house on call?
    Totally agree with this. I would never give out the doctors number! This would not go over at all! If anything, I would get the on-call doc on the line for them.

    Our staff is expected to differentiate between what is an emergency and what is not, as well as who would want to be notified of what and at what hour. Very easy job!
  7. by   zambezi
    Personally, if it is not an emergency, I wait...our docs would not be very appreciative if I called them in the middle of the night, I usually just explain to the families that the doc is sleeping, needs to review history, needs to sleep to function well in the morning, etc and we can have the drug asap in the am if the doc wants it ordered...I also explain that many docs are working with different meds when there is an acute problem and does not have them on it for whatever reason...as others have said, strongly encourage families to get some sleep at night (they cant take care of their loved one if they are too tired and get sick), if the patient is sleeping (which they should be at night) the family can come back and peak at their loved on but can't come in and i can make up all kinds of reasons, of course i explain all of this is a very nice understanding tone
    If there is an emergency of course, I will call no questions asked.
    As ceecel noted, easy job, I would follow up on why it is happening so much in your unit and be assertive but gentle when discussing this with your patients/families.
  8. by   hogan4736
    Doc's phone numbers are published in the yellow pages...anyone can call the #, and get the service to page the on call doc...

    hand the insistent family the phone book, and give them the phone...
  9. by   kids
    Originally posted by hogan4736
    Doc's phone numbers are published in the yellow pages...anyone can call the #, and get the service to page the on call doc...

    hand the insistent family the phone book, and give them the phone...
    Ditto.

    Read your Patients Rights. We may not agree with the request but we do have to honor it.
    I worked in a facility that was given a $5000 fine (and lost on appeal) because a Nurse refused to call the Doc for a (truely) frivolous matter on a Sunday afternoon. We were told that every Doc has an answering service and that we would have been OK if we had documented the request, the refusal and rationale and that we had provided the patient with the Docs office number and a phone.
  10. by   Hellllllo Nurse
    Agree!

    The docs don't yell at the families. Let them call him.

    Oh...and I have told families: "Here is his number. Please do not say you got it from me. Doctors often ignore calls from nurses. I think you will get a better response if you call him yourselves."

    No one has ratted on me yet.
  11. by   grneyes676
    I try to explain to the family/pt. that it can be taken care of on morning rounds and I offer to place on note on the front of the chart. If they are persistant I will page the on call resident and let them deal with it. That is why they carry pagers!! I have only had one resident say something to me about paging him, I nicely reminded him that he choose his profession.....and it is 24/7.
  12. by   Pete495
    In our cardiovascular surgical unit, we only have 3 surgeons, so we are expected to deal with a lot of this kind of crap ourselves. If it's a medication question, I usually try to answer any questions they have specifically about the medication, and offer to get education material for what I don't know. If it's something I can't answer, then I usually tell the patient to write all their concerns down, and save them until morning when the doc rounds to see said patient. I usually tell the patient that the doctor has the patient on all meds he wants for that particular time, even if it is different than their schedule at home. I usually say that our doc has a particular reason for doing certain things even if we don't know the exact answer. I tell them that they go through all their treatmtents and meds and decide what is best at that particular time for them to have. Obviously there are always things that get missed every once in awhile, and that is why we write them down and save them for later.
  13. by   redshiloh
    Better check with you manager about your facilities' policy. I'd be skint alive if I gave an MD's number(or anyone elses for that matter.)
  14. by   Tweety
    Sometimes I tell a little fib and say their doctor isn't on call, so it's not worth the effort calling anyway and on-call docs don't deal with nonemergent things.
    Usually, I firmly, but gently say it's policy only to call MDs off hours for emergencies.

    Then I make a promise to call when the MD comes back on call if they are insistent. Then I make the call after 7:00AM.

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