A coworker and myself were discussing this on my last shift. I had paged the on call doctor for orders for a new admission, having already received orders for the basic admit orders ( vitals, normal prn's things like that) Normally if we are getting a few admissions at once the doc will order these "standing orders" for everyone and then we will call to get other things that we need.
An hour later, he still had not called back, but in the meantime, I had taken a referral from another hospital that I knew I was going to have to contact him about once I got all the information on the patient from the referring hospital. None of the patients medications that I was calling about were going to be given until the morning, so they did not miss a dose of anything.
I paged doc again and the nurse I was with was freaking out because she thought I was going to leave her with all of this to clean up. I told her repeatedly I was going to give him 20 mins to return my call and then call his cell. Was not going to leave anything for her to clean up. She kept telling me I should call him.
Yes waiting the hour after the first page was a long time to wait and if I did not have to contact him about the referal I would have repaged, then called earlier, but I was trying to get the most done in the least amount of calls, which is what we have been asked to do. I felt that the 20 mins after my 2nd page was an appropriate amount of time to wait before calling his cell. If I had not been calling for orders and just calling about the referral I would have paged, waited 10, paged again, waited 10 and then called, so still about 20 mins.
So how long do you all wait for the doctor to return your call before using other methods.
Feb 20, '12
You had two issues here:
1) Doctor not returning the call. Is this a normal issue for him? Maybe it was a busy night of admissions for him and he was caught up in an emergency. If this is normal behavior, it needs to be addressed up the chain of command. When he doesn't call back it decreases effeciency of the whole unit and possibley patient's satisfaction scores. This will soon mean a decrease in money paid to the hospital. If you point out the bottom line will be affected, they will be sure to follow up.
2) Co-worker "yelling" at you? Really? What gives her that right? I would have told her one time that I was going to call the doctor again, if she wasn't happy about that I would have assured her that she was perfectly capable of dialing a phone herself. If that still wasn't good enough, I would have told her that I would be more than happy to clock out at the end of my shift and let her take over, since it was very clear that she can do the job SO much better than I. Then I would have done it. Problem solved.
Listen, healthcare in general and a busy nursing unit specifically is a 24 hour a day operation. Sometimes you have to leave work for the next shift. Sometimes the next shift has to leave work for you. We are all there for the same reason (in theory,) to care for the patients. What one person isn't able to complete, the next should just do it.
Feb 20, '12
1- I work on a behavioral health unit, not sure how many he was covering last night. We have access to medical doc all the time, but not the psychiatrist. If it was an emergency I would not have even paged him, just automatically called his cell phone. This particular doctor has a habit of not answering his pages in a timely manner and has been reprimanded before by what I am told. All of our other docs, we just call their cell phones and if they are busy at that time they call back within 5 or 10 mins.
2- She wasnt really "yelling" just being very annoying about it. TPTB are being PIA about referrals recently because people are taking to long to accept. From the time I got the intial call until the patient was accepted by the doctor was about 40 mins. It took 10 mins for them to fax the first set of info we requested, another 25 mins to get updated labs. It was literally 2 mins from the time they sent the updated labs ( had already gotten the go ahead to admit as long as the questionable lab was wnl on the redraw) until I was calling them back saying we would accept the patient. Her big issue was she was afraid SHE was going to get in trouble for "loosing the referral"
There is a reason I hate being in charge.
Feb 20, '12
I work in home care. My client's doctor is "never" available in the office when I call, and never returns any of our calls. At regular office visits, he always says that he never was notified of any calls or he never has seen any written communications sent to him. I rely on 911 for real problems and continue to put things in writing and send it forward even though I am well aware that there will be no action forthcoming.
I would do as you did. Once the first follow-up call has been made, I would be more frequent in my attempts and I would document every one of them.
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