Quote from Kerrigan 06
Agreed, and to put it in the way I try to make the decision to call or not to call at 2:30 a.m.: "Is it safe for the patient to continue in this condition/this problem to go unresolved/this lab to go unreported until 6 a.m./rounds?"
In addition to this, I always ask myself, "What will the phone call change?" Is there a med, lab, or procedure that the physician could order that would benefit the patient? Is the lab a significant change for the worse? For example, a patient who is being treated for low potassium; if his afternoon lab was 2.5, and a lab comes up in the middle of the night that is 3.0; that's still a low potassium, but I'm not going to call that because it appears the treatment is working (unless, of course, the physician left parameters to call).
I also don't clarify orders in the middle of the night if they aren't pertinent to the current treatment. We have a nurse who clarifies EVERYTHING, and the docs hate it. Who cares if the physician didn't mark a diet at 0300? If the patient is vomitting and doesn't want to eat, don't worry about clarifying that, leave a note or pass it on to day shift. Who cares if the doc didn't clarify if he just wanted O2 on at 2L or if he wanted you to titrate it to a certain sat level? This is a call that in most circumstances can wait three hours for a more reasonable hour of the day; or you let your coworkers know that "If someone needs to call Dr. S's group, I have a question for him, too."
And santhony's advice is spot on; always get your info together (chart, MAR), get your vital signs, think of any question the doc might ask about. And when you call, introduce yourself, and give the doc a little background. They might or might not be familiar with this patient, and they might also have been sleeping HARD. Some little script like "Hi Dr. S this is Jean from SVHC calling about Dr. P's patient F.M. in room 306. Are you familiar with her? No, well, she's a 53 year old with KNA admitted with chest pain; no significant medical history, her CEs have been negative, EKG and tele normal. The reason I'm calling is that she is complaining of a headache rated 7/10 and she has no orders for any type of pain med." And then you can answer questions and go from there, but you given the doc some basic info as well as a chance to wake up.