need a nurses advise

[Rnmkonoinmedsurg]

i recently had a pt with a dx:cirrhosis of the liver with a large volume paracentesis. as a nurse i called the doctor to let him know the changes in the pts condition, bp decreased significantly form baseline, hr increased about 70 to 100, rr dropped about 24 to 20 and o2 sat was WNL on RA. The nurse on the previous shift explained that the physician made a point not to call unless there is something significant to report.however i called the physician, was there something else i could or should have done!

[Rnmkonoinmedsurg]

i recently had a pt with a dx:cirrhosis of the liver with a large volume paracentesis. as a nurse i called the doctor to let him know the changes in the pts condition, bp decreased significantly form baseline, hr increased about 70 to 100, rr dropped about 24 to 20 and o2 sat was WNL on RA. The nurse on the previous shift explained that the physician made a point not to call unless there is something significant to report.however i called the physician, was there something else i could or should have done![sOMEONES INPUT]

the doc was called b/c i am a new grad, and i just didnt want that left on my concious along with everything else when i leave, and i feel i was advocating for the pt. However the comment arrised that i should have still went through with other interventions before hand and in addition to calling him??

[EmmaG, RN]

If you're concerned about a patient, call. Best to err on the side of caution than not call and have something happen to the patient. It could have been due to the fluid shift, or a bleed exacerbated by his liver disease or it could have been nothing at all. However there was a change, you were concerned, and reporting it to the doc was the right thing to do.

[jessiern, BSN, RN]

If you're concerned about a patient, call. Best to err on the side of caution than not call and have something happen to the patient. It could have been due to the fluid shift, or a bleed exacerbated by his liver disease or it could have been nothing at all. However there was a change, you were concerned, and reporting it to the doc was the right thing to do.

Agreed. The doctor is on call for a purpose. If he doesn't want to be on call, perhaps he needs to find a new profession.

[al7139, ASN, RN]

I don't care if it's 3am. If you are concerned about a pt, call! If the MD wants to be a jerk and complain that I woke him up, that's fine, I just document that he was notified, and that I recieved no orders. Your job is to assess and report, and follow through on problems. The MD's job is to be available to you 24-7 to give you orders. If they choose not to, that's fine, I always make sure to document it so that it doesn't come back to haunt me.

Do your job, keep your side of the street clean, and you will be OK.

I agree with Jessie. If they don't want to be called, they should choose another career.

You did the right thing.

Amy

[nialloh, RN]

I don't know how many times I have seen a nurse call the Dr for a slight change. Mostly it was because they felt something was very wrong but couldn't put their finger on it. Quite often that pt will end up in the unit, or being coded. If in doubt, Call.

Trust your fealings, you are around the pt a darn sight more then the MD is.

A good MD will listen to your concerns, a bad one will fight with you.

[madwife2002, BSN, RN]

I aggree with the above, if your gut feeling is to call go with it. So what if the Doc shouts they like doing that sometimes, your priority is the pt not worrying about the Doc. You know what I said to a doctor once who shouted at me for calling him up in the middle of the night " call me stupid but is it not your job, dont you get paid for it?" I have never ever phone a doctor for a stupid order because the way I see it I am my pt's advocat and if they need something they need it!!