I work in a small rural hospital. Our hospital has about 80 beds total. The med/surg floor has about 30 beds, and there is a 4 bed ICU. Our ER is staffed 24/7 by a physician. The other doctors are family practice who usually round just once a day. Here is the question. A couple of the ER docs basically refuse to come to our unit if there is an emergent situation and the family doc can't get to the hospital in a reasonable amount of time. We very rarely call for the ER doc to come, but when we do we mean business. Some of the family practice guys are 20 to 30 minutes away from our facility. The ER docs say their malpractice insurance
won't cover them outside of the ER, therefore they don't want to get involved. Our DON supports the ER docs on their position. She says 30 minutes is a reasonable amount of time for us to wait for the family doc.
She says the ER physicians number one priority is the ER. The ER docs are suppose to respond in a code blue situation on our unit, provided they are available. I think the DON's idea stinks. She has no idea what it is like to be in a situation with a crashing patient and no physician available. What do other facilities do in this situation? If the ER doc is the only physician in the house and an emergent situation arises, is he or she expected to respond? Or do you just wait until the patient's regular physician or on call doc arrives? I would really like to know. I need to know how to present this to my DON. Thanks.