Do you have to always call for abnormal labs? - page 2

by Blackcat99 6,059 Views | 21 Comments

When I worked in LTC 3 years ago, we were told to fax all of our lab results to the doctors. That included both normal and abnormal results. Do any of the LTC's do this anymore-Faxing? Or do most of the LTC's require that you... Read More


  1. 7
    Quote from Isitpossible
    i was very glad to see this post... i phonde a doc recently to report albumin level that was a 9, normal range (18-45)... doctor was LIVID and told me in no uncertain terms dont call her for this BS!! as a new nurse, now im SCARED to call... when should i call??? and there are NO parameters to guide me... (and this call was about 6ish-not like a 1am call)....
    Since you are a new nurse allow me to give you a piece of advice that you should never forget....some Drs are just jerks and they will act LIVID over anything and everything. If you really are unsure on when to/when not to call and there is no one with more experience to ask...PUT ON YOUR INVISIBLE SUIT OF ARMOR AND CALL. If you really didn't need to call you might get yelled at. If you fail to call when you should someone might die!

    Seriously, some people (including doctors) are just jerks.
    SquishyRN, tyvin, theleaf, and 4 others like this.
  2. 3
    Quote from Nascar nurse
    Since you are a new nurse allow me to give you a piece of advice that you should never forget....some Drs are just jerks and they will act LIVID over anything and everything. If you really are unsure on when to/when not to call and there is no one with more experience to ask...PUT ON YOUR INVISIBLE SUIT OF ARMOR AND CALL. If you really didn't need to call you might get yelled at. If you fail to call when you should someone might die!

    Seriously, some people (including doctors) are just jerks.

    Yep, you did the right thing. I called a doc once around midnight on a bp around 200/100 in ltc. The doc. said, "And you think that's high?" I said, "yep". He gave the clonidine order. About a week later the patient was in ICU for a stroke... and passed a few weeks after that. I only worked there part time but I know I did my job, and you have to CYA because no one else will.
    theleaf, Esme12, and Blackcat99 like this.
  3. 3
    Quote from Isitpossible
    i was very glad to see this post... i phonde a doc recently to report albumin level that was a 9, normal range (18-45)... doctor was LIVID and told me in no uncertain terms dont call her for this BS!!
    *** I hope you entered that as an order! I would have.
    NutmeggeRN, Esme12, and Blackcat99 like this.
  4. 2
    Quote from Nascar nurse
    If you really didn't need to call you might get yelled at. If you fail to call when you should someone might die!

    Seriously, some people (including doctors) are just jerks.
    I agreed but I preferred to be yelled at than let someone died which is thousand times worst.
    theleaf and Blackcat99 like this.
  5. 2
    Dont you worry about that doc..... you have to protect your license....god forbid but if that patient had died....they will try to put a blame on you for NOT calling a lab in....

    It all depends on the lab and the patient symptoms....I cant advice you when to call a doctor....
    I work in a LT faility....like if I receive for example...a vitamin d level @ 10pm that's a little bit high from the normal range....I wont call the doc....unless i am calling him for another patient, then i will just slide it in...... but if i receive that same lab @ 3pm....I will definately call....and expect a return call from the doc

    I always call for INR results.... urine cultures esp if ABT has to be changed....if i work 11pm to 7am shift...i try to call @ 6am to give them a chance to wake up etc......
    Blackcat99 and Esme12 like this.
  6. 2
    Quote from Isitpossible
    i was very glad to see this post... i phonde a doc recently to report albumin level that was a 9, normal range (18-45)... doctor was LIVID and told me in no uncertain terms dont call her for this BS!! as a new nurse, now im SCARED to call... when should i call??? and there are NO parameters to guide me... (and this call was about 6ish-not like a 1am call)....
    not to offend anyone but would an abnormal range of albumin be considered as an emergent case to call the doctor? if we don't call right a way....will the patient die because of this albumin result? could it not wait till morning? i believe a high bp is an urgent case but an abnormal albumin.....hmnn, am not too sure about it.
    psu_213 and Blackcat99 like this.
  7. 4
    I promise you and any experienced nurse will tell you this>>>>>>>
    The day you get an abnormal lab that turns into something bad and has a negative outcome for the patient,,,,this same doctor will swear to high heaven that she never said don't call and no one told her about the abnormal labs. You my dear new nurse will be left hanging out on the chopping block all by your lonesome. Your DON will not back you up, your unit manager will not back you up.
    If there are no parameters,,,,,always call abnormal labs esp. stuff like pt/inr, hgt/hct, wbc, cr/bun. I would call all my abnormal labs until this doc decides to put out some parameters.

    Also please discuss this with you DON/DNS and quality control persons. They may be able to talk to this doc about putting out some parameters.
    tyvin, Isitpossible, Blackcat99, and 1 other like this.
  8. 2
    I am a recent grad and just began my first job in LTC a little over a month ago. We fax all labs (normal & abnormal) to the doctor, and call in all critical values asap. As for abnormal labs, we call about 90% of the time, depending on the lab, possible complications, resident history and current status. Of course, make sure to assess your patient to be ready to answer the MD's questions or at least leave a detailed message. Sometimes, a detailed message can save the doc a pointless call back on the weekend/overnight.

    I agree with the above posters that, when in doubt, call. Not only does this protect your license but, most importantly, is the best case scenario for the patient. I understand why one of the posters felt a little intimated by the doctor "going off" about a phone call, but those calls 24/7 is why he/she gets paid more than us! It's the MD's job!
    theleaf and Blackcat99 like this.
  9. 2
    Quote from Isitpossible
    i was very glad to see this post... i phonde a doc recently to report albumin level that was a 9, normal range (18-45)... doctor was LIVID and told me in no uncertain terms dont call her for this BS!! as a new nurse, now im SCARED to call... when should i call??? and there are NO parameters to guide me... (and this call was about 6ish-not like a 1am call)....
    If I had a dime for every time a MD yelled at me....."You are calling me about that!!!! Don't call me again!" I'd make Warren Buffet look like a pauper.

    Save your own behind.....call them. If you don't and something happens.....YOU will be the first lone that MD blames.....Forget them. You call. 6am is a perfectly OK time to notify of labs.
    theleaf and Blackcat99 like this.
  10. 1
    thanks everyone, and i called at 6pm, so definitely not late in the evening... I documented in my notes exactly what the doctor said... and yes i see the point of albumin level low not causing fatality, but again I have NO parameter of when to call vs not call... in LTC all nurses call with abnormal labs PERIOD and that was their advice to me... and that lab was low, bottom line.. and it was NOT 2am, it was 6pm... i will continue to call and document whatever their response is, i cant let them make me feel afraid to call.. thanks for the advice seasoned nurses... appreciate it much!!!
    Blackcat99 likes this.


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