Do you have to always call for abnormal labs?

Specialties Geriatric

Published

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 call the doctor on the phone?

Specializes in LTC, Hospice, Case Management.

We fax all normal and usual abnormal labs (ie: someone who has had a BUN of 40 for years is a usual abnormal lab). Abnormal labs are called to the MD

Blackcat99

2,836 Posts

Thanks. What kind of abnormal labs do you usually see in LTC that need to be reported right away?

CoffeeRTC, BSN, RN

3,734 Posts

It really depends on your doctor. Do they prefer labs and do they check them or look for them? If it is abnormal, I fax and then make a call to the office and leave a message. If it is a lab on the weekend, I will call the service.

Make sure you are looking at any recent lab work and compare them too.

If it is a critical value, I call that asap. Abnormal lytes, WBCs, PT/ INR, cultures that need antibiotics etc just to name a few labs. Make sure you are looking at the patient too..are they showing s/s?

psu_213, BSN, RN

3,878 Posts

Specializes in Emergency, Telemetry, Transplant.
We fax all normal and usual abnormal labs (ie: someone who has had a BUN of 40 for years is a usual abnormal lab). Abnormal labs are called to the MD

In the hospital we have a list of 'critical' labs for which we have to call the doctor right away (for example, K > 5.8 or K 15). As someone else said, assess the pt before you call the doc with the lab value. If you are calling with a high white count--what is their temp/HR/other pertinent VS? Do they have a cough/resp distress/what do their lungs sound like? etc.

CapeCodMermaid, RN

6,090 Posts

Specializes in Gerontology, Med surg, Home Health.

Unless there are specific parameters, and there seldom are, we call every abnormal lab. Too many times we've been tagged by DPH for not reporting a lab that was one tenth of a point off from normal.

psu_213, BSN, RN

3,878 Posts

Specializes in Emergency, Telemetry, Transplant.
Too many times we've been tagged by DPH for not reporting a lab that was one tenth of a point off from normal.

and of all the issues that they could be monitoring...

Blackcat99

2,836 Posts

Thanks to all for your input. Very helpful.

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)....

casi, ASN, RN

2,063 Posts

Specializes in LTC.

Unless the lab needs intervention I don't wake up doctors at night. I'll normally fax normals and normal abnormals to the doc or leave the NP a voice mail.

Specializes in LTC, Hospice, Case Management.
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.

SinikRN101

70 Posts

Specializes in Lvn to RN, new grad med/surg.
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.

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