What to do when the Doctor wont call back??

[sleepdeprived1]

As a new nurse I never thought that I would have a problem with a Doctor returning my page, Boy! Was I wrong! I had a patient with a history of seizures with current multiple acute medical conditions and had grand mal seizure x 4 within 2 hours. Longest one was 5minutes. This concerned me because the Doctor was not returning my page and even after 911 paging him no answer. I thought WHAT IF this patient DOESNT stop seizing? I paged him right away too. Patient was safe and given 02,lowered to floor,..... and what ****** me off is on call doctor that FINALLY returned page sounded ALL irritated with me for calling him saying "I dont know this patient I dont feel comfortable......you need to call the attending, WHAT is the purpose of the on call if they dont do anything?? and WHAT IF the docs attending or on call NEVER CALLED BACK and the patient seizure continued over 5minutes and brain damage occurred , there were no standing orders for IM benzos and where i work is not a MEDICAL hospital so ......im gonna start documenting the HELL out of these incidents because this is sooo unsafe!!! THANK GOD the attending called back with orders to give meds and send out pt. and safe outcome...anyone work at medical hospital where the on call tells you to call attending for orders..or have this happen??

[Indy, LPN, LVN]

The OP got some good advice here. I once worked in a small rural hospital with one surgeon and no alternative coverage. So when the postop pt. has a kidney stone, which blocks her pee, reducing volume, and she feels pain through an epidural, well of course you gotta call the doc. Now by this time the powers that be had noticed this surgeon's tendency to not have coverage and so they made him have an internist on every case. So he doesn't call back, so I call internist. She gives orders for lab work and xray but says please keep trying the surgeon, clearly he needs to do something.

Nothing. All this calling back and forth is documented. Finally I went up the chain and called the medical director of the facility. He listened, ordered pain med (god bless his heart!!) and told me to call the police to go wake this dude up. Oh yes I enjoyed doing that. When the drunk, sleepy surgeon got woke up and finally called me, he was livid. He screamed, "are you crazy?" I said "oh yes" and went on with what was wrong with the patient.

It's funny the narcissism of some folks. He was put out; nevermind 3 hours of phone calls and in that place, in order to call a doc after ten pm, you gotta ask the supervisor. So the amount of calling and documenting and making excuses to the very sick, hurting patient, and generally running my butt off accomplishing NOTHING, was not fun but HE was livid. Pfft.

[katiedid53]

Oh, Indy, I loved that one, I needed that laugh, he so deserved it. Now for you, sleepdeprived1, I keep a clip board with me and note book paper to keep notes, such as, every time I have to keep calling the blessed (I am being nice) MD who is not returning my pages. I am also just nasty enough to write in quotes what he says when he is being a jerk (yah, I wanted to use another word). Because the person before me who said that he will be the first one to throw you under the bus is right, he will and you have to protect yourself. Make sure you let your supervisor know that a doctor is not returning your calls because she can also help with the calls, not that it will make the MD call back sooner, but it help free you up to do your work. If you are working in an area other than a hospital then you need to just call 911 and send the person out. I always say,"if in doubt, send them out." It is better to be safe than sorry, what is the worst that can happen? The patient is sent back after being assessed in the ER, but you still will have your license at the end of the shift. You do not need a doctor's order to send someone out to the ER. Good luck in nursing, I am glad we have new nurses coming in so that I can retire one of these days.

[turnforthenurse, MSN, NP]

Document each call/attempted call and make sure you leave a message if they don't answer. If it is the on-call MD I am trying to get ahold of but can't, I notify the nursing supervisor if I need to speak to them promptly. We have also notified security who will go look for the MDs...they know where to look because they know where the on-calls sleep. If a code blue is called, an ER physician will always come up to assess the patient/run the code/intubate if needed until the attending MD shows up.