What to do when the Doctor wont call back??
- 0Oct 5, '12 by sleepdeprived1As 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??
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- 2Oct 5, '12 by Marshall1Always, always, always document every time you call a doctor - not just when he/she calls you back. If you wait 30 min or so in this case and the doctor hasn't returned the call, call again and document it again. Document just what he said - he wasn't comfortable and to call someone else..then call them and tell them what he said and make sure the charge nurse and supervisor know about this. You absolutely need to protect yourself but this kind of doc will throw you under the bus in a heartbeat.
- 0Oct 5, '12 by sleepdeprived1I guess something I really need to work on is being aware of the time I call the Doctor and writing it down right away. I always seem to forget what time ,how many times I have tried paging so when I go to chart I seem to generalize for example: paged on call doctor several times with no response, instead of paged dr. so and so at 0200. no response at 0215. ..Overall my charting needs to be more accurate. and hopefully this will help me remember to look at the times and write them down!
I wanted to go in tonight when I work and do late documentation on what doc said.. but i don't know if I should really bother now since I can't remember specific times...and how many times I paged.
- 0Oct 5, '12 by CherylRNBSNOf course, tell charge nurse.
Document times, as you have already learned.
And don't worry; there is an ER doc in house if your pt needs immediate attention. Also: Rapid Response, Code Blue.
If your pt is seizing, you will have to document that time anyway! Of course, you KNOW you callled the doc right after that.
And I'm sure you know how long you waited for that answer. You don't have to be down to the second! You prob know if it took 10 or 20 minutes before you re-paged him.
Second seizure; you will once again have to document that, and know the time, right? I'm sure right after that, you called him again.
As a new, staff nurse, there is a chain of command. Charge nurse, house supervisor, ER doc.
All you have to do is document, go thru appropriate channels.
As long as you do that, DON"T WORRY.
- 2Oct 5, '12 by wish_me_luckWe were told in nursing school that when you can't get ahold of the doctor to document it and then, go up the chain of command-charge nurse and nursing supervisor.
They can take care of it and get ahold of whoever while you care for the patient.
- 0Oct 7, '12 by SaoirseRNI once couldn't reach the on-call doctor. It wasn't an emergent call but a necessary one. At my hospital the GPs manage their own patients. We use a call-group system for weekends, where one GP for each group or clinic takes call for the weekend. On-call for starts Friday at 1700.
That particular clinic had an evening walk-in on Friday nights, so I called the clinic, explained the problem, and one of the GPs working the walk-in took care of my concern.
I've also (again on a weekend) called the patient's regular GP when we couldn't get the on-call. In this instance it was an urgent concern and she even came in to assess the situation though she wasn't on-call.
Lastly, we have a case of a surgeon who was not answering his pages/calling back for a post-op urology case who was going septic. We called the GP, who dealt with it, even though the surgeon was the most responsible physician on the case. If we hasn't got the GP, we next were going to call another urologist.
- 0Oct 9, '12 by Meriwhen Senior ModeratorCall whichever MD needs to be called (depending on your facility, it may be the attending or the on-call). If they can't be reached, document that you left a message and let your charge nurse/manager know ASAP.
Where I work, if we can't reach the attending doctor (time frame and number of attempts depending on patient condition), we call the medical director.