What to do when the Doctor wont call back??

  1. 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??
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    About sleepdeprived1

    Joined: Nov '10; Posts: 48; Likes: 6


  3. by   Marshall1
    Always, 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.
  4. by   MrChicagoRN
    As stated, document all contacts, or attempted contacts. Find out what your chain of command is at your facility, so you know what to do the next time
  5. by   sleepdeprived1
    I 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.
  6. by   CherylRNBSN
    Of 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.
  7. by   serenidad2004
    I always call the attending first whether they are on call or not
  8. by   wish_me_luck
    We 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.
  9. by   MomRN0913
    Is this a psyche hospital? If it is and there are no docs in house or an er, you call 911!!!!
  10. by   SaoirseRN
    I 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.
  11. by   Meriwhen
    Call 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.
  12. by   uRNmyway
    Where I used to work, we would call whoever was on call for that specialty for the night. Depending on the severity and urgency of the situation, I might page again 2-3 times, and like others have said, document each time you have them paged. If after several attempts I still dont hear back, I would call the on-call resident.
    I had something like what you described happen to me. The docs started playing patient hot-potato. Specialist would not take charge of the patient because he was made aware of the transfer at 10:05pm (cut-off was 10:00), and ER doc said the patient wasnt his responsibility anymore. We finally managed to get the ER doc to put his boy boy briefs on and keep him on charge until the next morning. But that is part of our job, to advocate for our patients so they get the best possible care.
    Oh, and dont be afraid of the attitude they will give you. In the end, if you were doing what was in your patients best interests, and if you followed P&P for your facility, you will win and they will look like spoiled children.
  13. by   anotherone
    i work in a teaching hospital. first i page the intern, r2 , r3 never got to attending on night shift. sometimes the 1st dr is busy in another emergency. so then i might overhead page that medicine or surgery team. that will bring alot kf drs out of the woodwork. another reason i dont want to work any where aside from a teaching hospital or a place with in house coverage
  14. by   Indy
    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.