didn't call doc for something significant

Forever Sunshine, ASN, RN · Jun 25, 2011

Did you receive any write up for this? Either way let it go.. and next time if your gut tells you to call the doctor. call the doctor. If you aren't sure.. ask another nurse whether to call or not.

raskol · Jun 25, 2011

We make mistakes. We learn from them. It is in these situations we learn and never forget.

I remember I did a trauma as a new tech (EMS) of a girl who was ejected from her car. She was drinking and puking excessively. I finally managed to control her breathing, switching from a bag-valve mask to a non-rebreather mask and all was good. But she was hypotensive and I couldn't figure it out for the next ten minutes of transport time. I looked pretty stupid at the hospital when they quickly realized the back of her calf was open and bleeding.

I looked and felt like an idiot but I NEVER forget to check the back anymore.

You realized you made a mistake, feel bad but now you'll never forget to call a doc again.

That's how we learn our jobs.

caliotter3 · Jun 25, 2011

This was your learning experience, free of charge (of a writeup or termination even). It will help you be more aware so that next time you do make the call. Now don't beat yourself up over it or you will still lose some effectiveness on your next shift.

brownbook · Jun 25, 2011

I have been away from cardiac nursing too long. However I do remember being a new nurse and working the night shift. I do completely understand the feeling, hesitation, about calling doctors on the night shift.

The way the event unfolded, you were talking to her during the run, she was obviously in no apparent distress, then long time to see the strip, etc. Yes you should have called the doctor, but I really understand why you hesitated. You learned a good lesson, all turned out okay.

Tait, MSN, RN · Jun 25, 2011

Live and learn :) and when in doubt, give a shout (to the doc) especially if it is after 6am.

:hug:

SilentfadesRPA · Jun 25, 2011

Maya Angelou Wrote "At the time, I did what I knew to do, and when I knew better, I did better."

Learn well from this, go easy on yourself, and let it go.

Marc :)

MTRN13 · Jun 25, 2011

Always follow your gut. It is hard being a new grad. You are always seeing new things, and may not always know what it is. It is overwhelming at first, but it gets better. I also know which of my co-workers who have my back and I trust. I have learned so much from them. There is a few I would never ask them anything.

Never feel bad about paging a doctor no matter what they say, or what time of night it is. You are a patient advocate. The Doctors are paid the big bucks to wake up and call back.They knew what they were signing up for when becoming a doctor. I never feel quilty when it comes to the patient to call at any hour. I do try and call before 10 PM or after 6 AM if possible. I would never call for something like colace at 0200 when it can be handled in the AM, and in the mean time I can encourage fluids and prune juice. Sometimes when I am not sure if a doctor is groggy (which I completely understand) I will repeat lab values, test results, or vital signs if they do not seem to be respoding to something outside of the norm. Usually by saying "Dr. Smith... no orders... for the patient results of ..., and you will see them tommorow" ( I say this nicely, I know in typing it does come across wrong) I learned from doctors not comprehending a apical pulse of 133. Everything turned out ok, but it was stressful. I have had doctors catch on, and then order tests or medications.

RNJill · Jun 26, 2011

As a fairly new nurse, I just had to repeat what's already been said and tell you not to beat yourself up too much. This might rattle you for a while, but looking back you'll realize that you DID learn. I know that reflecting on my first (almost) year of nursing the one thing I have learned is GO WITH YOUR GUT and call the MD/advocate for your patient!! I ignored it the first time I got my "signature" panicky/sick feeling-and my patient ultimately ended in the SICU. The next couple of times I paid attention, and low and behold, 1) my inexplicably weak/nauseous patient had a minor heart attack and 2) the increasingly tachycardic and pale post-op patient with a large incision actually DID have a Hct of 13 (and the MD had wanted to wait on labs until the AM).

So, we are far from being experts but we do learn every day and let that encourage you :redbeathe

tokmom, BSN, RN · Jun 26, 2011

Do you have protocols to fall back on when you are in doubt? Our dr's do not want to be notified unless it is over a 7 beat run or frequent shorter runs. We then get an EKG, lytes and call with results after they are back.

You lucked out this time and you learned from it. Take it and run.

suanna · Jun 26, 2011

Where the heck is your support staff. I would hope a more seasoned nurse would have been around to advise you. You are still where the buck stops so you had better never pawn off a mistake by saying " so-and-so said I didn't need to call" but your best option is keep the more experienced staff informed of the problems your patients are having, and what you are thinking. Keep your eyes and ears open as well. If another nurse is having problems with a patient you can learn a lot by seeing how they handle it before the same problem comes up on your team.

Nurse_Breonna21 · Jun 28, 2011

Been there done that. As a brand new nurse I guess I was intimidated by Dr's and made excuses in my mind to not call them. Working 2nd or 3rd shift I was always scared to call the on-call doc and "wake them up". Luckily I never had any serious issues I failed to call on but I did realize there were issues that could have been addressed way sooner had I not been to scared to call. Now I follow my gut feeling and call (sometimes multiple times!). I realized these docs work with 100000s of nurses and while they may not be happy with you they will most likely not remember you or see you in person.