Calling Docs, Who's Responsible?

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I work 7-3 and have always made sure calls to the docs were made regarding issues occuring on my shift BEFORE I left work if necessary. Well yesterday the 11-7 nurse mentioned to me a lab that came in that she hadn't mentioned in report. She also mentioned the patient was on two antibiotics that covered the problem. Well, apparently she had just gotten the results, but never called the doc. When he came in, he went to the charge nurse who said something to me about it. I told her I found out from the previous nurse and that seemed to end it. Then I spoke with the doctor for further orders and he said he didn't need anything done he just felt it was protocol to call about the lab. Wouldn't you know, he's one of the docs who when you do call, he acts like you're a pain!! You just can't win.

Regardless I wonder why it is our night nurses often seem to put off making calls to docs and expect the 7-3 nurses to make the calls. I understand you don't want to bother the docs in the middle of the night if it isn't needed, but this nurse should have called before leaving (she got out at 800 am!) and I'm stuck with the attitudes. If I have an issue at change of shift, I place the call and then wait for the call and make the oncoming nurse well aware if I reach the doctor or expect her to follow-up if they don't call back soon. I guess you could always say "did you call the doc?", but if something happens within your time frame,you should take care of it, not push it off on the next shift.

How do your floors work with issues occurring at change of shift?

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Specializes in Med/Surge.

In our hospital, we try really hard to get everyone out on time, so if the lab that came in was important but not "life threatening", the 7a-7p shift would have called the doctor and also gotten clarification on the 2 meds. That's why I love working with the nurses that I do. We work as a team. And though we aren't always able to get everything done all the time on every shift like we would want, the other team picks up the slack b/c we have each others "backs". I love the nurses that I work with!!

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I think working as a team is the best, but I do believe it seldom works. You always have those who just seem to push off work to the next shift which is something I do not like doing. I want to know when I leave, I've taken care of everything or have made it clear if something didn't get done, they may need to handle it. I show up to work early because I want to (I don't get paid for it,) but while sitting at the nurses station, I'm amazed how much the night nurses will try to get me to do while they are still on the clock and I'm not.

The other day I had a patient in surgery and he didn't get a couple meds because he was off the floor, so I asked the next shift nurse to give a med when he returned and she said she wasn't going to bother. It blew me away as it was an important med.

It's great you work as a working team and you sound like a happy nurse!! That's so awesome!!

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Have you ever worked nights? To me, this isn't about pushing work off onto the next shift. I can not imagine calling a doc for something that requires no action on their part on a night shift. Rounds are made for a reason and that's the time to talk about those things unless you have a standard policy to call about lab results. The downside of working nights is that we have less access to the MDs for little things. The flip side of that is that days has to pass on more of the unimportant info. I understand it's frustrating that you had to deal with an annoying doc, but IMO it's the doc you should be annoyed at.

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Specializes in Oncology/Haemetology/HIV.
Have you ever worked nights?The downside of working nights is that we have less access to the MDs for little things. The flip side of that is that days has to pass on more of the unimportant info. I understand it's frustrating that you had to deal with an annoying doc, but IMO it's the doc you should be annoyed at.

If you think the MD is annoyed during the day, try calling him at 0400 AM. Especially about something that can wait. In addition, many times the call will go to a covering MD that doesn't know squat about the patient.

I agree with fergus.

If the MD is annoyed, THAT IS A PROBLEM with the MD not another shift.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

If this particular nurse seems to do this a lot, I would yell her something like, "Call him (the doc) before you leave please so you can answer any questions he has." I would have no problem processing any doctors orders he might give her as long as she wrote them on the chart before she left. Especially, with this particular doc. The other thing I might do is discuss this kind of situation with the doc when he comes in and doesn't seem so rushed one morning, "so doc, when the night shift gets labwork on one of your patients, what would you rather they do, call you or would you rather they just pass it on to us on the day shift to call you about it, or what?" Nail him down. Then if he gives you a hard time some morning you can remind him that you had discussed it with him previously.

I worked nights for many, many years. I often waited as late as I could before having to leave to call things to doctors. (Give them time to be up out of bed, showered and coherent!) I feel still that it is my responsiblity to do that because I have been the one who has been caring for the patient for the last 8 or 12 hours and can answer his questions about the patient much more accurately. There were many times that I went to the time clock, clocked out, and went right back to the nurses station to finish up calls and charting. It made up for the times when we sat around goofing off.

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Specializes in Med-Surg.

Calling a doc on night shift with nonessential information that can wait during the day is not necessary, even calling at 7AM before office hours still may not be necessary. Just depends on what it is.

If it can wait for the doc on rounds, then the day shift nurse should communicate the information to the doc. Teamwork.

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Yes I have worked nights and know we need to try to do all possible before bothering the docs, but this particular situation happened at change of shift. I think Daytonite stated it best (thanks again...you always seem to have great advice!!) Personally I would have never left this unfinished business for the next shift. This nurse had time to call the doc as she was standing around talking until 0800! If she wants to do that, that's her business, but don't make me deal with the unfinished business and the doctor's attitude later on. It's not fair for any of us to do that to each other.

I've actually worked all three shifts, while I think 7 to 3 is by far the busiest, I think 11 to 7 have the greatest challenges as they don't have a lot of backup all the time. 3 to 11 also has it's own challenges. I got the sense someone sensed I wasn't being fair to the 11 to 7 nurse, but this goes with ANY shift. We shouldn't be walking away from unfinished business. Again, I go through all my paperwork before leaving each day. I want to leave knowing I've done my best to not miss anything.

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Well, if you feel that way perhaps you could say something to that nurse next time. I just don't see the point of docs doing their rounds if we're going to call them with information that they don't need to act on every 8 hours. I would feel differently if there was something to be done about the results, but if there isn't then I see no reason to bother the MD before office hours.

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Well, if you feel that way perhaps you could say something to that nurse next time. I just don't see the point of docs doing their rounds if we're going to call them with information that they don't need to act on every 8 hours. I would feel differently if there was something to be done about the results, but if there isn't then I see no reason to bother the MD before office hours.

I've been a nurse for 25 years, and no one I know calls lab results to the doc unless they're abnormal. We let them know on rounds that the labs are back and on the chart, but only call if there's a reason to do so.

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I am a nurse on a med/surg floor and also work tele. Many times I call a doctor in the wee hours of the morning for something as simple as MOM. We all know that there are patients that will not rest until they have moved their bowels. I realize that as a night nurse these doctors do not want to be bothered for simple things, but as an advocate for my patients I have no problem adressing their needs regardless of the time. So not ALL night nurses pass the buck- I'm sorry you have that problem @ your place of employment.

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Specializes in Med/Surg, ICU, educator.

At facility where I work, our shifts are 6p-6a/6a-6p. Many docs state "do not call after 9:00 pm or before 8:00 am unless pt dead or dying." We have a housewide rule that house sup must be contacted to make a decision about any calls between those hours. If anyone thinks that I would want to stay over any more that necessary, I can honestly say NO WAY. Some days I am there that late and can do the calls, but most days, the day shift must do it. I get frustrated yes, and think that MDs should know that their job is 24/7, but can also sympathize/empathize-some things really can wait, I'm just glad we can put it off on sups and chart that to cover my ace. My facility may screw up other stuff, but they at least got that right!

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