calling the MD for Every Little thing...vent

[NurseLoveJoy88, ASN, RN]

The nurses at my job have a habit of calling the md for every little thing. Now as a new grad I'm still learning when and when not to call the md, however some of my experienced coworkers call and fax the md for little things. Here are some examples:

1. "Resident sneezed" ( since when was sneezing a medical issue. This resident sneezed one time and the nurse notified the md)

2. " Resident had one loose stool" ( okay, so how about we give po fluids, hold dairy, hold colace ,if ordered give prn immodium, continue to asess and monitor before calling the md)

3. " Resident had emesis x 1 undigested food" ( once again what is wrong with assessing, giving fluids, crackers. And monitoring before calling the md)

4. " resident has runny nose" ( okay sometimes us humans get a runny nose from time to time, temp. Is normal, clear thin secretions, no c.o. pain, just monitor)

5. " resident noted with a dry cough"( okay so why not give fluids and see if it clears up, the cough wasn't even persistant for crying out loud)

I can go on and on but these are just a few. And I just love when they ask the md for an order before checking the chart and seeing that the resident already has an order.

Please let me know if these are reasons to call the md, maybe I'm missing something here.

[NurseLoveJoy88, ASN, RN]

I was taught to contact the md when all nursing interventions have bee n done or if its an emergency...

[GM2RN]

The nurses at my job have a habit of calling the md for every little thing. Now as a new grad I'm still learning when and when not to call the md, however some of my experienced coworkers call and fax the md for little things. Here are some examples:

1. "Resident sneezed" ( since when was sneezing a medical issue. This resident sneezed one time and the nurse notified the md)

2. " Resident had one loose stool" ( okay, so how about we give po fluids, hold dairy, hold colace ,if ordered give prn immodium, continue to asess and monitor before calling the md)

3. " Resident had emesis x 1 undigested food" ( once again what is wrong with assessing, giving fluids, crackers. And monitoring before calling the md)

4. " resident has runny nose" ( okay sometimes us humans get a runny nose from time to time, temp. Is normal, clear thin secretions, no c.o. pain, just monitor)

5. " resident noted with a dry cough"( okay so why not give fluids and see if it clears up, the cough wasn't even persistant for crying out loud)

I can go on and on but these are just a few. And I just love when they ask the md for an order before checking the chart and seeing that the resident already has an order.

Please let me know if these are reasons to call the md, maybe I'm missing something here.

Assuming that you have accurately conveyed each situation and there's nothing else going on with the patient, I would never even consider calling the MD for stuff like this--especially if it the night shift.

[bagladyrn, RN]

Sounds to me as though at some point the MD has given someone on your unit serious grief about NOT calling for some issue - as a result everyone is going to call for everything.

[NurseLoveJoy88, ASN, RN]

actually the md complained to the don that nurses notify him ofminor issues too often, we even had a meeting about this but nothing has changed.

[Honeynurse]

That sounds exhausting calling the doctor for every little thing that is not really a big deal. The doctors have enough to do without being called all the time.

[Morning-glory]

I might suggest that a set of medical directives or standing orders might be of use.

If patient sneezes, do this

If pt sneezes, do that.

Dry cough, hydrate and monitor

Loose stool x1, hold laxatives and reassess in 8 hours.

Emisis, 50 mg gravol/dramamine, hold feed and reassess in 4 hours.

Etc...

Obviously somewhere along the way someone had a hissy fit and chronic MD calling was instated. This is a way out of the loop.

[PolandM]

So much for "critical thinking". I bet these people were the same that chose "notify the md" on the nclex. (I've learned that is normally never going to be the correct answer on the nclex).

[disgirlluvsdogs]

I can understand if the nurse is new because, when I was new I was a bit paranoid when a client complaints, one of my seniors taught me that assessment is important before you call the MD. In addition, if I am the MD I would definitely get irritated, when a nurse will tell me this stuffs (problems) without her even assessing the situation first and exhausting all the known nursing intervention for the situation.

"Being a chill-pill at the hospital is not a crime, it's a skill. :D"

[meadowsong, ASN, RN]

Sounds to me as though at some point the MD has given someone on your unit serious grief about NOT calling for some issue - as a result everyone is going to call for everything.

This is what comes to my mind also. Happens. It's a shame also.

Depending on your facility, it may be worth taking the time to set up some standard guidelines. Such as "if resident has loose stools for 2 days contact MD" or "symptoms of increased temp, discomfort, nasal discharge noted for 2 days, contact MD". Saves everyone a lot of time and headache when those guidelines are in place. Of course, you can always notify if you feel it urgent, but a lot of the things you described, do not appear to warrant an immediate call to the MD.