Can't get a hold of Dr.!

*Posh* · Mar 31, 2011

Many times. All you can do is document it. I suppose you can write the dr up but I have never been blessed with having to do that :icon_roll

PammyRN,CEN · Mar 31, 2011

In the event that you cannot contact the patients primary care doc you then notify the medical director. CYA!

Isabelle49 · Mar 31, 2011

You did the right thing. The doc, being human, goofed!

NightNurseRN · Mar 31, 2011

I always try to remember that doctors, just like nurses, are human too. When something like this happens in my hospital I would just call the NP on call if the doctor signed off on NPs, but of course not all facillities have this.

sarafina · Mar 31, 2011

This happens often with one of our docs. esp at night. He will call back 8 hrs later as if that's normal. We had an inservice the other day when the DON and Admn said we can NOT chart attempted to notify MD return call pending. I was like "yeah right..." and when a lawsuit drops,,,how exactly am I supposed to prove that I did infact attempt to notify the doc??

canchaser, BSN, RN · Mar 31, 2011

Had this happen last week, beeped every 30 minutes x3. We realized we had her beeper, it was after hours, so we called the exchange they called her on her cell and told her. Next time explain how many times you've called without a return call, the exchange may have a cell phone number.

Cessna172 · Mar 31, 2011

This happens often with one of our docs. esp at night. He will call back 8 hrs later as if that's normal. We had an inservice the other day when the DON and Admn said we can NOT chart attempted to notify MD return call pending. I was like "yeah right..." and when a lawsuit drops,,,how exactly am I supposed to prove that I did infact attempt to notify the doc??

Is that DON crazy? Charting stuff like when you called the doc is important. What's that old saying...oh yea...if it wasn't charted, it wasn't done. I'm sure a lawyer would love to get ahold of the nurse who can't prove he/she tried to call the doc.

GM2RN · Mar 31, 2011

This happens often with one of our docs. esp at night. He will call back 8 hrs later as if that's normal. We had an inservice the other day when the DON and Admn said we can NOT chart attempted to notify MD return call pending. I was like "yeah right..." and when a lawsuit drops,,,how exactly am I supposed to prove that I did infact attempt to notify the doc??

This sounds like the kind of DON who "fixes" the RNs charts... :eek:

felineRN · Mar 31, 2011

Situations like this bother me to no end. I hate feeling helpless as to intervene and waiting for the almighty MD to call back with orders that I was already anticipating. I hate being at the mercy of an MD for simple little things like this. Many of our docs forget order sets (like a tele order set includes nitro, EKG for HR > 140 sustained or :clown: :clown: :clown: :clown: :clown:

It's a little off subject I know, but blargghhhhh

Ruthfarmer · Mar 31, 2011

This happens often with one of our docs. esp at night. He will call back 8 hrs later as if that's normal. We had an inservice the other day when the DON and Admn said we can NOT chart attempted to notify MD return call pending. I was like "yeah right..." and when a lawsuit drops,,,how exactly am I supposed to prove that I did infact attempt to notify the doc??

BULL CORN! Your DON and Administrator are nuts.

MICPEricRN · Mar 31, 2011

Recently there was a resident w/a bs of 489. The agency nurse called the dr. but never received a call back. The sliding scale calls for give x amt of insulin and notify dr. The nurse called the DON and she told her to keep trying to reach the dr., recheck bs q 15 mins and document. Needless to say the dr. called back 4 hours later. He said he didn't realize he was on call. Has anyone had this similiar experience, and if so what steps were taken?

Had a similar situation with a patient I had recently while working my paramedic job. We were called to a local long-term care facility for a "request to transport patient on a monitor." Mind you, I was not working the SCTU (transport unit), but a 911 paramedic unit.

What happened was this: At 1130, patient (with multiple hx including DVTs, obesity, type 2 diabetes, HTN, released from hospital 2 days prior s/p knee replacement) c/o chest pain. Nurse gave pt mylanta and called doctor. (hmmm ?) Pain resolved within a half hour or so. MD finally called back about 1800 and told them to call for transport with monitor to the contracted SCTU service. The contracted service did not have a unit readily available. The doc then told them to call 911. Thus why we were summoned.

Of course at this point the patient was totally complaint free, so as a paramedic in a 911 situation, we were not really needed. We did a complete assessment on the patient, EKG, vitals, blood sugar, etc., and found nothing outside of normal limits. Patient had no drips or running IVs, only a capped, heparinized PICC line. Our role is not to provide monitored transports to a patient for whom ALS can not be justified. We called our medical control physician and explained the situation. In our system we respond as a non-transport ALS unit with a dual dispatched BLS ambulance. With the base physician's authorization, we released this completely stable patient to the BLS unit for transport.

This of course did not sit well with the nurse in the LTC. I felt for her, because as an RN, if I were placed in a similar situation, I'd be very uncomfortable. When I asked why they did not simply call 911 when the patient was acutally experiencing chest pain, they said that they were told that they have to have authorization from the MD first and he didn't call back...for six and a half hours. I was dumbstruck. Do the LTC folks out there really have restrictions like this?

We ultimately explained to the nurse there the patient was stable and really did not need our services on the relatively short transport to the ER. She understood fully, but I think had some trepidation about explaining the situation to the MD. I would certainly not have wanted to be in her shoes. IMHO, these folks need to have a little more autonomy in decision making. They should not have their hands tied playing phone-tag with the doctor in a potentially serious emergent situation.