Charge nurse calls doc at night

[Nurse-please]

Tell me what you guys think of this.....

my current job (NICU) on nights, when you have an issue with your patient you report to your charge nurse and then the charge makes the decision to call the physician or not. I have a couple issues with this.... 1. Your charge calls, gets telephone order read backs, places orders and then tells you-what if she misinterprets those orders, placing wrong orders? That will fall on you. 2. What if your charge disagrees with needing to call doctor, so you go above her and do it anyway? Places staff in an awkward/power struggle situation.

I overheard scenario #2 the other night... nurse wanted to call to clarify a medication order so she could "protect herself" (rightfully so). Charge nurse told her she is protecting herself by following her orders..... ouch... and talk about awkward.

has as anyone ever heard of this practice?? It's bizarre to me!

[nrsdrw]

I think a solution to this problem, and one I have used as a new grad, would be to go to your charge for advice prior to calling the doctor. There are a lot of things that can be resolved by speaking to other staff, calling a physician is last resort. But at the end of the day, it is their job to be on call. Patient comes first.

I agree with this.

A primary nurse should be in direct contact with physician when exchanging assessments/concerns/orders.

An effective strategy on night shift should be to collaborate with experienced nurses on the floor and charge before making a phone call to a provider at night.

Out of respect for the provider, the nurse making a call at night should gather other nurses who also need to contact the provider before making a call. This is an unwritten rule that our providers appreciate in our unit.