Communicating with MRP

[nursinghealth]

Hello:

I'm a new nurse. Two weeks into my first job out of nursing school. I'm on a surgical unit.

I remember hearing that nursing school teaches you what you need to know, but you only learn how to actually be a nurse by working on the floor. I can attest to that!

I am finding it difficult to tease out when / how often to contact the MD. For example - my post-hemocolectomy patient was bleeding large amounts of blood from her rectum. I told the MD when it happened and he ordered a CBC and maintenance fluids. Labwork was done and her Hgb dropped from 123 to 79 in about 24 hrs. She bled a few more times the next day and was eventually given a blood transfusion.

I understand that the MD must be notified if there is a change in the patient's condition. I did that as soon as I learned of the incident. My question is: do I continue to notify the MD if there is a repeat occurrence of the same thing? He seemed really frustrated when I called the second time, and though I can handle myself because I have a thick skin, I wonder if I am calling too much? Is it safe to say that he knows she's bleeding because I told him once? I don't think so because it doesn't reflect the amount of blood loss, but surely he doesn't need to know every time?

My thoughts are that I should ask the MD for parameters regarding when HE/SHE wants to be notified. In absence of that, any other suggestions?

I've very new and very green. Please be gentle!