Consults??

SaoirseRN · Nov 21, 2012

If you don't know the doctor's specialty (which is the most likely reason for consult) tell them you are new to the facility and just getting to know everyone, which may prompt them to tell you what type of doctor they are. If all else fails, just ask, or (based on patient's dx) try, "are you the urologist?" Provide info based on reason for the consult. It's also nice to ask if they know the patient at all. If not, a quick intro (age, brief history, admit reason) followed by details related to the consult.

Silverlight2010 · Nov 21, 2012

Where I work the consulting doctors, or occasionally their residents will come and see the patient in person. I'm unsure what they would want to know that could be determined over the phone unless it's to arrange something specifically prior to their visit or check on other tests that the patient might be off the unit for and therefore be unavailable. A neurologist might want to know about any current treatments that could affect his tests and give me a time to stop sedation prior to a neurological assessment. You could always try a general "Hello Doctor (fill in the name here), how can I help you" or "what would you like to know?"

classicdame, MSN, EdD · Nov 21, 2012

how arrogant of them to assume you know what they want to hear. Also, just because they "say" they are the consulting MD does not mean a thing. You have to be very careful about what you say on the phone. I would respond with, "Great. When are you coming in to see the patient?" If the caller asks questions that HIPAA will not allow you to answer, tell them so. "Sorry. I would be violating HIPAA to discuss this over the phone but will be happy to meet you when you come visit the patient". It is the admitting MD's responsibility to give report to the consulting MD, not yours. In my facility the first MD has to make a referral through our computer (they have access via email to this portion). This way everyone knows who the consulting MD is and can deal with it intelligently. Don't let them bully you. Always smile when you talk on the phone even though you are thinking otherwise.

RNperdiem, RN · Nov 21, 2012

Different hospitals do things differently. You might ask the charge nurse what the customary way of handling these types of calls.

Nurses usually do not call for consults of other doctors. We might call for a wound/ostomy nurse consult or a swallow evaluation or a nutrition consult, but not doctors.

At my facility, I would give the consulting doctor the name and number of the doctor in charge of the ICU so they can talk to each other. Then the consulting doctors come see the patient to do an assessment.

SaoirseRN · Nov 21, 2012

At my facility, I would give the consulting doctor the name and number of the doctor in charge of the ICU so they can talk to each other. Then the consulting doctors come see the patient to do an assessment.

Really, though, sometimes the consulting physician just wants a bit of front-line info on the patient before coming in.

Likely they've been left a message, on their phone or from their clerk, and maybe they can't get in right away so they want a bit of a heads up on the patient. A good way of doing this is to actually speak to the nurses looking after the patient.

It shouldn't violate the patient's privacy (since they have been asked to see the patient) nor should nurses be refusing to give them info, either. If the most responsible physician calls for an update, are you going to say "I'm not telling you because I think you should come see for yourself."

No, we are all part of the same team caring for the patient. Ask the doctors why they were consulted and what they would like to know.

classicdame, MSN, EdD · Nov 21, 2012

If you do not know the doctor's voice you do not know to whom you are speaking and this could result in a HIPAA violation.

Born_2BRN · Nov 21, 2012

Look in your nursing report, usually it will tell you which doctors on there and what his or her specialty is. For instance, if the GI doctor is being consulted then he or she will need to know if patient experiences any diarrhea, abd pain, or anything relating to the GI problem. Or if Infectious Disease MD consulted then you need to know if patient has a wound somewhere or is being infected by anything. Patients who being admitted often having more than one health issues and that how MDs with various specialties are being consulted.

SaoirseRN · Nov 21, 2012

If you do not know the doctor's voice you do not know to whom you are speaking and this could result in a HIPAA violation.

Using this logic, a new nurse is going to have to go around refusing to give info to every doctor he or she meets for the first time. I can't imagine that would be very good for working relationships.

noyesno, MSN, APRN, NP · Nov 21, 2012

You should be aware of all the doctors consulted for your patients. Write their names down on your brain.

In report, we usually go over who is consulted and why and if they were recently notified (gives you a heads up they might be calling to talk to you).

redhead_NURSE98!, ADN, BSN · Nov 22, 2012

Where I am a consult is an order, so they are on the kardex and on my list of CPOE orders. Reviewing those might help. I seriously would be like "What can I help you with?" I mean, come do your job and see the patient! lol

dudette10, MSN, RN · Nov 22, 2012

One of the most difficult things when starting a new job is learning the docs' names and specialties. Which ones are consults, which ones are attendings, and which consults are sometimes attendings? If you work in a facility that has residents, it becomes even more complicated when you are new.

I have found that nursing strangely has very few "job aids." My husband is in IT. Job aids are their lifelines to systems when someone new is taking over. I did many jobs aids in my previous corporate life because it made training easier! In my experience, job aids in nursing come in the form of a many times photocopied sheet that a random nurse has tucked into her binder that also has 10 people's handwriting on it as information has changed.

Simple things like the search terms for the supply Pyxis drive me nuts that I have to ask someone how to access new tubing. Shouldn't those common terms be posted next to the SPyxis? But noooooo.....

You really have to make your own job aids as you go along. Try to find out where the consult information is stored in the system so that you can check during your research on a patient. Ask the consult specialty if you don't know and write it down, so you never have to ask again. It's up to you to research what he might like to know, as that is part of gaining knowledge and critical thinking as a new nurse.

Good luck. It is frustrating, but you'll make it through.