Doc comes up to me and says "oh the pt is transfered "?

[BlearnRN]

So my pt is to be transfered to a on site rehab facility. I notice that her foot is twitching. I ask other nurses that have had this pt if she had been doing this. They say yes, she has spasms and the attending has been in the room when this has happened before. So I go ahead text page the resident the info and the main extension number and do not hear from him. Transport gets there a while later and I still have not heard from the resident. So, I transfer the pt. Then about an hour later, the resident comes down and asks if the pt has left- I say yes - he goes " I was trying to call, but no one was answering, I probably would have given her 1mg of ativan...well, I guess if she has any problems, she will be back" -----I am so annoyed...should I go to the supervisor about this...there has been problems with the clerk not answering the phone because of being on breaks, meetings, etc and not having coverage....

[ChocoholicRN]

Unfortunately, you cannot blame this on the doc or the unit clerk, there is no one person to put this on. Did you text page the doctor only once? From your story, it sounds like there was a decent amount of time from the page till the transfer. I would have paged the doctor over and over until I got a call back. Now if the doctor kept trying to call and no one was picking up, and since the patient was to be transferred, he should have just come to the floor to see the patient and get everything straightened out. Lastly, there are many times when there is no unit clerk to answer the phone. They are either on break, doing another task that takes them away from the desk, or just short staffed so there is no clerk. But they are not the only ones to answer the phone. Nurses and aides should also be answering the phone, one unit clerk surely can't handle all the calls that come in (usually 2-3 at a time) plus their other tasks. It doesn't sound like the patient was in distress and she should be okay, I would just be more aggressive next time.

[Boston-RN, RN]

I have to agree 100% w/jerzytech

[ecnav]

the resident comes down and asks if the pt has left- I say yes - he goes " I was trying to call, but no one was answering, I probably would have given her 1mg of ativan...well, I guess if she has any problems, she will be back"

It's not on you. If the pt had acute distress you would have suspended the transfer pending further evaluation. Otherwise, transfer the twitching foot. Did you document your nursing diagnosis and supporting assessment?

:heartbeat

[BlearnRN]

ya, i documented that service was notified via text message of left foot twitching and also that the pt had a history of foot spasms

[ecnav]

ya, i documented that service was notified via text message of left foot twitching and also that the pt had a history of foot spasms

Good job. Move on

[bollweevil]

Unfortunately, you cannot blame this on the doc or the unit clerk, there is no one person to put this on. Did you text page the doctor only once? From your story, it sounds like there was a decent amount of time from the page till the transfer. I would have paged the doctor over and over until I got a call back. Now if the doctor kept trying to call and no one was picking up, and since the patient was to be transferred, he should have just come to the floor to see the patient and get everything straightened out. Lastly, there are many times when there is no unit clerk to answer the phone. They are either on break, doing another task that takes them away from the desk, or just short staffed so there is no clerk. But they are not the only ones to answer the phone. Nurses and aides should also be answering the phone, one unit clerk surely can't handle all the calls that come in (usually 2-3 at a time) plus their other tasks. It doesn't sound like the patient was in distress and she should be okay, I would just be more aggressive next time.

Who's got time to page and page and page? Or to help answer phones? Just my .

For OP: do you guys have portable phones? If this is an ongoing problem with this doctor, address it to him directly, privately first. If no change, go to your boss.

[TiredMD]

I am so annoyed...should I go to the supervisor about this...

If you go to your manager, one would expect his/her first question to be, "If this was such a serious issue to you, why didn't you delay the transfer?"

[RN1989]

If this was important enough to contact an MD for, then you should have delayed the transfer until you received a reply.

If something were to happen and it turned out that the twitch was the beginning of something else like a seizure, your liability would be sky high. It would have been better to document less on this issue if you were going to transfer without waiting any longer for a call back. Documenting your pages and lack of reply would do nothing for you since it was your nursing judgement to transfer anyway despite your concerns.

[ChocoholicRN]

Who's got time to page and page and page? Or to help answer phones? Just my .

For OP: do you guys have portable phones? If this is an ongoing problem with this doctor, address it to him directly, privately first. If no change, go to your boss.

I sure hope you have time to page a doc, especially if the nurse felt this was such an emergency. To page a doc on the phone takes less the 15 seconds, to text page (if your hospital has that feature) takes less than 30 seconds. If you don't have 30 seconds to page a doc about what you feel is a critical issue, how do you have time for anything else? And everyone should be answering phones. If the call is for you, you have to take it unless its a personal call and you should call the person back on your break. If its not for you, anwer the phone, take 5 seconds to overhead page, and go back to your work. One person can't answer every phone call and do everything else, as I mentioned earlier.