Doctors on Call

I work nights and usually end up calling the doctor on call instead of the patient's primary doc. The problem is that the doctors never seem to know what is going on with the patients. I feel like I have to tell them what they should do half of the time. Does anyone else have this problem? Don't you think they should have a better system for reporting off to one another? I feel like faxing them the H&P's that I always end up reading over the phone, along with the progress notes!! Any thoughts on this would be appreciated!!

Yep, I go through that too. Comes with the territory, I guess, but on the flip side, I would be worried about the patient if the doc didn't ask for all that information.

Deal with that alot in LTC on the weekends. Pretty much I start off by saying...are you familiar with so and so...Well...then I will give a short history..most often the orders I get are "send them to the hosp" Until I tell them what I want...simple labs, chest xray, pain meds, etc.

There are 3 groups of general surgeons at our hospital with one to three partners each. They decided last year to take turns covering one anothers' patients after hours so on our med-surg unit, after either 1700 or 1900-- can't remember which-- for post-op patients, we have to call whichever surgeon is covering that evening if there's a serious problem. If the house doc can handle things, we call him/her first, but a house doc isn't available until 1900.

So invariably you have to call a surgeon who doesn't know this patient from Adam and you have to take a lot of time filling them in on their history, surgery, meds., etc., things that I have to sometimes do for other doctors who cover for each other within one practice. But these surgeons from different practices can be a challenge to deal with, and yes, I tend to have to ask pretty directly for what the patient needs.

I don't have any solutions-- feels like the patients with doctors who are complete strangers to them who we have to call might not be getting the best care. It adds more to our responsibilities as advocates as we communicate as much info as possible about our patients to get the orders we need.