Dr anxiety...ridiculous!

FireStarterRN, BSN, RN · Feb 18, 2009

I always start the call by saying "I'm so sorry to have to bother you at home but..."then go into my spiel about the patient. I work days now, but that's what I did when I had to call doctors at home. Hope that helps. I never had any problem with doctors.

squee-gee · Feb 18, 2009

I do know what you mean....this is one part of nursing that I dread as well. I am also a new grad, so I don't have the self assurance older nurses do when they speak to the docs on the phone. I haven't had a doc be a real jerk on the phone yet, but I'm sure I will at some point (I work the night shift as well...). The advice I've received from more experienced RN's is to preface calls with "you realize I am required to call you with this information" (if you are calling in a critical lab or if the Drs orders require a call if parameters fall below a certain number). Of course, there will always be those docs who are jerks plain and simple. I always take a consensus from the other RNs I work with if I'm unsure whether I should call or not. From what you describe, you were totally correct in calling the doc about that patient - but why would it be your fault the pt died? Your the one informing him of the pts declining health!

casperx875x · Feb 20, 2009

I never apologize for calling a physician. It's BOTH of our jobs to care for the patient whether it be 10AM or 2AM. I will clearly state that A) I am concerned about a change in the patient's status, B) I have a direct order to notify the physician if X, Y, or Z occurs or C) I am required to notify a physician for critical labs, etc. If they don't want to be notified about a certain event, ask them if you can discontinue that order, otherwise they will continue to be notified. I've only been yelled at once in my 8 months so far *knocks on wood* but actually received a return phone call from that physician stating that I was right to call him, and he even apologized.

If you feel a physician is ignoring your concerns, file a complaint, notify your NM, get your charge nurse involved and call an RRT if you have that available at your facility. Better to be safe than sorry. Continue to be an advocate for your patient!!

LogCabinMom · Feb 20, 2009

gericare -

I recently found an article about the SBAR communication tool, it helps organize my thoughts when I have to call a doc. It was in a Nursing2006 article on the airline industry, interesting enough...if you're a subscriber to Nursing2009, you can browse their old articles and just type "airline industry" - it's from Nov 2006.

RedhairedNurse, BSN, RN · Feb 25, 2009

Maybe you should have called him back and said.....Well Dr, I'll chart what you said to me so if he does pass, it will be your fault for not giving me any orders to carry out.

Geez.....what a jerk of a Dr !!

schroedie · Feb 25, 2009

i was very nervous at first when i had to start dealing with the mds but i quickly realized that residents are not to be feared (i work at a teaching hospital) and its getting to the point where ive been on my unit long enough that more attendings have started approaching me for opinions. that usually catches me off guard more than scares me because im starting to realize that my opinion and assessments are important to the bigger picture. what scares me the most though is when the resident asks me what the order should say or what order they should give me. holy cow.

the sbar tool is great. i was taught that during one of my advanced clinicals and it is just a great way to deal with a doc. if you are unfamiliar with sbar it is:

situation

background

assessment

recommendation

ive noticed that mds seem less annoyed when you keep it short, to the point, and you really knwo why you are calling them. when you call, say something like im calling about so and so who has x y z order, this is what i have (vitals, assessment info etc) and i was wondering if you could (make a suggestion - put in an order for pain meds, tylenol for fever, can you come see the pt - although only suggest this if you are talking to an oncall or someone already there - somthing along those lines.

and then my last real suggestion is to document document document. its totally CYA but its necessary. document your assessments and what you did about it - you called the MD, made a request, and the response you got. a lot of time, i will document what i found, that i notified which specific md and then whether they said they would see the pt etc. if they give you a negative response, document that as well and as objectively and accurately as possible. that way if something does happen ie a pt dies then it "wont be your fault if the resident dies" because you have all the legal documentation of your actions and efforts. there is only so much you can do and without md orders we are "stuck" so to speak (obviously if the pt is going to die dont just sit there and watch, but i think you know what i mean).