dr won't call back.. grrrrr ..vent

EmmaG, RN · Sep 16, 2007

My last assignment was wonderful... in every way except the propensity of the docs not to return pages. I'm not talking about one or two of them; the ones who DID return pages were in the minority. On more than one occasion during the 6 months I was there, we moved patients to the ICU without the doc even knowing the patient was in trouble. There were even 2 full-blown codes and the doc wasn't aware until the next day. I went to the manager about this numerous times, only to be told with a shrug "that's the way Dr. ___ is".

Shame. The staff was great; the hospital had recently been renovated and was very 'nurse friendly'; the patients were awesome; and (even better) the administration hadn't heard of Press-Ganey.

I was asked to stay on (or return), but I can't handle that crap.

allnurses Guide · Sep 16, 2007

Fortunately for us, in a small rural hospital, we call the ER doc.

All the docs up here take turns in the ER so they are all ok with the ER doc being in charge, especially in the middle of the night.

steph

EmmaG, RN · Sep 16, 2007

This particular hospital had a small group of docs that covered the house at night. A few of the specialties "allowed" them to cover for their patients, but the majority didn't. We were not allowed to call the in-house docs for their patients, but at the same time, they knew the hospitalists would cover in case of an emergency. There was many a night I called the house doc to beg for some help when the admitting/on call wouldn't return a page. Most were sympathetic and would help out, but some were as fed up as we were, and refused. When I left, I sensed that things would be coming to a head pretty soon.

It was a damned lousy situation for us and the hospitalists and especially for the patients caught in the middle.

allnurses Guide · Sep 16, 2007

Wow, that is too bad. We have it pretty good here . . .always have access to the ER doc, 24/7 . . .

steph

fronkey bean · Sep 16, 2007

We have one doc here that you usually have to page a few times and sometimes get the operator to call his home phone before he calls you back and he invariably tells you "thank you, I'll cover that in the morning". But at least he says thank you and doesn't get mad when we chart the repeated attempts to notify him or the refusal to give orders (honestly though, I doubt he reads NN).

leslie :-D · Sep 16, 2007

frankly, when i have finally reached a certain md, i have ended an unresolved phone call with, "ok dr. xx, i will document that in my nn's.' more often than not, that has gotten their attn. and i get the orders i need.

leslie

Charge205 · Sep 16, 2007

Recently I needed to call a oncall Md. I had a critical resident that needed to go to the emergency room.I paged the on call Doctor 3 times. I waited over 1.5 hours he wouldnt call me back. So I asked my supervisor after 1/2 hour if I could call the Medical Director.. She said yes.. The Medical Director asked me how many times I had him paged. Needless to say She chewed him out. He did call me. Hollared at me over the phone.. I told him.. If you had answered your page I wouldn't have called the Medical Director! I have a critical patient that needs to go to the Emergency Room for Evulation. ( The resident had a stroke.). He never apologied to me.. But I didn't care. My Resident came 1st. I could never figure out why he took on call.. If he didn't want to be bothered why become a Doctor!

CaLLaCoDe, BSN, RN · Sep 16, 2007

one key to possibly putting a twist in the mix regarding paging the md is to add a brisk reason for the page to the exchange: patient on the verge of respiratory failure, patient hemorrhaging call back stat, patient in vtach.....but i know that if once you page the md for a diet at 0300 its hard to ever expect a call back from the doc ever, possibly never! plain and simple, call at 0300 for dire needs and 0600 for diets and laxatives.

my resident came 1st. i could never figure out why he took on call.. if he didn't want to be bothered why become a doctor!

i've figured it out! mds act all rude, act mean and curt, don't return pages for the main reason: their license is not on the line...our's is...our living depends sometimes on their giving the right order at the right time. so, doctor's play the rude card to get you to never call so that they and their sweet @ss can get some sleep!

ebear, BSN, RN · Sep 16, 2007

Hi,Kizzy!

ABSOULTELY document this in the nurses notes. Eventually this MD is likely to end up in court. Also keep a copy of this documenation with the pt's. name, date, time of call, and quote the doc at home. DO NOT add your opinion (just the facts, M'am). Your reply to the doc who told you not to document this: Calming but firmly say "Sir, I will write in the nurses notes EXACTLY what needs to be documented for the care of your pt. and the protection of my license." THANK GOD for caring and efficient nurses!

I wrote this in a journal not long ago (still have it at home) that you may enjoy:

"I'm Sorry, Did I Wake You Up?"

:trout::trout:

Dear physician,

I'm sorry, did I wake you up? I'm with your pt. 8 to 12 hrs. a day. I see the changes in your pt. that you can't possibly see during your 5 min. rounds. I also see the family struggling to get answers to all of your rambling medical terminology and your "touch-me-not" persona. I see other less experienced nurses debating over whether to bother you with your pt.'s quickly declining status because it's 3 a.m. and is it really worth having to listen to your ranting and contempt?

Sorry-- did I wake you up? Did you forget why you went to medical school in the first place? Did you REALLY think that it's all about the money that you'd someday be floating in that seems to be floating away? Have you become disenchanted with the bureaucracy that you must face daily, while trying to do what you worked so hard to learn to do? Well, we nurses fully understand that. Ours hand are tied not only by bureaucracy but by you. While we understand the enormous professional and personal pressures that you face, may I remind you of something? Without us, you would have no practice. You could neither physically nor legally take care of your pts. Hospitals would shut their doors. Both you and your pts. would sorely suffer. We are not your underlings nor handmaids. We are the stuff that attempts to keep it all running smoothly. We are the stuff that does SO MUCH daily in the face of every obstacle. We are the stuff that still cares about your pt's. welfare. We are the stuff that will continue to wake you up.

Perhaps it's high time...

ebear

EZGM · Sep 16, 2007

Wow-I am really spoiled. I work at a major teaching hospital so we always have an intern on the floor 24/7. We are thinking about moving to a small town that does not have access to a teaching hospital.

I am so fearful of the changes that I am going to have to get used to at a non-teaching hospital..........

VivaRN · Sep 16, 2007

I also work at a teaching hospital and once had a 3rd yr resident not answer after I paged him x3 on a pt. de-satting into the 70's. This was night shift. There was no one else around.

This resident had a hx of going to parties, getting drunk and blacking out. I paged the attending and the matter was swiftly dealt with. The resident came to me and apologized.

Docs not answering pages - sooner or later somebody's going to get hurt. I'm glad the OP is documenting and doing incident reports. Maybe risk management will get on his tail.