Fax doc ONLY labs?

[jschut, BSN, RN]

OK, here's my delimma.

We are ONLY to fax our facility doc labs, and he will call the facility between the hours of 5p-5:15p for any other information.

Now, personally, I am not ok with this. I work 6p-6a. And I am told that I cannot fax the doctor anything I may have a question aboiut concerning my patient because he only wants to be notified of labs?

And please pardon, but frankly, I do not trust quite a few of the nurses I work with, when I find labs and orders and everything else under the sun shoved here and there and not processed or even acknowledged!?!?!?! (I have found orders from a doctor for one of my patients shoved in a drawer more than 3 weeks later! For petes sake!)

And I am supposed to trust these people with my patients information that I want the doctor to know?

Is this legal for him to do? And am I to be held liable of a fax DOESN'T get sent about something I want him notified of?

What would you do in this situation?

(Right now, I fax him regardless of if he gets mad or not. I don't want my license on the line for whatever he isn't notified about...)

[BluntForceTrauma]

Find another place of employment...your license is NOT safe...that is BS. There is more to a patient than labs!

[CapeCodMermaid, RN]

You can't always find another job if you don't like something about the place you work. Is he the medical director? If not and if you have already spoken to him about this, speak to the medical director and tell him/her why you are concerned about this practice. If the doc. needs to be notified then do it. Talk to your DNS...maybe she can run interference or be the one to talk to the doc. I had a doc screaming at the nurses because they notified him of an abnormal lab. He said it wasn't 'abnormal enough' and what was the matter with us. I explained to him that we had been tagged on our DPH survey because we didn't notify the doc for a BUN that was one point high. I told him that if he wanted us to stop faxing him, he would have to write an order specific for each resident. He decided that was too much work so he stopped complaining when we faxed him. Good luck.

[achot chavi]

I agree- you do what you gotta , cause you have a licence you worked hard for and want to keep it!( BTW congrats , )

Let him scream- just makes him look stupid- if there is something to know- shouldn't he care.....

ANyway, I would take CCM's advise and add to it- keep a diary or a log of what you faxed. Patient care first!!

Regarding not trusting your coworkers, thats another kettle of fish, and concerns me more. SHare your concerns with staff developement and the DON or unit manager in a respectful and gentle manner.

keep us posted!!

[freddiebear]

As far as notifying an MD we must notify an MD if a resident has a change of condition or if we receive abnormal/critical lab values. Where I come from the Lab will call in critical lab values in addition to faxing them in and record the persons name they gave the report to. Whoever is on duty is responsible for checking for labs and calling them into the MD. If an abnormal lab is found stuffed in a drawer and not documented or reported then that is an incident report needs to be filed out. If you find reports laying around and not called in you can show them to the DON. For example if a resident has an elevated dilantin level or dig level if you ignore the lab, dont notify the MD and document it and give these meds and a resident gets toxic you could be held liable.

[evilolive, BSN, RN]

I fax the MD any non-partial lab reports that the 3-11 shift has not followed up on (we write on the original lab report if it's been faxed, then file it). We don't just fax labs though. If a resident has fallen, or we notice a change in behavior or from baseline, we fax after hours. I also fax the MD if I implement a new Tx order for a wound, for example.