Faxing or not faxing

[violetrose]

As RN, chg nurse I do much of the reporting to the MD's on the day shift I generally fax the chg of condition or updates to the MD, and wait for his response, if no response by the end of my shift I call the MD. I always call on anything I need an immediate response to, and then have to wait for him to call back, sometimes hours. My concern is our nurse consultant have informed us we are not to fax to the MD anything that needs a response. Basically NO FAXING, apparently a NH got into trouble when a faxed COC was sent and the MD didn't respond. The COC was considered not reported (did the MD recieve the fax? or maybe he didn't feel it was important to call back.) Apparently there was no follow up charting that the MD called back, only charting that the report was faxed. We don't have a NP or PA we can call for orders eg: laxatives, report non critical things, wound care chg's and day to day updates. Does anyone have a simular concern with faxing?

[classicdame, MSN, EdD]

I do not think it is a good idea either to fax something that requires a response. There could be a major time lag. Phone calls are faster. Even if you don't get to talk to the MD right away you can document the name of the person to whom you did leave the message with and then call back in a reasonable time if no response.

[pielęgniarka, RN]

That's the exact opposite of the facility I work at, the doctor's office asked that we fax ALL pt updates, order requests etc. No more phone calls -- only for emergent. Usually the MD is good about faxing back an order or calling it in to the facility.

We do always document that the MD was notifed via fax and that the transmission went through. Keep the transmittal reports in a folder so you can prove they went through. If we don't have a response we are calling at the end of the day to get one.

[CoffeeRTC, BSN, RN]

If it doesn't need a STAT response and you follow up on these faxes at the end of your shift or the next shift is following up on them, then I see no problem.

What does the doc say/ want?

[mondkmondk]

That's the exact opposite of the facility I work at, the doctor's office asked that we fax ALL pt updates, order requests etc. No more phone calls -- only for emergent. Usually the MD is good about faxing back an order or calling it in to the facility.

We do always document that the MD was notifed via fax and that the transmission went through. Keep the transmittal reports in a folder so you can prove they went through. If we don't have a response we are calling at the end of the day to get one.

This is the way they do faxes at my facility. We have a designated employee go through each station's fax folder, fax them herself and will occasionally make a copy of the POS depending on which doc it is being sent to, then brings the folder back to the station's charge nurse and she double checks to make sure "faxed" and date/time faxed is stamped on them, then puts them in the chart. If there is something that was faxed that requires a response, she will leave those faxes in the fax folder and will call towards the end of the afternoon to try and get a response then.

Blessings, Michelle

[achot chavi]

Since we have a doctor in house 10 hours a day 6 days a week we only receive faxed doctors orders for the hours that a doc is not in the building.

But I understand the need in a smaller facility where there is not doctor all the time, Unfortunately you have no idea if the fax was received, if the machine was out of paper or ink or whatever, the doc might even be home sick or out golfing that day...

I would follow up all faxes with a phone call to ascertain that the doc received it and it is getting the attention it deserves,

We have to be our pts advocates, no matter how busy the doc.

It sounds like your facility needs a clear policy on this or you could be in trouble.

[CapeCodMermaid, RN]

We fax for routine orders that can be answered by the end of the day. Of course any sig. change is a phone call but so many things we have to notify the doc for aren't urgent, the fax is a wonderful tool. If we don't get answered in a timely manner we call the doc. Not many of us are as lucky as you, Achot, to have a doctor in the house every day.