Charge nurse calls doc at night

Nurses General Nursing

Published

Tell me what you guys think of this.....

my current job (NICU) on nights, when you have an issue with your patient you report to your charge nurse and then the charge makes the decision to call the physician or not. I have a couple issues with this.... 1. Your charge calls, gets telephone order read backs, places orders and then tells you-what if she misinterprets those orders, placing wrong orders? That will fall on you. 2. What if your charge disagrees with needing to call doctor, so you go above her and do it anyway? Places staff in an awkward/power struggle situation.

I overheard scenario #2 the other night... nurse wanted to call to clarify a medication order so she could "protect herself" (rightfully so). Charge nurse told her she is protecting herself by following her orders..... ouch... and talk about awkward.

has as anyone ever heard of this practice?? It's bizarre to me!

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Maybe I am missing something. We have 80-100 babies at any given time. The doctors are being called numerous times throughout the night. They are getting paid to be at the hospital, why wouldn't the bedside nurses call them?

In the OP, Im guessing the physicians are not in house. I'm guessing no overnight hospitalist.

Specializes in Emergency Medicine.
In the OP, Im guessing the physicians are not in house. I'm guessing no overnight hospitalist.

Nope. Physicians in house at all times

Tell me what you guys think of this.....

I overheard scenario #2 the other night... nurse wanted to call to clarify a medication order so she could "protect herself" (rightfully so). Charge nurse told her she is protecting herself by following her orders..... ouch... and talk about awkward.

Oh HELL no. Just...no.

Specializes in School Nurse, past Med Surge.
Tell me what you guys think of this.....

I overheard scenario #2 the other night... nurse wanted to call to clarify a medication order so she could "protect herself" (rightfully so). Charge nurse told her she is protecting herself by following her orders..... ouch... and talk about awkward.

Umm...nope. I certainly hope the nurse called anyways! The buck stops with us, period. What if the provider did order something incorrectly & the pharmacy didn't catch it. The nurse's butt is on the line.

I wouldn't be cool with that, for lots of reasons but mostly this one.

This "procedure" is an attempt to appease the physicians for their complaints of being called too much. My patient, my call.

Specializes in Case manager, float pool, and more.
My patient, my call.

Heck yeah! Exactly.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Nope. Physicians in house at all times

Well that's just a whole lot of bull poo. As someone else said, if they're in house, then that's their freakin' job.

Specializes in Med/Surg/Infection Control/Geriatrics.

I would bring this concern to the Director or Nursing Administrator. It isn't standard nursing practice to my knowledge. Check your Nursing Policies and Procedures Manual. You could also make a call to your State Board of Nursing and ask if this is an acceptable practice.

This "procedure" is an attempt to appease the physicians for their complaints of being called too much. My patient, my call.

And I would add it also smacks of an environment with no mind toward growing and nurturing nurses. If there's truly a problem with numerous inappropriate calls (which there very well may be), the best answer isn't to circumvent but to support and teach.

Specializes in Emergency.

I am with guy in babyland. I work in a large ER and have an iphone to communicate with er people (or will go find them) but when i work in our part of the ED with boarders or have boarded patients in the ER, I will call whoever the service is. IF I have time and it is appropriate, I will text page the provider....for example requesting something for anxiety for a patient going to MRI who needs it. I will also ask if anyone else needs to talk to pulmonary or whoever the service is, but that is only if it isn't urgent. We have multiple teams for basically each service line so it would not be logistically possible to coordinate calls or have charge do it, not to mention the patient safety aspect of it, growing rapport with providers, and learning how to communicate with them as a nurse.

Specializes in Geriatrics w/rehab, LTC, hospice patient.

Hmm, I've never had this issue. Mostly, because, when the managers are not around, our supervisors prefer the floor nurses handle as much as we can on our own. We are expected to make phone calls to the providers, which makes sense-we know the situation the best. It seems silly to delegate this task to a charge nurse in order to avoid inconveniencing the physician with multiple calls. Physicians are paid well to be on call. I do not care if I have to call them multiple times, as we are patient advocates, not physician advocates.

Specializes in ICU.

My hospital wants the med surg nurses to go thru the supervisor first, simply because they were making multiple, frivolous calls and waking the docs up several times per night. This policy didn't affect me because I work in ICU. That said, I would not want anyone calling the doctor for me. My patient my license.

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