What I usually do is explain why I am asking for clarification and inform them that it is my job to update them and that I will continue to do what is necessary for the patient, including calling them with questions.
Do you consult with your charge nurse or house supervisor before making these phone calls to see if they can clarify or answer any questions you have? As a house supervisor, I'm often able to clarify what some of the floor nurses did not understand, and as a result, the multiple extraneous physician phone calls are minimized.
I'm cognizant that physicians entered the profession with the full understanding that calls are part of the territory, but after a while I imagine that certain inconsequential phone calls and pages can grate on their last nerves. Examples include the following:
1. The nurse who calls at 2:00am to report a critical creatinine level of 4.5 on a patient with ESRD who has been on hemodialysis for seven years.
2. The nurse who calls to request orders for pain medication without first looking at the standing orders for Norco, Tramadol and Morphine if not allergic.
3. The nurse who calls to report a blood pressure of 170/100 without first administering the PRN blood pressure medications and awaiting the response.
Some physicians are less open to answering questions than others. Some physicians have such a wide protocol and list of standing orders that eliminate the need for certain calls. Some physicians do not want phone updates on their patients unless a significant change in condition is transpiring.
Whenever possible, we combine phone calls. This essentially means that one phone call is placed to each physician at a certain time for all non-urgent issues, and at that time, all the nurses talk to the doctor and make their notifications, suggestions and requests.