I'm faaaaaaaaaaaaaaaar from an experienced nurse :uhoh21:
But permit a fellow night shifter to share some thoughts:
1. Before you make the call - know
what you are making the call about. Most MDs have standing orders on what to call for (for example: "Call if urine output < 100cc in 2 hours" or "Call if SBP > 160") etc.
2. Once you've decided - gather all pertinent data. A good collection would be:
* Description of problem
* Recent vitals
* I/O so far (have I/O of previous shift(s) handy)
* Latest/most recent labs
* Any pertinent history of patient
3. Once you have this on hand, check the board and see who is "on call" for the patient. A quick way to check is to usually call the office - most of them have voice recordings giving you directions. If not, most floors have a book that lists who is on call for whom and when. If this doesn't help, ask your fellow floor nurses. A last ditch effort would be the nursing/house supervisor or the ER - call them and ask if "Dr. so and so on call and if not, who is covering for him/her".
4. Most docs have pagers and don't like to be called. Make sure you call the numbers they list - call the home phone number only if in a dire emergency
. And when you DO make the call, make sure you know the "call back number" (i.e. if I'm calling from outside the hospital, what number should I use to reach the unit?"). [I once made the dumb mistake of calling the doc at 3 am and leaving the wrong call back number. After waiting 20 minutes, I called his home phone number and well, he wasn't very happy!]
5. When MD calls back, speak slowly and clearly. Remember, that person is probably a little groggy - allow for their own perceptions to catch up. Be very sure about the orders you write down - repeat them if required so there is no confusion. (One of our orthopedic surgeons jokingly refers to me as "the Repeater" - but he appreciates the fact that his orders never get mis transcribed).
6. If you made a mistake - apologize for it right away.
7. Above all else - be confident and sure of yourself. Never fail to ask for assistance from your floor mates. Have one of your floor nurses walk you through one - or just watch and observe them make a call.
I know this post seems long and tedious - but believe me, it is not! Most of these things you know/have already.
Remember: "Excellence is a matter of habit. Form good habits, and your work will be excellent always".
PS: There are some docs I don't bother calling at night:
1. Because they never answer pages. I have better luck and more success getting their PAs (who almost always end up being really nice, real helpful folks. Makes you wonder how they manage working for chowderheads).
2. Because they will get nasty on the phone. These docs always have the hospitalist/internist on their cases [especially our ortho docs. Unless it has something to do with their ortho-surgery, I'm better off calling the hospitalist]. A lot of these docs are rather senior (and dare I say it : "old school" and don't take kindly to "nurses bothering them at night". Management lets them get away with it time and time again - *sigh* long story).