Getting orders noc shift

[Nursing_excellence]

Hi. Im a new grad nurse who just started working in a snf. I was supposed to orient that night. (I work 11 to7) but 2 nurses called in sick so they had to put me on the floor. Then around 2 am. I had a patient who was nauseous and was asking for a medicine. I looked at her prns and nothing for nausea. So i thought i need to call her doctor to get an order for antiemetic. But my charge nurse said that we cant call that physician until 9 in the morning. So she told me to just hand it off to the next shift. And they will f.u with the doc. Is this common in snf? I know it does not look emergent or anything. But my resident was uncomfortable and there was nothing i could do about it.

[Golden_RN, MSN]

This is not right. The DON should stand up for the nursing staff and let the MD know that the nurses will contact him/her when they need to. I do understand the intention to not call for every little thing.

Remember to do an assessment related to nausea (residual, abd sounds, last BM, etc.) and if you have an unresponsive MD that you need to get a hold of, your next option is to call the medical director.

I'm sorry they threw you out on the floor w/out proper orientation!

[CapeCodMermaid, RN]

I worked in a building where we got tagged during survey for not notifying the MD for abnormal labs. The plan of correction was to have the nurse call in EVERY abnormal lab even if it was off by a tenth of a point. Needless to say, the docs were pissy and yelled at me. I told them that we would continue to call with EVERY abnormal lab unless and until they wrote a specific order on when they wanted to be notified. For example: Mrs. K always had a high BUN but she was fine (and if I remember, 105 years old). So, the doc had to write an order which read "Do not notify MD unless BUN is greater than 40" or whatever.

WE are mandated/obligated/regulated to notify the MD. Tough touchas if they don't like it!!

[Tippyrn]

This is how it works at many long term facilities, unless it is an emergency, it can wait until morning. Where i work everyone has a standing order for Mylanta.