How do you handle this?

Document and keep trying; after the second try go up the ladder of command.

Does anyone else have this problem? I work nights and some of the doctors do not answer their phones overnight or do not call back during my shift. It's very frustrating.

Sometimes they don't call back during the day shift, either. If you need an answer or an order, call the medical director. He/she will have to give an answer/order and then most likely speak to the doc who wouldn't answer the phone.

But, don't call the docs for something that could wait till the day time.

Old story. Has happened since Adam. What is important is the patient. Take care of your patient. It's a bunch of "cover your ass." The truth is admin. puts the M.D.'s in the same situation. I mean: would you write orders for a patient you never saw... in fact a patient who was assigned to you because you were next on the EC PCP list? It's not the docs, it admin.

Your facility should have a policy on how to handle it. At mine its call wait 15minutes call again wait 15 minutes. Call the house supervisor and document document document

absolutely document document document! I know that for one particular doc the police have been called to wake him up at his house....but he is the one on call....no matter how angry he becomes. This has happened to often for this particular doc.

At most of the hospitals in our area we have 'hospitalists'. These are MD's who work for and in the hospital and are charged with caring for the patients and they are called, not the primary or other MD.

At most of the hospitals in our area we have 'hospitalists'. These are MD's who work for and in the hospital and are charged with caring for the patients and they are called, not the primary or other MD.

That's the hospital.

I would call the on-call and wait. If they didn't call back within 15 minutes I'd call again. If no call back I would go down the line of every provider and apologize with, "I know you're not on call, but I can't get a response from x and we have a problem with resident x."

I only had to do that once.

CCM is right. In most LTC/SNF facilities, the medical director is the one who is called. He is responsible for the overall physician's services for the residents. It is ultimately his responsibility to make sure the docs are doing what they are supposed to do.

Once I had a pt. in his 40's and he had a huge MI. He looked bad and was getting more critical by the minute. When I called his doc all I got was drunk gibberish. He made absolutely no sense. I ended up calling our unit Management doc who was ALWAYS grouchy and hateful.

I told him everything that was going on about this patient and his attending physician. He was stonecold silent and was there in 5 minutes and saved this guy.

There is always going to be someone there to help you if you follow the chain of command.

I work in the hospital, so if I can't get a hold of the resident on call after a couple tries, we overhead page them :) Nasty trick I know but it works. Plus neither of us have to get chewed out by the sleepy R3. win-win

Once I had a pt. in his 40's and he had a huge MI. He looked bad and was getting more critical by the minute. When I called his doc all I got was drunk gibberish. He made absolutely no sense. I ended up calling our unit Management doc who was ALWAYS grouchy and hateful.

I told him everything that was going on about this patient and his attending physician. He was stonecold silent and was there in 5 minutes and saved this guy.

There is always going to be someone there to help you if you follow the chain of command.

If that was my patient in LTC with no MD in house at 3am. I'd just call 911 and send them out, then get hold of the doctor.

When I worked at a SNF I would send patients out before calling the MD if it was really an emergency. I never had a doctor get upset about me doing this.