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I'm an LPN and don't case manage and so I very rarely call pts when not scheduled to see them. Personally, if I felt a patient was so unstable that he/she could not safely be at home with or without family checking in, I would want to get social work involved to consider long term placement. Remember to remind patients to call the HHC office for serious issues, and 911 for critical ones.
I am one NCLEX away from RN case management and hope to continue to keep my work and home life separate as much as possible--for me, that's the only way to prevent burnout in HHC.
As for the second question, to answer the specific scenario, for a wound with an odor but no other s/sx infection, no way would I call the MD on a holiday when the pt. has an appt. the next day. Heck, even with other s/sx infection, by the time the on-call MD calls back and -possibly- calls in an antibiotic, the pharmacy may be closed or the family may not be able to pick up the script till the next day anyway. If it looks serious enough send the pt. to the ER.
So yes, I call MDs on weekends and holidays taking each situation on a case-by-case basis. More often I do not.
We do not have a social worker that works for our company. I have called the office of the aging a few times, and constantly call POA's and PCP on pts that forget to take medications on a daily basis. I do usually call a MD of most change in conditions. My clinical nurse manager told me to call the wound doctor about the odor. He did not call me back but I did leave the info on his emergency line, and of course documented everything.
I agree with both Kiszi and Susan317. You will burn out quickly if you keep up this pace....AND they should call the office during office hours or on-call nurse after hours if they have a problem....not you.
Another reason you should NOT call when they don't have a visit arranged, unless necessary is that they will become too dependent on you and will have a very hard time adjusting when discharged from the agency.
I know you think you're helping, however you're hurting yourself and them if you continue doing this, for the reasons I've already mentioned.
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twokidsmom,rn
198 Posts
I see most of my pts 2-3 times a week. But I worry about some of them so I call them even if I am not planning on seeing them for a few days. Wondering if it is just me or do others feel they are on everyday? Do you call MD even on holiday for something like odor in a wound? Pt has appt the next day. But had to leave a message on their emergency voicemail.