How do you talk to doctors on the phone?

Trauma Columnist · Jul 20, 2012

I'm an APN who gets lots of calls from staff nurses. So, maybe call the mid level if that is an option? I do ask questions prior to giving orders and if I'm really busy I do sometimes ask that they gather the info and call me back. Could you volunteer to get the info and call back? The other thing I'll do is to tell the nurse upfront I'm going to need allergies, current meds, weight of pt and anything else I know I'll need.

#1ME · Jul 20, 2012

I make sure I have all the petinent information I need, prior to calling the doc. I would have the chart with me, patient's medication list, vital signs (if pertinent), and the patient's labs up on the computer already. I am not the one to take verbal abuse from a doc, be it on the phone or in person. I have hung up on a doc for being rude, and have written up a few.

proud nurse, BSN, RN · Jul 20, 2012

I make my best effort to have everything I'll need before calling. Yes, the MD's do have a way of making you feeling stupid but I won't be talked to like I am. I'm not perfect and neither are they.

Lael · Jul 21, 2012

lol I know some of them want to make you believe they are! Ugh =P

sauconyrunner · Jul 21, 2012

Some people suggest using the SBAR method for calling a doc as well as giving report. It does help. Sometimes MD's are really cranky- especially if they have been woken up at an odd time. (I mean none of us are at our best when we are woken out of a sound sleep). It helps if you can ask them, "Do you want me to give a bolus of saline?" rather than wait for them to come up with something on their own.

THe other thing that will really help you is to get really familiar with how to find stuff in the charts. That way when they ask, you can click to it faster.

Plus after a while, you will start to know better what MD's want to know...it takes time. You can also work with the other nurses on the floor to stack your calls if applicable. So you all are calling less.

DedHedRN · Jul 21, 2012

Have a full head to toe assessment, full set of vitals, and a chart you know how to navigate right in front of you when talk to them.. so if they ask you something you don't know you can just flip to the page you need and read them the info.

JRD2002 · Jul 21, 2012

IsisC has good advice...although I wouldn't bother with a head to toe assessment and just do a focused assessment on whatever problem the patient is having.

Part of calling the MD is anticipating the outcome of the call. Before calling you should ask yourself is this a problem that needs to be solved now or can it wait? Try to think of possible causes for your problem and then assess your patient to see if any fit. After identifying the problem and possible causes start to think about possible solutions. Out of the possible solutions are there any that might not be appropriate for this patient? What data would be needed to come to a decision on a course of treatment. The more you talk to doctors you will begin to identify things that they frequently ask especially if you work in a specialty area.

Aeterna, BSN, RN · Jul 21, 2012

It just takes time and practice. Live and learn - if you forgot to do something, you'll know for next time. As the others said, too, it also takes time to get to know the doctors and what they want to know and what they would want done. For example, there is one doctor who hates it when we call the critical care team without his go-ahead even if the patient is literally in critical condition (unless, of course, they are actively coding). He would prefer we call him first and go with his instructions. Then we have another doctor who is very easy-going and will order whatever we need (within reason, of course).

That being said, there will always be difficult doctors. And again, this comes down to knowing them. There is one doctor who will always be cranky if you call him. We just let it roll off our backs and advise new nurses to not take it personally.

And sometimes, doctors will yell at you for things you can't help. For example, I was working night shift and one of my patients was complaining of back pain. The only analgesic I had ordered was Tylenol, which was ineffective, so I called the on-call MD. He asked me, "Why is he having back pain?" I told him the patient hadn't had any obvious injuries and he hadn't had this kind of back pain before, so I really didn't know. I just knew he was having uncontrolled back pain. The doctor gave me a short rant about how I should know more about my patient before calling, blah blah blah...until he finally gave me an order for prn morphine.

The next night, I looked through his chart. Seems like the tests revealed the patient was having back pain due to the spread of his cancer. How the heck was I supposed to know that? >_

Maevish, ASN, RN · Aug 22, 2012

When I first glanced at the topic I laughed cause I just thought: "like you'd talk to anyone else!" cause they're not gods (although many of them don't share that opinion lol). If you have your ducks in a row before you call and it's about something important, they should have no reason to be rude to you, but you have to be ready for rudeness so you won't be surprised when it happens.

I daresay all of us at one point or another have had to call a doctor back because we forgot something, but that's life and you learn from it. If you keep doing it that's one thing, but I don't think that applies to most people because most of us don't want to call the doctors in the first place (especially those of us on night shifts!).

Some doctors you'll never please even when you're doing what they tell you to do (in a code I was literally getting hollered at by one of the docs, who's a known A-hole, for doing exactly what he'd just told me to do, multiple times) so you have to build your "nursing balls" up a bit. ;-)

eatmysoxRN, ASN, RN · Aug 22, 2012

Example: this is made up but similar things happen all the time.. Mrs. HTN had steadily had a bp of ~180/110 all day. I don't like those numbers, especially when an admitting dx was hypotension. Needless to say, I called for something when the PRN IV Lopressor didnt work well:

"Hi Dr. Grumpy. This is eatmysox RN on the 7th layer of heck. I'm calling about Mrs. HTN in room 71234. Her current bp is 190/110 (((note, this was a manual - always get a manual))) and her hr is 110 after I gave her 5mg IV lopressor. The also received her P.O. lopressor and lisinopril. She is asymptomatic. She came in with cp and hypotension. It appears her bp has been elevated all day, but it is higher now. She has NKDA. Is there anyway I could have another PRN medication?"

Anyways. I think that's how it would go. Naturally, this isn't a script but I try to keep it straightforward and tell what I think they want to know. Always have a set of recent vitals. Don't call about a funky rhythm without assessing first. Patient first. Have your notes ready and keep the chart in front of you. If you don't know something, apologize when appropriate and find out.

I still hate calling docs, although I usually have good experiences with them. Now tonight Dr. Grumpy will cuss me out. Haha.

eleectrosaurus · Aug 22, 2012

Beautiful

S=

"Hi Dr. Grumpy. This is eatmysox RN on the 7th layer of heck. I'm calling about Mrs. HTN in room 71234.

B=

Her current bp is 190/110 (((note, this was a manual - always get a manual))) and her hr is 110 after I gave her 5mg IV lopressor. The also received her P.O. lopressor and lisinopril.

A=

She is asymptomatic. She came in with cp and hypotension. It appears her bp has been elevated all day, but it is higher now. She has NKDA.

R=

"Is there anyway I could have another PRN medication?"