I'm sorry sir, I cannot call the neurosurgeon at 3AM for that...

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3AM during my last night shift...

Walkie/talkie patient with a cervical neck fusion on his second day post op. Continues to have sore throat and hasn't eaten much in the last day.

Patient: I'm having really bad heartburn, could you get me some tums?

Me: I'll check your chart to see if you have something that could help like Mylanta...No, I'm sorry the doctor didn't prescribe anything. Have you tried eating soda crackers, drinking water, going for a walk...etc.

Patient: Can't you call the doctor, you guys do that kind of thing all the time.

Me: You want me to call the neurosurgeon for some tums?

Patient: Well, yeah

Me: I'm sorry sir, I can't wake up the neurosurgeon for tums.

Patient: Well, don't you have some in your purse that you can slip me??

Me: Um, no :uhoh3:

What are some things patients have asked you guys to call the MD for?

Call the cardiologist.. stat.."I haven't had a bowel movement in 2 days"!

Specializes in Trauma, ER, ICU, CCU, PACU, GI, Cardiology, OR.

undoubtedly, i have no problem calling a physician @ 3:00am since i'm the advocate for my patients. consequently, in a case like the one you have presented here, i wouldn't hesitate in calling him/her stat!!!... it's better to be safe than sorry. lastly, i had patients ask me to call their physician because they forgot to leave food out for their pet and they want to go home and come back later :eek:

Specializes in Med/surg, Quality & Risk.

I have started asking pts that I admit, "What do you take when you have heartburn? What do you take if you can't sleep? What do you take if you have a sore throat? What do you take if you're constipated/have diarrhea?" "Is there ANYTHING that you can think of that you take OTC for any reason?" I put every single one of these things on their home med list as a prn and hope that the doc checks off to continue it while in the hospital, so when they decide to get obsessed about their bowels at 2330 I can just give the meds.

Specializes in Med/surg, Quality & Risk.

Yeah I prefer my neurosurgeons to have gotten plenty of sleep the night before surgery and not woken up 10 times for tums, sorry kids lol

Specializes in Med/surg, Quality & Risk.
The surgeon chose not to write PRNs for very common, normal and expected problems overnight. I assume that means he is lonely and wishes to speak to a nurse at 3:30AM.

LMAO I want to tell a doc this next time I get lip for calling them at night!!!

Specializes in Med Surg - Renal.
I put every single one of these things on their home med list as a prn and hope that the doc checks off to continue it while in the hospital, so when they decide to get obsessed about their bowels at 2330 I can just give the meds.

Thank you!!

Specializes in Neuro.

bravo! you guys are all such wonderful nurses and i appreciate all the insightful and well thought out criticism.

however, pmfb-rn and sapphire 18, i love you enthusiasm and moxie to call everyone and anyone at all hours of the night. you make some great points, however in some instances i just don’t think it’s feasible.

nrsang97, fair is a hard statement make and follow up on. nothing is really ever “fair”

grntea: love your posts, cynicism, and words of wisdom. the patient was 43 with great vitals, probably worked out. cervical fusion is a neck surgery to help with pain/other neuro symptoms…actually pretty routine on a neuro floor.

as i have said, heartburn is painful and frustrating. and itis unfortunate that the neurosurgeon didn’t anticipate that this would happen. and too bad there an no standing house orders…

this last overnight i consulted a few certified neuro nurses on my floor and one of them put it very simply…. “would you want a surgeon opening up your brain if they were woken up the night before to discuss antacids for someone??”

redhead_nurse98: i agree, let the damn neurosurgeon sleep so he doesn’t screw up someone's brain in the am.

Specializes in none.
I probably would have called the doc for tums. I know when I have heartburn sometimes it is AWFUL and I do not feel like the patient should be punished because we don't want to bother the doctor. I do not feel bad for waking up doctors. I am sorry but it is common knowledge that doctors get calls at all hours (I remember seeing this in movies as a child). So a doctor knows years before becoming a doctor that this is what he/she is signing up for.

Me too, that's what doctor are there for. Might be something else going on with this patient.

OMG, I loved reading this thread, lots of funny stories but more importantly it is great to see so many nurses here advocating for their patients.

Yes, the doctor should have been called. I've had heartburn, it was so bad when I was in the hospital they had to do a EKG on me. First time I'd had it and scared the crap out of me.

It is not a comfortable feeling, hurt and burned like crap! Entirely my fault, had snuck and ate barbecue chips when on NPO (but I was hungry) lol, taught me!

BTW, this was years ago and the nurses were great! Can laugh about itnow and greatful it happened in the daytime but I can tell you, heartburn hurts. I can't imagine telling a patient to basically grin and bear it until the doctor makes his rounds 7am in the morning.

Having said that, hopefully the oP realizes that we have to advocate for our patients first, doctor's feelings be damned.

Specializes in Pedi.

I, too, work in Neurosurgery and I would have called for an order for this at 3am. The difference is I work in a teaching facility and we have a resident in-house 24/7 who would just write the order.

I disagree that the surgeon would not be able to operate in the morning if he got woken up for 2 minutes to give a verbal/telephone order for an antacid. He'd still operate in the morning if he got called into an emergent case or had to come in at 3am to see a patient in the ER, wouldn't he?

If the patient was PO, I'd have done the crackers, etc. first. A few saltines with just sips of something to swallow, then wait 15 minutes and reassess. In this case no need to medicate without trying some food first. Not gonna wake a surgeon and tell him/her that I didn't try crackers first... LOL to those who would.

But, really surgeon should have standing prns.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
bravo! you guys are all such wonderful nurses and i appreciate all the insightful and well thought out criticism.

however, pmfb-rn and sapphire 18, i love you enthusiasm and moxie to call everyone and anyone at all hours of the night. you make some great points, however in some instances i just don’t think it’s feasible.

*** actually you missed my point. i would not make that call in my hospital. i wouldn't have to. our neurosurgeons know how to write a proper set of post-op orders, or they consult the icu team, or medicine to deal with those issues, or there are standing orders.

if that surgeon chooses to not do his job, or consult with another service to do so then it is fair to assume they are lonely and wish to speak with a nurse at 0330. if that is not the case then it will be a teachable moment for them.

in actualy my actual practice i almost never call a physician for common or predictable issues. it doesn't come up.

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