When I was new at my hospital, I called an MD and after identifying the patient about whom I was calling I didn't give a complete SBAR, because I guess the MD seemed to indicate at the beginning of our conversation that he was familiar with the patient, so giving an SBAR just seemed awkward and wierd. After I explained the reason for my call, the MD had me transfer the phone to the charge nurse - then he went off on me because I hadn't started off my conversation with a proper SBAR, and the CN had to have a big talk with me, and I was made to feel like I'd committed a pretty huge transgression.
Fine. Lesson learned. Skip ahead about a year in time.
Now, I find that MDs sometimes get irritated with me for starting off with the SB part of SBAR - nothing long and involved, just an "I'm calling about Mr. so-and-so, a fifty year old male admitted three days ago for shortness of breath related to lung cancer" kind of thing. Just today, the MD on the other line was like, "why are you telling me about this patient? He is my patient, and I know him."
I said, "I'm just trying to give a proper report."
"But why must you tell me all these details about my patient?"
"Because," I said, "I'm trying to give a proper SBAR so that I don't get yelled at for not giving SBAR."
(I probably shouldn't have added that part about getting yelled at, but there you go.)
I know that we're all pressed for time, because me, I'm SO pressed for time every minute of the day. I don't give SBAR because I love it, or because I enjoy talking to MDs so much that I want to prolong my phone call by a precious minute - I do it because it's our protocol, and because I've gotten in trouble for NOT doing it, and because I can't always intuit how familiar the MD is with that patient or how readily they'll recall the patient simply from hearing the patient's last name.
I wonder if I should bother speaking to the MDs about what they really want (consensus, anyone?), or it I should just chill out and know that I'll never really know for sure & that's life.
I just talk to the docs like any other person - I ask 'em if they know the patient and go from there with the background and detail appropriate for the doc's familiarity with the patient.
The doc in your first example was a prick, though, for complaining to the charge nurse.
Some docs and some nurses make the whole MD/DO-RN relationship much more difficult than it needs to be on both sides.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
In the first situation, the doc should have asked you questions. No need to triangulate in the charge nurse. That doc wasted his time, your time, the charge nurse's time.
In the second situation, doc wastes his own time complaining to you about giving him information. Then accuses you of wasting his time.
I sometimes get caught between what the managers keep harping on us to do, as opposed to what makes sense at the time. In meetings, managers love to bring up MD complaints about nurses who aren't consistently giving SBAR, but it sounds like SBAR is situation-specific.
Sorry your first doctor was a jerk. He should have stopped you right away and asked for what he wanted.
It just goes to show you can't win, no matter how hard you try, especially if your manager tells you to do wrong. Good luck.
Working part-time in LTC as the charge, i'm often calling doctors on off shifts and getting an on call. Some of them may have see the patient before in their office or during their office stay...how am i to know.
i start my calls by saying "Hello Dr Jones. This is Mary calling from Happy Homes. I have Mr. Smith (admitted under Dr Blue). Are you familiar with him?"
Yes, I saw him yesterday and did his discharge..what's up? or
No, I don't recall.. Then they get the full run down.
I've been doing this too long to care about nasty attitudes from the on calll MD. It just rolls right off my back. I have a job to do and will remind them of thiers if they want to give an attitude.
You've been in the hospital for 1 year. You should know doctors and be flexible. When talking to a mean doctor, start conversation from SBAR, when talking to an adequate doctor, skip it. I once was yelled by doctor for having all 4 rails up. The doctor asked me, "Do you have doctor's order for 4 rails up??? Really you went to medical school to learn writing orders about side rails? The doc reported me to the nurse manager' but the maneger only laughed and said sarcastically? Oh, you already know Dr ///
Specializes in New Critical care NP, Critical care, Med-surg, LTC.
On nights we aren't supposed to call, we text the hospitalists. Name, DX. Complaint. That's all they want. Apparently they read on a small cell phone like screen, so more than three sentences and they get annoyed. They enter orders and we go on our way. Don't even think about trying to address anything that's not a one-time, all you'll get in response is "pass it to the day team". Sometimes it's frustrating, but it's what we've got.
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bgxyrnf, MSN, RN
1,208 Posts
I just talk to the docs like any other person - I ask 'em if they know the patient and go from there with the background and detail appropriate for the doc's familiarity with the patient.
The doc in your first example was a prick, though, for complaining to the charge nurse.
Some docs and some nurses make the whole MD/DO-RN relationship much more difficult than it needs to be on both sides.