Is this my responsibility?

MunoRN, RN · Oct 10, 2015

It's a pretty common part of the discharge process to notify a patient that a follow up CT is recommended in 6 months or whatever it is. I'm not sure why it's not something an RN can do.

TakeTwoAspirin, MSN, RN, APRN · Oct 10, 2015

Back when I was an MA I used to call with lab results, biopsy results, follow up testing needs, etc. Not sure why as a RN you would consider this inappropriate.

Charlie Raye · Oct 10, 2015

This is a "healthy" pt who started with a new cough about a month ago. The X-ray report indicates that the findings are highly concerning and immediate attention is required. I have no hesitations calling a pt to alert them of abnormal lab results but in my opinion a case like this should be addressed by the doctor.

BuckyBadgerRN, ASN, RN · Oct 10, 2015

Well, now you've added more information than you originally shared. I still feel it's within your scope LEGALLY to do. You DO call patients regarding lab results, no? You aren't going to divulge any diagnoses in this call, right? I think you're overreacting and think it absolutely IS your responsibility to do as your boss asked you to do.

This is a "healthy" pt who started with a new cough about a month ago. The X-ray report indicates that the findings are highly concerning and immediate attention is required. I have no hesitations calling a pt to alert them of abnormal lab results but in my opinion a case like this should be addressed by the doctor.

TakeTwoAspirin, MSN, RN, APRN · Oct 10, 2015

A case like what? There is no diagnosis yet, you are simply indicating that they have had an abnormal test that requires further testing. It's not like you are breaking the news that they have 6 months to live. "Concerning" isn't a diagnosis. You are simply conveying that there is an abnormality identified on a test indicates need for further evaluation before a diagnosis can be made. If they have questions, offer to schedule an appointment for them to discuss with the physician after the diagnostic studies have all been completed.

Charlie Raye · Oct 10, 2015

I completely understand what you are saying. However, if I were this patient I know I would have questions. And I KNOW this pt would have questions. Sure I could offer him an appt with his PCP to discuss this but it would be weeks before he could get in. So why not just have the PCP Make the call and any questions the pt has can be answered right then? I didn't feel it was fair to my pt to call him on Friday and tell him the Crx was abnormal and leave him hanging until Tuesday, when his PCP returns to the office and might be able to call him back.

brownbook · Oct 10, 2015

I so completely agree with you Charlie Raye I'm really surprised you and I are alone in thinking this way. I have read discussions whether a nurse can tell a patient the results of their lab work and nurses argue on both sides. (I think except in rare cases that of course a nurse can tell a patient the results of their lab work.)

But telling a patient their chest x-ray is abnormal and they need a CAT scan, I can't imagine any situation where the patient isn't going to have a lot of questions. The doctor should have asked for the patient's phone number and called him or their self, or since it isn't an emergency, call the patient Tuesday when they returned to their office.

I think it was totally wrong.

Libby1987 · Oct 10, 2015

I realize you aren't comfortable with it but until the CT and possibly further test results are back you can answer the patient's questions as well as his PCP. Not wanting to is different than unable to.

It is a crappy situation for the patient to be in. They're wanting to know the cxr results and could be quite anxious and frustrated if no one got back to them until the following week while having to wait any length of time to get more answers is frightening. It's a no win and it doesn't matter who gives them the initial information that further testing is needed.

Of course they are going to be scared but there is nothing the PCP could have said that would aleviate their fears or reduce the odds of a terrible diagnosis.