dak. . .SBAR is a technique one can use to follow when calling a physician about a critical situation with a patient. It is what MARIAN202 has posted just above me. Here is more information about SBAR and making phone calls to physicians.
There are some things you need to keep in mind about calling physicians.
- During business hours on weekdays, call the physician's office directly.
- After business hours and on weekends and holidays, call the physician directly (if permitted and he/she is taking call). That includes calling cell phones, or direct page the doctor, if you know the number. Call every 5 minutes if you are getting no response to pages.
- Use the physician's answering service. I always advise nurses to impress on the operators that this is an emergent situation and contact with the doctor is necessary. Ask when you can expect to hear back from the doctor and follow up every 15 minutes or sooner if you have not been called back.
Before calling the physician:
- Make sure you have seen and assessed the patient yourself
- Discussed the situation with another resource person
- Checked the chart to make sure you are calling the appropriate physician
- Know the admitting diagnosis and date of admission
- Make sure you have reviewed the most recent doctor's progress notes, orders and reviewed the previous nurses nursing notes
- Have the following in front of you when you make the call: (1) the chart (2) the medication sheet (3) a list of all current IVs and IV meds (4) immediate access to lab results past and current (5) most recent set of vital signs (in fact take a set of vital signs before calling) (6) any allergies (7) patient's code status
In making the actual phone call to the physician, follow SBAR. SBAR is an pneumonic for:
- Situation - "I am calling you about (patient name). I have just assessed the patient and I am afraid that ____ is going to happen."
- Background - You give your physical assessment data
- Assessment (or analysis of the situation) - "This is what I think the problem is. I think something needs to be done." If you think the patient is deteriorating, say this.
- Recommendation - State your request or tell the doctor what you would like him/her to do. It is appropriate to suggest orders if none are forthcoming and to ask for parameters as to when you should call back.
Finally, don't forget to document the change in the patient's condition and that you have called the physician. All the information you need for the documentation can be gathered from the information above. Now, you have just saved a bundle of money because to purchase the course from the company who developed all of this costs lots of $$$.