My "Aww crap" moment of the week: Calling a Dr.

chare · Aug 22, 2009

Learning the specifics of how each physician want's to be briefed is something that will come with time. If you're not saying what they want to hear, most of them will start asking you questions. If they do this, don't get discouraged. It's not that they think you're stupid, you're just not telling them what they need/want to hear.

There are a few things you can do however to help alleviate your anxiety.

Before you call, and it's not an emergency, take a moment or two to quickly review the patient's history.

When you call, make sure that you have all current labs and vital signs handy.

Think about what you want to say, and even consider jotting down a brief outline.

Remember, if you are calling about a specific issue or problem, the physician doesn't necessarily need an in depth report, just cover the pertinent information.

One method we use at my facility is called SBARQ. This acronym covers the areas that you need to address.

Situation: A brief one or two sentence statement describing the reason you are calling.

Background: A brief review of the facts behind the patient's admission and clinical course.

Assessment: Pertinent findings pertaining to the situation to hand, to include current vital signs, lab, and other diagnostic results.

Recommendations/Requests: What you think you need. If you only have questions ask them. If you think that the physician needs to come and evaluate the patient then say so.

Questions: If you pay attention to the questions you are asked, you will soon learn to focus on what's important to that particular physician.

I hope this information is helpful. :specs:

Editorial Team / Moderator · Aug 23, 2009

Remember -- the docs are humans, too. Good luck!! :)

shamari · Aug 23, 2009

Learning the specifics of how each physician want's to be briefed is something that will come with time. If you're not saying what they want to hear, most of them will start asking you questions. If they do this, don't get discouraged. It's not that they think you're stupid, you're just not telling them what they need/want to hear.
There are a few things you can do however to help alleviate your anxiety.
Before you call, and it's not an emergency, take a moment or two to quickly review the patient's history.
When you call, make sure that you have all current labs and vital signs handy.
Think about what you want to say, and even consider jotting down a brief outline.
Remember, if you are calling about a specific issue or problem, the physician doesn't necessarily need an in depth report, just cover the pertinent information.
One method we use at my facility is called SBARQ. This acronym covers the areas that you need to address.
Situation: A brief one or two sentence statement describing the reason you are calling.
Background: A brief review of the facts behind the patient's admission and clinical course.
Assessment: Pertinent findings pertaining to the situation to hand, to include current vital signs, lab, and other diagnostic results.
Recommendations/Requests: What you think you need. If you only have questions ask them. If you think that the physician needs to come and evaluate the patient then say so.
Questions: If you pay attention to the questions you are asked, you will soon learn to focus on what's important to that particular physician.
I hope this information is helpful.

Excellent Info, I couldn't have said it better myself, we also use the SBAR system and it works very well. Kudos to you Chare:yeah:

teeniebert, LPN · Aug 23, 2009

One of the places I did clinicals had a stack of forms by the phone that had SBAR guidelines on them. I wish I had one now; I'd scan it and post it. The important thing is to make sure you have all the info in front of you when you call the doctor.

Editorial Team / Moderator · Aug 23, 2009

I have an SBAR guideline PDF. I'll post it here. :)

sbar_draft.pdf

ThanksForAllTheFish! · Aug 23, 2009

JustEnough - The above posts are right are target. Just remember that eventually you will get a doc that will be difficult on the phone. Just keep in mind that you are doing what's right for you patient and in the process helping the doc do his/her job. And when you get off the phone after talking with a difficult doc and do whatever stat stuff you need for you patient, find a nurse buddy and vent you momentary frustration regarding the crankiness of Dr. so and so. It will help and then you can move on.

shoegalRN, RN · Aug 24, 2009

I'm so glad I work at a teaching hospital. The docs are usually residents with a medical student. They are usually "right there" or in the "call room" which is located on our floor and they will come right over and speak to us in person.

I've only had to call a doctor twice since I've been on orientation and I work nights. Both times, I spoke with the medical student and the resident who came right over to speak with me directly and looked at the patient. The doctors understand we have nurses in orientation and they also have med students with them, so they understand we are all learning. After all, it's a teaching hospital.

**NickiLaughs, ADN, BSN, RN** · Aug 24, 2009

I always jot anything I can think of. If I have to call about a situation, not only do I ask for labs, I'll ask for parameters of what to do if they come back funky (so I don't have to call them again for orders.)

example: Pt bleeding: I'd like to do an H & H, if it comes back funky, do you want me to give blood? Oh yeah, she doesn't have pain medicine I should get that too, or I see this testwas ordered tomorrow, did you want her NPO.

They've never yelled at me for taking a couple extra minutes, because I work on night shift, I try to correlate it all together.

rmejia97 · Aug 24, 2009

you can download a copy of the SBAR online, but I'd check with your facility for specific directions or permission for it's use.

knittycat1 · Aug 24, 2009

I'm a new grad RN (December '08) who has been working off orientation for about 9 weeks now. I used to be soooo nervous calling docs but then I started to get the hang of it. I'd recommend the SBAR if your institution uses it - we do and I do it very informally (especially with certain MD's). And it is very true that you'll get to know the docs and their individual needs. Just yesterday the charge and an equally experienced nurse were talking with me at lunch about the different docs and the degree of data/suggestion/request they like from the nurses (don't you love those docs that ask "is there anything else you think we need to do for the pt"?).

I also starting realizing that "hey, this is my patient - my responsibility - why I even pursued this career" so yup, if I have to call you at an unseemly hour to get something my patient needs, well then so be it. The docs can be as upset as they want to but I'm gonna call when I need to and I'm not gonna feel bad about it. Now, when the doc reams me a new one (and one surgeon really did once when it was her mistake), I still feel bad and do gripe to one of my nurse coworkers, but hey if the worst thing that happens is the doc yells at me or even yells at the charge about me, then whatever - I'll live to nurse another day.

So, as the previous posts have said, like most things, calling the doc gets easier with time. Organize your thoughts and data and go for it. Good luck!

emtb2rn, BSN, RN, EMT-B · Aug 24, 2009

All of the above and if a doc orders iv pain meds, make sure there's a prn zofran (or anti-emetic of your choice) included.