New RN texting Dr. advice

Nurses New Nurse

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I'm a brand new nurse at a very small end of life care facility. I got a new admit when I worked last and I was told I needed to text the facility's MD to let him know the new pt must be seen by a certain time Monday. It's been over a day now and the MD has not responded to my text. I charted that I did contact the doctor and summarized what I said to him in the text. I've never really communicated with MDs much before, but is there a "best way" to text MDs to get them to at least respond with an "ok" to my text to cover my butt? Thanks!

There are no in house MDs at my facility. I was told to text the MD by a senior nurse and when I was hired the administrator told me that the MDs prefer texts over phone calls. I did not violate HIPAA in any way because I used no identifying information for the patient, only the room number and that it was a new patient. The new patient came in an hour before the end of my shift and expecting the MD to text me back within less than an hour on a Friday night seems unreasonable. The patient needs to be seen by the MD this coming Monday by the early evening so there is still time for the MD to see the pt. Unfortunately no one really has answered my initial question. So, can someone give me an example of how they would text the MD and politely indicate that they would also like the MD to text back so the RN knows the MD got the text properly? Thanks again.

We have a new patient that needs your admitting assessment by 1/26/15,

J.D. on Station 1

Please confirm receipt of this message.

Thank you, Libby RN,

ABC LTC

Specializes in geriatrics.

If they haven't responded, call. Texts can easily be lost or forgotten.

We use text paging at work. I have the phone numbers of several physicians I work with, and would likely never text them anything patient related. I prefer to use the hospital managed text paging system as the hospital keeps a copy of all text pages in a database. An "extra" trail if you will for if something should ever come up and someone argue they weren't contacted (I suppose it could get you in trouble if you were inappropriate, but if you keep things about patients/patient care/work related - should not be issues). Our facility allows physicians (well, really all staff who have a reason to - transplant coordinators, some managers, etc) to use mobile devices (phone/tablet) to access the EHR system we use. There are caveats - they have to set up special software and a special type of encryption/password protection to even unlock their device if they choose to use that type of access (this was explained when we went to the new EHR). Hospital pager users are also allowed to "forward" their pages to their cell phone as text messaging, which is fine, but the message transmission is still sent from/through hospital software to enable tracking of sent messages.

I wouldn't send any patient info over cell phone messaging. Unless both sides are encrypted it's really not remotely something to think about, but to be honest, there are too many potential "faults" in that process, it's far too insecure. I hate calling patient's families over cell phones and I NEVER leave messages, in case I got the wrong number by accident. Even as it is, when there is an answer I generally try to ask if I'm speaking to so and so (whatever family member's name was given with contact info). My updates are pretty vague though. Sometimes I don't have the time to update families - but I always warn them that in general, no news is good news though we like to give updates when we can.

Specializes in Transitional Nursing.

"Just confirming that you got my last message regarding xyz".

In the future you can add "Please confirm receipt of this message", etc.

Specializes in Peds Hem, Onc, Med/Surg.

We text through the computer too. Only certain nurses can get away with personally texting a MD. These nurses have been working with these MDs forever! And it's always been something along the lines of we need you to.... Or you forgot to put in an order, call me. It's quicker than paging that's for sure.

I only did it once because the PA asked me to. I felt super awkward about it

Specializes in L&D, infusion, urology.

I have an on-call job, and if you don't respond to a text from the clinic, they'll call you pretty soon after. I would think that a text that goes unacknowledged should be followed up with a phone call.

Specializes in Emergency, Telemetry, Transplant.
So, can someone give me an example of how they would text the MD and politely indicate that they would also like the MD to text back so the RN knows the MD got the text properly? Thanks again.

Obviously there is a facility policy that indicates you should be texting the physician. What does the policy state? The policy should spell out what to include and what not to include (like PHI). Patient initials? Diagnosis? Room number? Since the policy is to text the physician, keep it short, to the point, and stick to the facts the policy states to include.

Specializes in public health.

Can you call and leave a message?

Specializes in Reproductive & Public Health.

Texting is an increasingly common method of communication, and when I am not using a hospital based e-texting system, I absolutely prefer texts to phone calls, as it avoids the annoying phone tag thing and allows me to gauge if I need to respond immediately or if it can wait until I finish whatever I am doing.

However, texting only works if both parties participate. It is your responsibility as the patient's nurse to ensure the provider is notified. If the doctor doesn't answer you text, you can send one follow up asking for confirmation, and if you don't receive it, then you need to call them. It doesn't matter what their preferred method of communication is; if they don't respond to the text then you have to call them. And, of course, make sure you document all attempts you made.

In your situation, I would not have waited this long to follow up. Even if it is a friday night and the patient doesn't need to be seen until Monday, it is critical that the provider knows the patient is admitted and gets an update on their status. What if the s**** hits the fan over the weekend, and the doctor didn't even realize the patient was there? That could cause a delay in appropriate care/assessment.

If I didn't respond to a text, I would fully expect to be called and it would never EVER occur to me to be mad, even if it was for a completely non-urgent matter. In fact, I would be pretty darn p-o'd if I DIDN'T get a phone call, a page, a telegram, a skywriter and a knock on my door. If you cannot contact the pt's doc, then you get their partner on the phone. If you can't get anyone, you report to your DON and document, document, document. Maybe he dropped his cell phone in the toilet, or forgot he was on call, or ran away to Mexico- you don't want to wait to find this out until you are trying to get in touch with him in an emergency!

There should always, ALWAYS be more than one way to contact a provider, (and a plan B in case all your docs are suddenly MIA) and it is your responsibility to ensure they receive your message.

Specializes in Physical Medicine & Rehabilitation.

For my unit, texting is usually reserved for the nurses that doc's trust and for those on day shift (meaning that the docs are the ones that give out their cell #'s to the nurses). Unfortunately, texting wouldn't work on nighters like us. It is convenient and wish it would be the new thing. Would love to just text docs and not have to worry about attitude/emotion behind it.

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