Night time notifications

[JBMmom, MSN, NP]

I work in a small critical care unit in a community hospital less than 200 beds. We have an admitting hospitalist overnight and a hospitalist that addresses issues throughout the house, including transfers. Our intensivists are on-call overnight but no one in house. It has become increasingly frustrating recently that no one notifies intensivists or specialists when patients are admitted/transferred to our unit. Then, if we need orders, we are sometimes calling an irate on-call physician that was never given an MD-MD report or consulted on the patient. (Some are more easy going about it) We have been told that the hospitalists can admit or transfer to intensive care with the understanding the patient can be managed until day shift by the nurses and hospitalists. We the nurses are often just asked what we want for orders by the hospitalists. (Which would probably be fine if more than two night nurses had more than two years experience, but that's not the case in our unit.) My frustration is that people have arrived in the morning chewing us (the nurses) out for not contacting intensivists/ specialists when issues have come up, for example a patient that came to our unit alert and oriented but coded within an hour and was then VERY busy with interventions. Shouldn't the responding hospitalists be calling that change in condition to the on-call? It is beyond my scope to request a consult or give a MD-MD handoff, and there are times where scope of practice is very closely followed, but I'm supposed to ignore this particular aspect because the hospitalist is busy? Well, we are busy too. I want to do what's best for the patient, but for a couple intensivists, I will refuse to call them until the hospitalists calls and consults, which potentially delays patient care interventions. It's really frustrating, thanks for listening.