Nurses- medical provider needs your opinion!

[Buckeyeqt]

My SO is a medical provider at a hospital (internist). He does a call shift to answer questions from nurses. He has NPs in his group as well. He was venting the other day and mentioned how he wasn't so short with the nurses when he first started, but now the phone has a bad connotation as he knows when it rings it's due to a problem he has to help with. It's silly when it's his job to answer, but he says he gets annoyed but he said he likes nurses who think critically and he said the ones who usually call tend to call for mundane reasons and he admitted his med group has started to see a pattern in the nurses who do keep calling because they choose not to figure out a problem themselves. They have NPs with their group as well. He also mentioned the NPs have started to get cranky with phone calls too even though some were the floor nurses at one point. Is it common when you call for help, to deal with the providers who are moody and what's a good way to remind them you call because it's their job to answer and they should try to be more understanding? NPs---can you relate to this? He said he's trying to remember it's his job to help and he wasn't always like this, but I guess when he feels the answer is right infront of your face and you still call for help-he feels it's a waste of his time. I informed him id get feedback from here-what would you guys want him and his colleagues to know regarding your position when you do call for advice? ..He's trying to work on getting past being short. It's not all the time just when he thinks phone call is unnecessary.

[calivianya, BSN, RN]

I totally agree and love your suggestions for both providers and nurses. Perhaps it is a defense mechanism but when nurses say they don't feel sorry for calling and waking up a colleague in the middle of the night it makes me wonder about them. I mean seriously it doesn't make them feel at all bad? It would seem to me it's just decent human respect to feel a bit sorry if you have to wake someone up when they are trying to sleep whether it is their job or not.

I actually don't feel bad for them because there's a pretty easy workaround to being called at home in the middle of the night if a provider is taking care of inpatients - consulting the hospitalist/intensivist service. I would much rather call the hospitalist, who is AWAKE, than call an attending physician at home. I almost never call attendings if hospitalists are consulted. Exception is a surgical patient who starts hemorrhaging or something of that nature, but that's a little less common than the Tylenol/sleeping pill/pain med calls, which a hospitalist can handle just fine.

If a physician is going to take his own call and not consult a hospitalist service, it is his decision to get woken up in the middle of the night over stupid stuff.

[Jules A, MSN]

If a physician is going to take his own call and not consult a hospitalist service, it is his decision to get woken up in the middle of the night over stupid stuff.

We don't have that option, for psych stuff, it all comes right to the provider on call first. No biggie, I truly don't mind being on call and was just trying to discuss both sides of it.

[Jules A, MSN]

Wonder about me all you like, but in nursing, I could feel bad about something all day long. A patient yelling at me for something beyond my control, causing pain during very gentle turning even with meds on board, forgetting a patient request, not moving fast enough for someone's liking, etc.

Nurses feeling bad for doing their jobs? I wonder about you...

Seriously you don't feel even a little bad for causing someone pain? It doesn't stop me from doing my job or cause me to lose sleep but I do feel bad about it.

[applewhitern, BSN, RN]

We do not have any "standing orders" for any meds whatsoever, even Tylenol, so yes, we have to call for every little thing. I work ICU, so it is easier for me to make critical decisions, but some of the new nurses don't have a clue. One called the doctor because she didn't understand "free water," and called to tell him "all of our water is free." Another one called in the middle of the night to report an elevated triglyceride level!

[Karou]

About being on call...

I have always thought that the provider on call gets paid for being on call. I had someone else tell me that's not true. Does it depend on the physician group? This was from a small 4 member physician group. Just curious.

I know it's their job to be on call, but I still say I am sorry for calling and end with "have a good night". I say that because despite it being something they signed up for, I know it sucks having your sleep disrupted all night long. These providers have families and other obligations just like any other person. Their kid might be sick or their spouse trying to sleep as well. I do that to my coworkers also. "Hey sorry but room 15 needs pain meds", or even, "I am sorry to bother you but I tried this IV twice, do you have time to give it a try?".

You catch more flies with honey.

[dudette10, MSN, RN]

Seriously you don't feel even a little bad for causing someone pain? It doesn't stop me from doing my job or cause me to lose sleep but I do feel bad about it.

I try to minimize pain in everything I do, but no, I don't feel bad about it at all. I stick needles in people daily; it's part of my job. I reserve feeling bad for things that are my fault.

Maybe be your definition of "feeling bad" and mine are different, but, seriously, I would feel bad all day long for just doing my job. Talk about burning out!

[TriciaJ, RN]

We do not have any "standing orders" for any meds whatsoever, even Tylenol, so yes, we have to call for every little thing. I work ICU, so it is easier for me to make critical decisions, but some of the new nurses don't have a clue. One called the doctor because she didn't understand "free water," and called to tell him "all of our water is free." Another one called in the middle of the night to report an elevated triglyceride level!

That kind of stuff makes us all look like idiots. Their schools have failed them. Their orientations have failed them. The hiring/orientation/probation process has failed everyone.

[TriciaJ, RN]

When I say "I'm sorry to call you at this time" it doesn't mean I'm overcome with guilt and remorse. It's just a polite acknowledgement of someone else's situation. I can usually be nice and still get what I need.

[blondy2061h, MSN, RN]

We do not have any "standing orders" for any meds whatsoever, even Tylenol, so yes, we have to call for every little thing. I work ICU, so it is easier for me to make critical decisions, but some of the new nurses don't have a clue. One called the doctor because she didn't understand "free water," and called to tell him "all of our water is free." Another one called in the middle of the night to report an elevated triglyceride level!

Stuff like this is why all calls should at least be run by the charge nurse before they happen. And to see if there's any other issues that can be called with simultaneously. Even without a "standing" order, someone writing admission orders can be sure and write thorough PRN's. One of my NP school textbooks had a whole chapter on writing clear, thorough, admission orders. I think I could do it in my sleep now though, anyway.

It amazes me how many people treat Tylenol like no big deal. I've already explained why it's not great to give to neutropenic patients, and it is harsh on the liver.

[Farawyn]

OP, not that it matters, but are you a nurse, or just being a nice wife?

I'm nosey.

[chare]

Does anyone else think it's somewhat odd that the OP hasn't been back?

I can't help but think we're all being punk'd.

[mander]

Hey, if someone gets pissed at me for calling them at 3 a.m. then they can go ahead and not get pissed when I write an order given by Dr. XYZ that wasn't given by Dr. XYZ but I thought was a good call. And at that point just pay for my med school. I can get into serious trouble for not calling and for "solving problems on my own" if that means writing orders willy nilly.