On call issues

[Holisticlifern]

I just made my first visit on call. I received a call about a leaking foley catheter, initially the operator said the foley was out. When I called the patient he said "my catheter is out, its leaking" I asked him when was the foley placed, what reason, when is it supposed to come out, when is his next dr appt. He answers "it was placed a few days ago because I couldn't pee when I was in the hospital and i see my dr on tuesday to take it out" Today is saturday btw.

Anyways since we hardly get calls to actually visit patients while on call there really isn't any set policies/procedures or anything. We basically get a call from the answering service giving us the patient name, number and issue. On hand at home, I don't have any charts or any patient information. Before heading off to see the pt I check my email to see if his name is listed as one of our recent (last 2 months) admissions. I don't see his name, but since I only work per diem maybe just never met him.... I call my on call director just to confirm whether or not we have this patient on our census but she doesnt answer, i leave a message and she didn't call me back.

I arrive at the patients house and his foley is fine, he just didnt close it completely after emptying it. I ask him where is is paperwork(admission agreement, consent, visit notes) from other visits and he says "your the first nurse to come visit me"! Apperently he was discharged over a week ago and has NOT BEEN ADMITTED!!!!

I am now very upset, because I feel like I was ignored by my director . In retrospect I realize my fault in the issue. I should have asked the patient when did we last see him or something like that. But when I got the call, all I could think about was if the patient was ok, i thought I could only determine that by going to see him.

I was only in the home for maybe 5 minutes, when I left I texted my director and told her what happened and asked if she was aware of the patient. She immediately texted back and said "he's never returned our calls to set up admission and his Dr never agreed to sign orders".... NOW IM REALLY MADE:madface:

This was a really long vent, I had to get it out. I plan on sending a nice email to my director and administrator demanding a on call policy and a list of current census for on call nurses. I refuse to take call again until they set something in place. I don't even think I can be paid for this visit????

I am known for being a little dramatic, please let me know if you all feel like I am overeacting??

Any ideas, advice, similar situations.

thanks for reading :)

[rachel0609, ADN, RN]

Does your agency not have computer records? I don't understand how someone with no access to patient information be expected to take call .

[Holisticlifern]

No we still use paper to document. I never understood call either without records. The office is closed on the weekend and there's no way to access patient information. I've been with this company since October and have taken call a few times and this was my first time ever having to go out. Like I said in my initial post, I won't be taking anymore call without access to at least our census with PT dx

[I<3H2O, BSN, RN]

You already know what to do here and you should follow through with that. What an idiotic set up. A patient calls and you have to ask name, address, dx, doctor, everything from the patient? When they have to give a complete hx to you before they can tell you the problem they called for seems pretty dumb. Of course, I work for a very small agency and we all know everyone. lol

[Mom2boysRN]

An agency that I used to work for that was on paper we had an "on call binder" it had a copy of every current patient's 485 in it. If we got a call we could look the patient up. It was updated every Friday before the new on call nurse took the binder. Not as good as having computerized charting, but you shouldn't be going in blind. I personally would ask for an hour of pay to compensate you for the time spent with the patient.

[Sterlink]

when we still documented on paper, oncall nurses would get a print out, at the end of the day, before they took call....