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Phone, cell, beeper and texting.

Specializes in LTC Rehab Med/Surg.

Nurses are texting MDs. Cell phones instead of home phones. Beepers are obsolete.

What's the world coming to?

Change comes slowly to my area of the country. Texting for orders instead of talking, is slowly making its way to my hospital. Apparently it happens more often than I thought.

The last 4 new MDs to the area only provide cell numbers. No home phone or beeper. We have to leave voice messages when the cell is not answered.

The old MDs still answer their home phones after office hours, day and night. We also page them, and for the most part you can expect a return call within 15 minutes. They don't know if I'm calling for an MI, or for Zofran for nausea. There is no hierarchy of needs. There's no screen. I call, they answer.

I don't want to appear resistant to change. However, it feels wrong to leave personal pt info on voice mail. Then the new MDs basically screen the calls, because sometimes they call back and sometimes they don't. Is this the way bigger facilities' nurses contact MDs? How many times do you call the cell and leave a message?

Larger hospitals in the area have hospitalists around the clock, and the middle of the night phone calls to PCPs are a thing of the past. We'll probably get the hospitalist program too, but as in all things, a little later than everybody else.

What do the rest of you do when you need orders from an MD?

Do you think it's inappropriate to leave personal pt info on a cell phone voice mail?

Is it harmless, a sign of the times, and I just need to get with the program?

OCRN3

Specializes in Med/surg, Tele, educator, FNP.

I text doctors all the time to get instant answers. I feel comfortable with it. I guess I understand where you are coming from, here in SoCal I have seen many other nurses text docs all the time too. It is a sigh of the times. Although I can see taking orders from a text could be wrong in some ways.

RNinCLE

Specializes in Pediatrics.

We are able to text page a doctor, but it still goes to their work pager, not their cellphone. They do not have a way to text us back. So they can either go into the computer and enter an order for us without calling back (which is nice) or they will call. Sometimes we text them with just an FYI, and do not expect a response. We are not permitted to take verbal or phone orders anyhow - so I don't see any way we'd be permitted to take an order over text anyhow.

And while we have a hospitalist in house, our off-service patients may still require a phone call to an attending at home late at night (though we really try to avoid that).

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg.

We are able to text page a doctor, but it still goes to their work pager, not their cellphone. They do not have a way to text us back. So they can either go into the computer and enter an order for us without calling back (which is nice) or they will call. Sometimes we text them with just an FYI, and do not expect a response. We are not permitted to take verbal or phone orders anyhow - so I don't see any way we'd be permitted to take an order over text anyhow.

And while we have a hospitalist in house, our off-service patients may still require a phone call to an attending at home late at night (though we really try to avoid that).

Our MDs do not enter orders in the computer. Ever. Maybe someday.

As far as the FYI text, if they don't respond, can't they then deny they received it, if the FYI concerning a pt turns sour?

I like the verbal exchange because it's concrete. The MD CAN say I never spoke to him, but a little less likely. With the voice mail and text, the MD can just say "I never got it".

We already covered this. This nurse will not text an md for an order. Nope. Never.

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg.

We already covered this. This nurse will not text an md for an order. Nope. Never.

Me either. Would you leave a voice mail on a cell phone about a pt and a change in condition? At least half the time our new MDs don't answer their cell, and that's the only way we have to contact them.

We were instructed by management to leave our name, extension, and brief message.

I don't like it, and I'm not sure if I'm just being old.

turnforthenurse, MSN, NP

Specializes in ER, progressive care.

We can text the doctors using an online paging system and then they call us back with phone orders. These "texts" go to their pager, not their personal cell phone. The doctors love this, and the nurses love this, too. Not all of the doctors use this system, though, so for many of the consults or other internal medicine doctors who are the attending (not hospitalists), we still call their cell or home phone if it's after hours.

When leaving a voicemail I do leave name of patient if kits a personal cell. I didn't feel comfortable with it however the docs said it was easier to collect information before calling the nurse back . So before calling back they would already have looked up the patient hx and dx. I hate having to choose between what is right and what is convenient for the facility. Ask your supervisor for policy on this too.

mappers

Specializes in Med/Surg/Tele/Onc.

Most of the MDs around here use an answering service after hours. You leave a message and they page the MD.

Morganalefey

Specializes in ccu.

I have not seen any texting happening at my hospital.

There are a handful of DR's that prefer to be called on their cell phone, and if I leave a VM, I leave it w/o any personal info. I simply say: "Hi Dr. so-and-so, this is Morganalefey from ABC Hospital's cardiac unit. I have a question about a pt. Please call me back at 555-1212."

Mostly we page or call the answering service and they page/call doc at home/on cell phone.

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg.

I have not seen any texting happening at my hospital.

There are a handful of DR's that prefer to be called on their cell phone, and if I leave a VM, I leave it w/o any personal info. I simply say: "Hi Dr. so-and-so, this is Morganalefey from ABC Hospital's cardiac unit. I have a question about a pt. Please call me back at 555-1212."

Mostly we page or call the answering service and they page/call doc at home/on cell phone.

I would be more comfortable with the basics as you describe, but we were instructed to give a brief message concerning the call.

How long do you wait before you repeat the call, when there is no response?

Morganalefey

Specializes in ccu.

I would be more comfortable with the basics as you describe, but we were instructed to give a brief message concerning the call.

How long do you wait before you repeat the call, when there is no response?

Honestly, I've never had that happen. Like I said, it's only a few doc's. But how long I would wait would depend on the severity of the situation. Just like when I page them and they don't call me back.

RNinCLE

Specializes in Pediatrics.

Our texting is also done through an online system. If they deny getting a page, they can all easily be traced - and yes, we've had to do it.

It is also our policy that docs are required to respond to a page within 5 minutes.

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU.

In a word, HIPAA.

I'm an APN and I use only my cell phone. My voicemail on my cell phone states who they have reached, which practice I work for and to leave a brief message.

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg.

In a word, HIPAA.

I'm an APN and I use only my cell phone. My voicemail on my cell phone states who they have reached, which practice I work for and to leave a brief message.

Do you use that brief message to judge which situation you can postpone? Or do you respond to each with the same speed?

Obviously somebody with a pressure of 70/30 would need a quicker response than somebody who had an earache.

Do you use your cell phone to screen?

Edited by imintrouble

RunninOnCoffee

Specializes in ICU.

I leave a msg with only my name, unit, hospital and call back # on it. No pt details, however I just realized when the answering services page I guess they send them the pt name and details though. Me, personally , have never left pt details in the MSG.

I worked at a hospital with text paging. I loved it and the doctors liked it because it helped them prioritize. Sometimes they would not have to call back - you could text, "pt XX in room 4 has a K of 3.0, please advise." Then a few minutes later an order for potassium would pop up. If they didn't respond, we'd use the paging system and try to contact them. However, I have heard that at that hospital the use of text paging was being limited anymore because people were texting "books" about critical situations which was inappropriate. I didn't text regarding critical situations.

If I have to leave a message on a doctors voicemail I only state "This is Jennifer a nurse at XX hospital. I am calling regarding your patient in room 222. Please call back at this number."

If I can't text, I prefer paging services because the service documents each time you put out the call, so therefore it is on record when you attempted a call a doctor 5 times and he or she did not call back. I've also had a doctor tell me she preferred the paging system for the same reason. (Ironically, it was a doctor notorious for not returning calls..) But I know some doctors have their pages texted to them, so the patient's info is relayed on the text message.

I think it all comes with the times, if doctors and nurses can work together using new technology in the best interest of the patient, I feel that everyone benefits.

joanna73, BSN, RN

Specializes in geriatrics.

We don't text Doctors, but we are calling cell phones for orders, and leaving a brief message re: patient concerns is common. That's the norm.

madwife2002, BSN, RN

Specializes in RN, BSN, CHDN.

As said on a previous thread, I text my MD with simple requests or asking for orders

Sometimes I email him for longer decisions I need

If it is an emergency then I call him on his cell phone or who ever is on call-answering services take too long and I am giving them as much critical information as if I was texting or calling him direct!

They ask nonsensical questions and delay responses from the dr, they have no medical knowledge and it seems to take for ever when all you want is a instant order, which 9 times out of 10 you already know what to do you just need the go ahead.

Text messaging gives you a time line plus it confirms that you contacted the dr and if he responded or not

You obviously have to use common sense when using such forms of communication

dirtyhippiegirl, BSN, RN

Specializes in PDN; Burn; Phone triage.

We text to the dr's pager for non-critical things like a k+ of 3, a positive response to an intervention, etc. As a night nurse, I like the option because I'm less likely to be screamed/snarked/lectured at for waking someone up. /kind of sad, actually

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