nursem8

Hi everyone I know it has been awhile but I really appreciate all of your suggestions and I apologize for not including more info I just didn’t want the post to be super long. I already knew by looking at the pt that the MD needed to be called but with how new I am I always always ask the charge or a coworker to come look at my pt to get their opinion, that night both charge and another RN said they would call in that situation so I knew I was right in that respect. My biggest problem is that on night shift we typically have to page an on call MD and explain literally everything and I just get flustered with all the info I have to give but I’m getting a lot of practice in these days calling the docs and it’s helpful. I also think things will get better when I call the same MDs multiple times but right now everyone I talk to is a new person which makes it harder. Anyways the pt did end up making a full recovery and went home a few days later so I suppose the lasix wasn’t a bad call after all. Thanks again everyone.

Hi! I really appreciate this comment and advice. I didn’t end up having this pt again but the lasix actually did help and I learned with some more research that it can actually increase BP which it did end up doing for this pt. I’m not entirely sure what ended up being wrong that night but I know that the pt was 100x better when I came back for my next shift. After another rough week of talking with many MDs I figured out that it’s going to take time and experience to be super comfortable talking with them, thanks again!

Hello everyone, I am a new RN (Jan 2021) and went from my nursing job at a long term care facility to a Post Surgical (with medical overflow) back in the beginning of April. I have been out of orientation for maybe a week total and at first I didn’t have patients that were declining enough to page doctors but last night was probably the worst night I’ve had since I have started. I am not struggling with knowing when to call a doctor or considering what could be wrong with my patient but I am struggling with communicating effectively when talking to a physician. My pt last night was technically post op day 1 into day 2 bc I work night shift. Basically overnight there were some changes in vitals (the biggest being that I had to put them on 5L of O2 after being stable on 3L) that were leaning towards the pt progressing into shock and when I paged the doctor I was told to decrease IV fluids and give IV lasix which was crazy to me bc the pt had a decently low BP that was clearly trending down. To be fair it was an on call doctor so they never really know the entire story no matter how much you tell them, but I thought I painted a good picture of the pt and they chalked it up to a possible PE and sedation from their PCA pump which yes that could also be possible (spoiler: CT was negative for PE). After all this the midnight labs come back and WBCs are increased, critical CO2 of 14, increase in creatinine and no change in pt after the orders. What are you supposed to do when a physician is on a completely different page than you are? How do you suggest more things to try? I felt so bad all night for the pt and there was nothing I could do. I didn’t feel like it was wrong to assess for a PE but I feel like we could’ve covered more bases and being a new nurse I haven’t gotten comfortable suggesting things yet. Any help is appreciated ?.