As a provider, I've definitely had those 3am calls where I'm like....really? You're calling me at 3 because a newborn has milia? Or a mild diaper rash? And not only that, you are calling every time you go into the patient's room because you are basically just telling me everything you see when you are there?
If every nurse was doing that, I would not be able to function. It would essentially be alarm fatigue. The system is structured so the more patients you have, the more you are going to rely on those in the chain who have fewer patients to accurately and reasonably keep you in the loop, but you can't have the same level of knowledge and awareness as a bedside nurse when you are the provider. You just can't. A NICU nurse has 2 patients. I have 8 if I'm on days, 25 if I'm on nights. Asking me at 2 am if we wanted to do a non-urgent intervention that would typically be done by the primary team is not appropriate. I round at night, checking in with the nurses and either tell me then or gather all those ideas together and at the end of the night, share them with me. That's what I do with the fellows. They have at least double my number of patients and if I am calling them with every time a nurse calls me, they definitely won't be able to get stuff done.
I also have known nurses to "punish" providers they don't like by calling them constantly all night, which is just petty. A provider shouldn't be brushing someone off, rather explaining what is and isn't important for a call, but also, critical thinking and respect on the part of the nurse too. It's sort of like the person who shows up in the ER at 4am because they have had a rash for a month. Ok, but what made you decide *tonight* at *this time* to go to an ER, instead of earlier, or seeing a PCP? Same thing with calling providers, it's helpful to keep in mind the SBAR framework. Situation, background, assessment, recommendation.
Situation: I have a patient who is having continued pain in chest that has now lasted for 5 hours, but has acutely intensified in the last 20 minutes.
Background: they were due to be discharged today, but it was postponed because of this chest pain, but EKG, troponins and whatever other big people tests you do were normal.
Assessment: While the patient was complaining of pain before, their BP was relatively stable, HR normal and no other concerning symptoms. Now with this acute change, they are diaphoretic, pale, tachypneic to 45, with an EKG that still reads normal and other big people tests pending.
Recommendation: I am looking for something to treat the pain of this patient and further guidance into the reason for the pain. I am concerned that the patient might decompensate, even though EKG is normal.
Or even if it is a mandatory notification (which can drive you nuts, because depending on your unit, some of the abnormals aren't really abnormal) to say "I am required by the hospital to call you to notify you of this value, and I do not (or do, depending on the patient) think it needs intervention at this time, open to discussion of course." That way you can communicate that it is a forced call, and that you are not asking them for an order in response, just that you have to notify them and they can say "ok, noted".