What would you do in this situation?

Notify the doctor.

2130 isn't too late to call the doc/extender on-call.

If for some reason you couldn't, and you felt like you wouldn't get in trouble for it, I'd watch them a little closer during the night and do a fresh culture to send out with the morning labs for a C&S.

Notify the doctor.

Would you immediately call the on-call?

Did someone verbally tell you? If so, I would have said ok and why?

I might call the nurse who told me to get the sample before I called the on-call, and ask him/her why they told me to get it.

Did someone verbally tell you? If so, I would have said ok and why?

They left it on the 24 hour report. It was hard to read. It said that it had been requested, but I couldn't tell who it had been requested by.

I might call the nurse who told me to get the sample before I called the on-call, and ask him/her why they told me to get it.

You would want to know about other symptoms the resident was having? Would the chemstrip itself be enough to make you call the on-call? Do you trust a chemstrip that much? I'm trying to find out if I should.

You would want to know about other symptoms the resident was having? Would the chemstrip itself be enough to make you call the on-call? Do you trust a chemstrip that much? I'm trying to find out if I should.

My point exactly - what was going on that made them think the resident might need it??

Regardless, with the elderly and UTI's, you can't know about something like that, and sit on it, so I'd still call the on-call before it got too late, to report it.

They may just tell you to watch them closely that night and do the C&S in the am, but then it's on THEIR judgement and not yours.

I would contact the MD on call, ask why the chem strip was ordered, and pass on the results. Then I would document everything.

At my hospital we'd add it to the doctors list for the AM (if no other symptoms) and send it for culture and of course watch the pt closely. If we called the on call doc he would be like, "What the heck, seriously... that can't wait for the pt's own doc @ 0700hr..." I know you all are saying, "well he's on call..." but at our facility we don't call for everything like that... we use our judgement and something like that would wait for the doc in the am. However, we are not LTC we are acute and chronic medical floor.

When I worked in LTC that sort of thing would have waited until the am and then called in to that dr's office

At my hospital we'd add it to the doctors list for the AM (if no other symptoms) and send it for culture and of course watch the pt closely. If we called the on call doc he would be like, "What the heck, seriously... that can't wait for the pt's own doc @ 0700hr..." I know you all are saying, "well he's on call..." but at our facility we don't call for everything like that... we use our judgement and something like that would wait for the doc in the am. However, we are not LTC we are acute and chronic medical floor.

Yeah. That was my thought process. I hate being yelled at by doctors. I thought it could probably wait. I thought maybe the chemstrip wasn't even reliable with no other symptoms presenting. I'm a new grad, and don't know quite what to do a lot of the time. I was dealing with actual, major problems that other residents were having, and just faxed this chemstrip to the doc for in the AM, documented, and reported it to the oncoming shift. I hope so much that I did well enough. I was so overwhelmed with the sheer volume of work I had to do, and by then I was so tired, and so hungry that I was in a daze. Of course, that won't keep me from getting in trouble if my manager doesn't agree with what I did.