When to call the doctor

[RN416]

Does anyone have any general guidelines on when to call a doctor? I know it seems like a basic nursing skill but I still have difficulty deciding when to call and when not to. We have such sick patients with multiple comorbidities like heart disease, diabetes, dialysis, and I have a hard time deciding if a small change in condition is OK for them or if it’s serious enough to bother a doctor in the evening. Just looking for some general guidelines. Thanks!

[RNperdiem, RN]

What kind of workplace? Standards vary depending on the kind of unit.

[Sour Lemon]

3 hours ago, RN416 said:

Does anyone have any general guidelines on when to call a doctor? I know it seems like a basic nursing skill but I still have difficulty deciding when to call and when not to. We have such sick patients with multiple comorbidities like heart disease, diabetes, dialysis, and I have a hard time deciding if a small change in condition is OK for them or if it’s serious enough to bother a doctor in the evening. Just looking for some general guidelines. Thanks!

It does vary a lot based on unit culture, your personal comfort, and the personalities of the doctors you're working with. There's no way I could began to write it all out. And even if I did, there would be exceptions.

Until you're confident with your own judgement, it's a good idea to run your plans by a more experienced nurse and ask for input. I also tend to ask doctors about their preferences and schedules as I meet them.

[caliotter3]

Ditto what Sour Lemon said. I always took my questions to the house supervisor (night shift), also because I had to let her know what was going on anyway, but primarily because I was seeking input.

[RNNPICU, BSN, RN]

Varies: If vital signs and other clinical assessments are outside the paramters, per orders, per protocols, so manh other factors, and including my clinical judgement based on my assessment

[Guest1144461]

Before you do call, please check the MAR first and apply some critical thinking regarding the situation as well.

[Kitiger, RN]

21 hours ago, Numenor said:

Before you do call, please check the MAR first and apply some critical thinking regarding the situation as well.

Working nights, back when, we would call around to the other units (UCU, Cardiac stepdown, etc.), first, to see whether they would have to call soon, anyway. Let's wake the doctor up as few times as possible.