When to call the physician

[mickeyfan]

What factors are considered when a physician is called regarding a resident and what information is needed before the call is made?

I am thinking condition of patient etc. Am I on the right track?

Info needed=condition, all nursing interventions completed, IV fluids, V/S, etc.

Any input would be greatly appreciated!!!

[Daytonite, BSN, RN]

I always called the doctor when there was a change in the patient's condition, an accident (falls) and I expected that the doctor was going to want to give me orders or he was going to want to move the patient to an ICU or come in himself immediately. Never call a doctor to waste his time. Some facilities require that you get permission from a supervisor or manager before calling a doctor or call when there haws been an accident or an incident and the doctors know this is a facility rule. I have two relatives who are doctors and nothing gets them in a foul mood faster than getting calls from nurses for stupid reasons that didn't need a call to the doctor at all. My one BILs face actually turns beet red while he's on the phone! Some facilities instruct their staff nurses to use the SBAR technique with regard to notifying doctors. SBAR is a mnemonic.

S - Situation

- What is the situation you are calling about? Identify yourself, unit, patient, room number. Briefly state the problem, what is it, when it happened or started, and how severe.

B - Background

- pertinent background information related to the situation could include the following: the admitting diagnosis and date of admission, list of current medications, allergies, IV fluids, and labs, most recent vital signs, lab results (provide the date and time test was done and results of previous tests for comparison), other clinical information, code status

A - Assessment

- what is your assessment of the situation?

R - Recommendation

- say what you would like to see done or what you think the patient needs to address the situation, request orders for tests, medications or treatments, ask that the MD to come to see the patient if you feel it is needed. Clarify the MD's plan of care if the orders you receive aren't clear or you feel they don't address the patient's need.