Why didn't someone bring in this up in school?

I think if you use SBAR for physician nurse communication it will go better for you.

You should always start by identifying yourself and your title, since only an RN can take a verbal order, not an LPN.

You want any abnormal labs, a current set of VS and state the background in a short snyopis if possible when talking to the on call. Then what you did and why you called and what you want, ask for what you want.

I think if you use SBAR for physician nurse communication it will go better for you.

You should always start by identifying yourself and your title, since only an RN can take a verbal order, not an LPN.

You want any abnormal labs, a current set of VS and state the background in a short snyopis if possible when talking to the on call. Then what you did and why you called and what you want, ask for what you want.

In Pennsylvania, an LPN can take oral orders, as long as they are trained in doing so whether by there school of nursing, or place of work. Some places though don't let LPN take oral orders, but it is legal in PA as long as those conditions are met.

http://www.dos.state.pa.us/bpoa/lib/bpoa/nurseboard/lpn_oral_orders.pdf

So I am interested in information that any PA new grad could offer me as far as specific scenarios, conversations, nurse/patient interaction, or anything that comes to your mind-that you really wish had been discussed or simulated BEFORE you were out on your own.

For example, when I first graduated I was paralyzed by fear when making a phone call to a MD. I didn't know what to say, identify who I had on the phone (resident or student) nor did I know how to really advocate for a patient. I really wish someone had let me practice that, so much so I still remember sweating during the first call.

So please if you have any pointers to offer I would love to know them.

Thanks

I feel and understand your pain. There is very little preparation for RN/MD clinical communication...if any at all.

Unfortunately, it's not tested on in the NCLEX, and most nursing programs are very focused on giving you the material to pass so they can keep their accreditation.

I encourage you to do this in your spare time; think of a patient you had, recall their condition and the issue that warranted a need to call the physician, and practice out loud contacting a physician (in the privacy of your home or car). It sounds hokie and maybe a little bit embarrassing (even though you are alone), but this kind of practice will improve your confidence as you contact physicians. You could even practice typing what you would say, and read it aloud to yourself. It sounds tedious, but it should improve your confidence.

And just remember...no matter how long you do this or how good you get, sometimes it just won't go well and it's not always your fault.

SBAR is good, but I find intuition and experience really makes the process flow. Before I call an MD, I anticipate what additional info they might want (i.e. fluid balance, electrolytes, etc), and anticipate what orders they might give. I even anticipate that they might not have any orders for me, but there are still those essential CYA calls.

Our school did give us some prep on this.

Very much liked Honnete's closing paragraph.

Good luck!

When calling a physician, I will often have a suggestion ready and ask it in the form of a question. "Patient's HCT is 7. Do you want blood products? Packed RBCs?" I'll have a complete assessment in my head. I don't try to dumb myself down but don't try to overpower either. It helps to remember that physicians eat, drink, and you know what just like the rest of us. Some will appreciate the input, especially in a teaching hospital. Some won't appreciate anything. Advocate for your patient and make them the center of your focus and your fears will subside. It all comes with experience and you'll get there before you know it.