Would you have called?

natawee · Feb 16, 2005

I am not a peds nurse, but I have been in the same boat many times. should I call or not? Will they get upset if I call again? I have only been a nurse three years, but I have found that if it is bothering me alot and im questioning myself enough whether to call or not. I usually do. Sometimes they address the issue, other times not. I'd rather cover my butt and have a doc upset with me then not call. Its ok if they get upset or angry, its YOUR lisence on the line and thats what they are there for. I dont know if I helped any but I thought I would reply since I have been in similar situations

jeepgirl, LPN, NP · Feb 16, 2005

Thanks for your reply. I just find the whole situation very frusterating. The doc grumping that I called, then the nurse grumping that I didn't listen to her!

There have even been times where I have called... gotten the same grumpy doc... then he calls back about 20 minutes later. Just so happened that he got a hold of the other nurse I was with, and he asks her... "is that kid ok?" after he's just chewed me out. Very frusterating! I don't know if its because I'm still new or what.

It really makes me not want to even go to work anymore.

DDRN4me · Feb 16, 2005

just the fact that he calls back to double check means he's second guessing himself !! as a fellow pedi nurse i would always go with my gut...i would rather take the abuse from him or my co worker than have the child suffer . it may be that he doesnt know you well enough yet to feel confident in your opinions...not fair, but it will come with time. keep using your instincts!!!

jeepgirl, LPN, NP · Feb 16, 2005

The doc I hear the most griping from is young and new himself.

*sigh*

I guess in the scheme of things, I should just let it go and let it pass. I've never heard complaints that I didn't give good care to my patients... I've heard the opposite, which is nice. It's just very upsetting as I want to do the best job possible. I don't want to irritate other people while I'm at work. Not that I want to be perfect or anything... these just aren't gripes that I hear about the nursing staff that has been there for forever.

DelightRN · Feb 16, 2005

How's the kid?

If I were as concerned as you, I would have called. There's no such thing as too much communication between RN and MD, in my opinion. I also would have documented my concerns, my communication with the MD, and his response. I know some physicians are grumpy when you have to call them at night, particularly if its something they are already aware of, but... that's part of their job description.

All the pediatricians I have worked with would have been more upset if I had not called, and they didn't know the severe, constant, unrelieved pain one of their kids was in.

fergus51 · Feb 16, 2005

I always have this problem working nights. On day shift, the docs are in the unit so the nurses never have to do this.... I have found one thing that helps me to decide is to ask them the first time I call what parameters they feel will necessitate a second call. Like "The arm is puffy, the baby is screaming, but pulses and cap refill are ok. If the baby's pain/swelling, etc doesn't decrease should I call you again?". Course, even if they say no, I'll still call if I feel it's necessary:)

Long Term Care Columnist / Guide · Feb 16, 2005

I tend to be pretty cautious anyway, but when it comes to kiddos I'm much more so.......I definitely would have called the second time, and a third and fourth time if I felt it necessary. I don't care if the doctor doesn't like it, s/he's the one getting paid the big bucks, and I'm going to cover my butt and document EVERYTHING that transpires, including the fact that I have notified the MD and what s/he said to do (or not do) about the situation.

Sorry to say this, but parents of pediatric pts. tend to be the most likely to sue if something goes wrong........you just can't be too careful when it comes to little ones, especially if you don't work peds that often. :stone

jeepgirl, LPN, NP · Feb 16, 2005

How's the kid?
If I were as concerned as you, I would have called. There's no such thing as too much communication between RN and MD, in my opinion. I also would have documented my concerns, my communication with the MD, and his response. I know some physicians are grumpy when you have to call them at night, particularly if its something they are already aware of, but... that's part of their job description.
All the pediatricians I have worked with would have been more upset if I had not called, and they didn't know the severe, constant, unrelieved pain one of their kids was in.

That's what one would think, eh? :-)

He was okay in the end.

After 3 hours of hot packing, raising it up, etc, he started to use it to grab at his bear, wipe away tears, and he started to dooze off again. I could see some difference in the swelling, but not much. That evening he was sent home... so I am guessing it was looking much better by the time night shift rolled around again!

Gompers, BSN, RN · Feb 16, 2005

I always have this problem working nights. On day shift, the docs are in the unit so the nurses never have to do this.... I have found one thing that helps me to decide is to ask them the first time I call what parameters they feel will necessitate a second call. Like "The arm is puffy, the baby is screaming, but pulses and cap refill are ok. If the baby's pain/swelling, etc doesn't decrease should I call you again?". Course, even if they say no, I'll still call if I feel it's necessary:)

Totally agree. It's so different at night. And it seems like your damned if you do, damned if you don't. You'll have some docs think you cry wolf on a regular basis and will have no patience for you. And you'll have others who think you don't know what you're doing because you didn't call them for some little thing that ended up turning serious later on. I also ask them for parameters for calling back again. Our docs stay on the unit overnight, but we do try to let them sleep at least a little bit since they do have 24-30 hour shifts.

On the other hand, it's funny sometimes to see day shift nurses float to nights. They don't always have the same thought process when calling the docs. We night nurses will try to get together and call the docs at the same time with our lab results, etc., unless something is really critical. We also know what needs to be reported NOW (and bad IV infiltrates are in that group!) and what can wait until the morning.

I always chuckle when I see a day shift nurse waking a doc up in the middle of the night to ask them to renew a baby vitamin order that doesn't even expire until the next evening. Sometimes they just don't THINK, they're just so used to calling the docs for anything and everything.

Jolie, BSN · Feb 17, 2005

Think about standards of care when deciding what constitutes quality care for your patient, and what protects you legally.

If you were to have to defend yourself in this matter, the BON would ask if you acted in the best interests of your patient, not whether you pi**ed off a doctor. And the plaintiff's lawyer would ask you what a prudent nurse would have done, not what nurses should do to avoid interrupting the sleep of pediatricians.

Calling was the right thing to do, and you know it!

Chaya, ASN, RN · Feb 17, 2005

Yep- that is what it means to be a patient advocate. If you haven't already, you will develop a sixth sense about when something just isn't right with your patients. Don't second guess yourself- let the MD eval these cases.