Need to call the doctor for your patient? Calling the doctor is scary for most nurses who are just starting out.
Understanding the rules will help you get your game on and quell those nerves. For starters, don’t begin by apologizing. “Hello, Doctor, this is Tiffany, I’m sorry to bother you..” There’s no reason to feel guilty, and you haven’t done anything wrong. It’s your job to call, and their job to respond. By apologizing, you’re placing yourself in the weaker position.
Rules for calling doctors can be likened to the rules of football. Here’s some tips from the playbook to avoid penalties:
Illegal procedure is calling before you’re prepared. Have you anticipated all moves from the defense, I mean questions from the provider? If your patient has new onset PVCs, be prepared to report the frequency and to describe the type (multifocal or unifocal). Be ready with the most recent labs, medications, and vital signs. Is there a recent EKG? Any allergies?
Ineligible receiver downfield
This is calling the surgeon when you should be calling the attending, or some version thereof. Having multiple doctors to choose from makes it tricky to know which one to call. Sometimes they pass the ball back and forth among themselves. Consult with your Charge Nurse when you can’t decide if your patient’s post-op low urine output is a surgical or medical problem, and you don’t have written parameters.
Delay of game
Not being logged on to the computer when you call causes delay of game while you fumble. “Hold on a minute, Dr., it’s not taking my password…” Either that, or you’ll be scribbling orders on your palm, in which case you won’t be prepared for computer alerts when you enter the orders later.
0300: “Hi, umm, I’m calling about Mrs. Woods, she’s in room 3120, I mean, wait, no, room 3142, sorry, Doctor! We had to move her out of 3120 because we needed to make an isolation room. She’s not your patient but she was admitted by Dr. Not on Call for pneumonia. She’s doing OK, except she’s been complaining of a headache, the day nurse said it started after she had alot of visitors. I gave her some Tylenol. But the reason I’m calling is because Dr. Gone made her NPO after midnight, and she has blood pressure pills ordered in the am…..” Holding is story-telling with sub plots that are not pertinent and holding the doctor hostage. Story-telling mode is great when you’re with your friends, but get to the point when calling a doctor.
Get to the goal line
Know what you want, or else you won’t know when you don’t get it! Critical thinking-What do YOU think is causing the change in condition? And what do YOU expect the provider to do?[Tweet “Critical thinking is crucial in order to evaluate the orders you receive”] You’re the receiver who wants to make a good catch but you have to be in the right position.
Check with other RNs on the floor “Hey, does anyone else need to talk to Dr. ?” When you’re done, pass your phone to your co-worker. The doctor will appreciate not receiving back to back calls from the same unit.
Using SBAR, you might say:
“Hi, this is Tiffany on 4S at Saint Francis. I’m calling about Dr. Gone’s patient, Mrs. Lee.”
Situation: “In the last hour, she started getting SOB. I put her on 02. She has bilateral crackles in the bases.”
Background: “She’s a 73 year old admitted yesterday with CHF. She’s on lasix 40 mg po qd and had her last dose at 0900. She’s also on digoxin and potassium. Her labs were all normal this am, and her K+ is 4.0.”
Assessment: “Her vital signs are 98.6, 98, 24, 120/76 and 02 sat is 94% on 2L 02. I think she’s filling up with fluid.”
Recommendation: “Would you like to give some IV lasix and re-check the potassium level in a couple of hours? Is there anything else you’d like for me to do?”
What tips do you have for calling doctors? Leave me a reply, I’d love to hear them!
Until next time friend,
Come visit me at Ask Nurse Beth career column at allnurses.com for all kinds of entertaining and informative career questions and answers, and to submit your own question 🙂