Home Forums Nurse to Nurse Advice PHONES!!!

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    Being a student nurse I do not have to use the phone for anything my nurse that I follow does. However, this phone petrifies me. I am so nervous to call another nurse or to receives calls. How do I know when to call the doctor or when to call for help, or when am I asking a dumb question?



    Phones are definitely a big part of a nurse’s day. You will get used to it. Don’t be afraid to call another nurse, we are all on the same team. Sometimes you will ask a dumb question, or you will call the wrong doctor and they will get snippy with you, or you will call the right doctor and they will still get snippy with you. The thing you need to remember is sometimes you have to call doctors for dumb things, like at 3am for tylenol because they didn’t order it (not the nurse’s fault it wasn’t ordered to start with!). Sometimes you have to call for important things, like a change in patient’s condition. But every day is a learning opportunity. Don’t let grumpy doctors bring you down- most of them are not that bad, but the ones who are grumpy will have you paranoid about every call. Brush it off of your shoulders as best you can and keep your head up. Remember your job is to make sure the patient is ok, not to let the doctor on call get a good night’s sleep.


    Do you have any suggestions on what to include in the phone call, to make it as quick as possible and giving the doctor all the information he needs?


    Just remember that the MD probably has no idea of the person you are talking about, even if they had recently seen them (they see a lot of people, and odds are, it isn’t even his patient, he is just on call for someone in his group) so start with the basics: I have a 73 year old female admitted by Dr. so and so with such and such condition. The assessment has recently changed from this normal value to this abnormal value, the related treatments currently ordered are such and such.

    Back in my ICU days at another hospital there were a couple of doctors who would not give you any order you asked for, as you were just a lowly nurse and they would order something of doctor quality, so the above report would end right there and I would let him make his decision on what to order. I would provide the assessment in such a way as to get the order I wanted, such as, “NS has been running at 250 cc/hr for the last 10 hours, the lungs have gone from clear to crackles, there is edema in the ankles which is new, and the SATs have dropped to 89% on RA, so NC was initiated at 2 liters/min per protocol.” With this information, I was sure that the order would come to stop the IV fluids and give Lasix.

    If you are not working with an ass of a doctor, I have found that most doctors actually want you to have a solution in mind, as you are the one who can actually see the patient, so give the above information and then ask if you could have an order for such and such. The doctor may give you the order, ask additional questions, order something else, but most are willing to take your word for the assessment and will appreciate the suggestion.

    Have your ducks in a row before calling and have the chart in front of you so you can quickly get to the H&P and Labs or whatever additional information the MD is going to ask for. Have a recent and complete assessment performed and review the patient’s history and past treatments. The doctor may want a thorough chart review before ordering something new on a patient he doesn’t know, so be prepared to start from ground zero and work your way up to the current problem … but the first paragraph is usually a good starting place, followed by a suggestion for an order and then just be ready for questions from there.

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