At some point every nurse will know the feeling . . .
It’s 3 o’clock in the morning, and your patient isn’t looking well, and your “nursing gut” is telling you that you’re going to need new orders.
EEK!! The panic starts to set in!
You pick up the phone to call the physician and you’re breaking out in a cold sweat! By now you are contemplating if you really need to call! Maybe you’re just over reacting, and what if the Physician yells about calling in the middle of the night? Or worst, what if you’re totally wrong and the patient is fine? So MANY what ifs run through your head, BUT you need to make the call! You need to do what is best for the patient, you have sworn to be their advocate, to be their voice when they are vulnerable, so if that means calling a physician at an inconvenient time, then we will put our nursing caps on and make the call!
When you’re working night shift calling a physician always seems scary, but truthfully they are invested in the patients also. They may not be thrilled to be woken up in the midst night but they also have a responsibility to their patients, so they would rather you call then end up in a sticky situation. But here are some helpful tips on calling a physician, whether it be during the day or night, about a patients change in condition.
- Before you make the call make sure you have thoroughly assessed the patient. A complete HEAD to TOE assessment, including all vital signs, whether or not you applied Oxygen, and if possible a previous set of vitals to use as comparison.
- Write out all your abnormal findings so you aren’t trying to remember while you are on the phone. Chances are you are nervous to start with, you don’t want to more pressure. If you have your thoughts jotted down it is easier to stay focused during the call and be concise with the actual problem the patient is experiencing.
- In front of you have: Current Medication List, Current set of Vital signs, Current Lab Values, Allergies and CODE status
- When you call speak clearly, slowly and concisely – give facts only!
- Write down the new orders as the Physician is speaking and read them back for clarification. (* if a physician seems sleepy when speaking to you have another nurse listen in for clarification also*)
These five tips will help calm your jitters and make it easier for you to focus on the patients needs. Calling physicians, PAs or ARNPs can be very nerve wrecking, even for seasoned nurses, but remember you share a common goal of treating the patient. By following the tips outlined above you will have a better experience overall and hopefully help build your confidence as your nursing journey continues along.
Remember to always . . . be confident . . . be concise . . . be your patient’s advocate.