When to Call the Physician We all know how much doctors hate to be called at 2 a.m. Nurses are trained to make split second decisions, and included in those decisions are when to call the doctor. When Not to Call If a patient asks you to call their doctor, you should let them know that you are available to help them at the moment, and if they will let you know what they need you will assist them. This reminds me of an incident that a patient requested her primary care physician be called. The nurse explained to her that she was currently under the care of nurses and it was after all midnight. The patient continued to insist, and the nurse finally gave in and went to her desk and called the physician. As she suspected, the doctor said she would see the patient in the morning, goodbye. The patient’s room was right outside the nurse’s station, and when the nurse walked away, this determined patient stepped over to the nurse’s desk, hit the keyboard, and got the doctor's cell phone number. The nurse was at fault for not locking the computer back; however, who would have ever thought a patient would go to that extreme? The patient then called the doctor herself, and her reason was, how long the doctor thought her recovery would be, she had a wedding to attend in 6 weeks. The nurse was very upset, the doctor was irritated, however, and the patient went to bed and slept fine. It is a good idea to always make sure if a doctor’s phone number needs to be exchanged, write it down and don’t say it out loud, and of course, always exit the contact screen on the computer. Related: Continuing Education Sometimes family members will say they need to speak with the patient's doctor. If they call on weekends or after hours, in most cases they should wait until doctor rounds the following day. The doctor can be left a note indicating the family requests a call; at that point, you have done your job. When Should the Physician be called? If a patient is in critical condition, and family requests a consultation with the doctor, this may be a time to call. When a DNR decision needs to be made, most families will feel more comfortable speaking with a physician they are familiar with.
When a patient takes a dramatic turn for the worse, in most cases the physician should be notified. Particularly if this is an unexpected change, they should be advised. Anytime doctor requests to be notified are sure to do so. On occasion, patients leave the hospital without officially being discharged. Should the patient decide they are leaving without the doctor’s orders, you would notify the doctor. The doctor may be able to persuade the patient to stay, however, if not they can document that the patient is leaving against medical advice. If you are new at a hospital, and unsure of the protocol for contacting the doctors, refer to your supervisor as needed. Some smaller hospitals require that the physicians take calls at any hour, while larger facilities may have more guarded regulations. Emergencies always constitute a call, however if a physician was called every time there was a question, they would never get a moments sleep. If there is something you can handle yourself, do so, and leave a note for the physician. If you have a question on whether to contact the physician, asks your supervisor for advice, they will generally have the expertise to make the decision for you. Related: Helping Patients with Seizures When you do have to call a doctor in the middle of the night, you can give a quick apology for calling, however, don’t dwell on it. Their job entails such events, and they are aware of this when signing on with the hospital. If you happen to work for a hospital with physicians on duty all night, that is usually the doctor you will refer to, and they will contact the primary PCP if necessary. Related: Exceptional Registered Nurse Marie-Gladys Darcelin, RN, BSN, MS, will be Featured in the Worldwide Leaders in Healthcare
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