The dreaded “I’m gonna have to call the doctor” phrase. Worst feeling ever sometimes, especially during the night shift. You stare at the patient’s chart for a few more minutes, searching for any trend that might suggest, “meh, this is normal for them” but alas, nothing. This is in fact, abnormal and they may be dying. Damnit.
You dial the extension and wait for a call back. It rings: “This is Dr. Smsdfsdfkjdh (can’t make it out). I was paged.” You freeze for a minute. Why did I call Dr. Smsdfsdfkjdh again? OH yea, patient dying, that’s right.
RN: “Are you familiar with Mrs. X?”
RN: “Great. Her BP is 80/50 and she’s basically dying. Wanna do anything?”
MD: “Push fluids. I’m in the shower. Be there in an hour maybe.”
Phew, that went way better than I expected. He didn’t yell at me, throw any cuss words or ask any questions I couldn’t answer. The night has been a success! Well, aside from a patient crumping but that’s splitting hairs.
I handled doctors differently on day shift than I do on night shift. Day doctors need wooing sometimes; you can’t always flat out say what you want from them. With some doctors, don’t you dare even consider giving your opinion:
Night nursing is different. You’re probably waking someone up. You have to be concise, brief and say exactly what you want: “Mrs. X is a 34 year old female with a history of hypertension and diabetes. She has Lopressor 50mg scheduled every day at 9AM. Her blood pressure at midnight was 170/101 but there is nothing ordered PRN. Can I get a one time dose of something?” They will most likely ask no more questions, give you a verbal order and hang up before you can say thanks. Fine by me, I hate chatter-boxes.