Calling the DoctorBefore calling the doctor the nurse should think… Have I seen this patient myself before I call? Are there standing orders I could use? Do I have on hand: The chart List of current meds & IV fluids Most recent vital signs If reporting lab work, date and time this test was done and results of previous tests for comparisons Code statusIf it is between 7 pm and 7 am, have I discussed this call with the RNon my unit or the Nursing Supervisor?
Calling the Doctor (continued) Have I read the most recent MD progress notes and notes from the nurse who worked the shift ahead of me? If calling for a consult, why is the physician being consulted?? This information needs to be communicated. When ready to call, remember to: • Have chart at hand • Identify self, unit, patient, room # • Know the admitting diagnosis and date of admission • Briefly state the problem, what it is, when it happened or how it started, and how severe it is • What have I done to resolve the problem? • What do I expect to happen as a result of this call?
Calling the Doctor (continued) Make sure you are calling the most appropriate physician. If in doubt, always call the attending physician Check to see if others need the same physician, cluster calls if possible Call the doctor only after answering all of these questions
Calling the Doctor (SBAR)(S) Situation: What is the situation you are calling about? • Identify self, unit, patient, room number • Briefly state the problem(B) Background: Pertinent background information related to thesituation could include the following: • The admitting diagnosis and date of admission • List of current medications, allergies, IV fluids, labs • Code Status(A) Assessment: What is the nurse’s assessment of the situation?(R) Recommendation: What is the nurse’s recommendation; whatdoes he/she want? SBAR is a communication tool