5 Dos And 5 Don’ts of Paging Doctors At Night

Calling a doctor at 3 a.m. usually means something is wrong with your patient that can't wait until morning. Some doctors take it well, some don't. Either way the call has to happen, so make it count.

Do's

1. Assess your patient fully before you dial. Take current vital signs and be clear on the concern you're reporting. If you're not sure the call is warranted, ask around first. Your supervisor has probably seen the same thing and knows whether it can wait.

2. Have everything in front of you. Pull the latest lab and diagnostic results and the patient's medication list. Keep the chart open to the last written order, and have paper ready for new ones.

3. Use SBAR: Situation, Background, Assessment, Recommendation. It keeps the call short and complete.

4. Read every order back, and have the doctor repeat it when you can. Some drug names sound nearly identical, like Cefotaxime and Cefuroxime. If an order sounds wrong or confusing, clarify it. Doctors make mistakes too, especially when just woken.

5. Document everything, including the time and length of the call. If the doctor gets upset and makes a scene, document that as well and tell your charge nurse.

"Doctors aren't always grumpy. They might yell at you for calling late, then greet you the next day like nothing happened," a nine-year ICU nurse said.

Don'ts

1. Don't be intimidated out of calling. You've heard the horror stories, but stay assertive and professional. Plenty of doctors want updates on their patients, whatever the hour.

2. Don't get aggressive. Speak up for your patient, but stay respectful no matter how cranky the response.

3. Don't take the reaction personally. Carry it through your shift and it drags down the care and safety of every patient after.

4. Thank the doctor. Helping patients is the job, but appreciation builds a working relationship that makes the next late call easier.

5. Don't pretend to know what you don't. If an order involves a procedure or drug you're not familiar with, ask a colleague or call back. Facing a frustrated doctor beats risking your patient's life.