Accountable Healthcare - Working with physicians
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October 5, 2020

Working with physicians

Don’t be intimidated! Follow these tips for working with physicians and banish your nursing anxiety for good.

Something I was super nervous about and didn’t have much experience with in school was working with physicians. I always heard horror stories about nurses getting screamed at for no reason and just assumed that would happen to me with every interaction with each and every physician.

I made it into a much bigger deal and source of stress than it needed to be.  Yes, I have been yelled at before. However, that is few and far between.. and there are many, many fantastic nice, patient, informative, and amazing physicians.

A Note For Physicians 

This note is for all of you doctors out there that are calm and patient with new RN’s that are so overwhelmed they could cry for 75% of their day.

Thank you. You have no idea how much easier it makes our entire day/life.  As soon as you leave, we tell everyone how nice you are.

Tips For Working With Physicians 

There are a few things we need to realize as nurses, and these tips will make your life a whole lot easier during your shift! 

#1 Remember That Doctors Are Very Busy 

Doctors are very, very busy.  Do you think you’re busy as a nurse?  So are docs, but in a different way.  They work on less sleep with much more responsibility.  

We get to clock out and completely forget about the patient’s we just took care of because we’ll be getting brand new ones tomorrow!  They are on call overnight and still expected to come in the next morning, even if they were in surgery for hours or had to come in for a consult overnight, then come in the next day to round on all of their patients.  

That patient is their responsibility for their entire admission and all decisions (good or bad, obvious or not) rest on the physician’s shoulders.

#2 Don’t Page Them Too Quickly 

Don’t immediately page them with every single question.  Don’t you hate 10 calls/questions when you’re trying to assess, document, and medicate your patient?  It’s the same thing with doctors.  

If it’s not an emergent/immediate need, wait for rounds, and then if they haven’t rounded by a certain time, then page.  If it is, ask all of your fellow RN’s if they need to talk to the same doc.  I also will utilize text pages or if the computer charting has the capability to send MD messages.  (Then I documented that I did so!)

#3 Reach Out To The Assistant First 

Find out if they have a Physician’s Assistant or Nurse Practitioner.  Then you can call them first!

#4 Be Ready To Answer Questions 

When you page or speak to them in person, they will probably ask you twice as many questions as you ask them. Have the patient’s chart readily available. Make sure you have a fresh set of vitals and know some of their labs or can quickly get to them on the chart.  

They ask about meds, labs, and vitals frequently. Rarely do they just say “yes” and that’s it.  I’ve had doctors tell nurses to call them back when they’re prepared.

#5 Provide Background With Your Question

Just because a doctor is covering for your patient doesn’t mean they know them.  Don’t call and start spewing out questions. If it’s an on-call doctor, you’ll probably have to give them a little background before you go over your list.  

Ask, “are you familiar with _____?”  If they’re not, then tell them a SHORT version of their story.

#6 Do Prep Work For The Physician 

Whenever they call ahead of time to have something on the unit for a procedure, it is your job as the patient’s primary nurse to make sure it’s there.  If what they need won’t be there for some reason, call and let them know.  They may want to switch up their time management.

#7 Do As Much Troubleshooting Yourself As You Can 

Before you page with concerns, make sure you’ve bounced your concerns off of others and have done all the troubleshooting you can.  

I’ve seen nurses page doctors about high blood pressure when there were PRN BP meds already ordered. Or I’ve seen nurses call the doctor when all they needed to do was call respiratory therapy and they were able to deal with the problem appropriately.

#8 Call The Correct Person 

Know when it switches to the on-call doctor/midlevels, it’s usually 1700.  It is ideal that you get most questions/concerns addressed with that patient’s primary physicians rather than the on-call staff.  

So if it’s 1645 and you’re just noticing they haven’t rounded yet, call them.  See if they’re going to make rounds and if not and ask them your questions then.  

It’s really frustrating for providers to get calls just after 1700 that could have easily been addressed by their primary physician earlier in the day.  And really, you want that doctor calling the shots.. not the on-call doctor.  They are there for needs as they arise, not for routine things.

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