Calling the doctor during any shift can be difficult, but it is particularly unnerving when you have to call the doctor on the night-shift. I have been a nurse for over 17 years and probably called a hundred physicians while working nights. Even after hundreds of calls, calling the doctor in the middle of the night is still a daunting task. I anxiously review all my information. In my mind, I practice what I am going to report. I check and double check to make sure I have all the information he might ask for. It has helped me to make the task a little less stressful by learning the different personalities of the doctors and how they are going to respond to a 3:00 a.m call. There are three common types of personalities nurses frequently encounter when calling a doctor during the night-shift.
Calling the Doctor at Night: The Nicer When Asleep Doctor
During the day, this doctor has a strong presence, he or she is known to be demanding and grouchy. Nurses scatter when they arrive on the floor. This type of doctor has little patience; he will ask a million questions and expect the nurse to have the answers at a snap of his fingers. You would think this type of doctor would be the worst when you call and wake him in the middle of the night. But, for some reason, this doctor is nicer on the phone than he is during rounds. On the phone, he is soft-spoken, agreeable, and open to a nurse’s assessments and suggestions. Usually, you have to develop a trust before benefiting from his kind, middle-of-the-night, demeanor on the telephone.
For their sake, remember to have all the relevant information available before making the call.
Calling the Doctor at Night: The Silent Mumbling Doctor
We all know the one doctor who stays quiet a little too long before mumbling an answer to your inquiry. This doctor needs a few seconds to gather his thoughts. When he finally speaks, it’s an unintelligible few mumbling words, with frequent pauses. When presenting information to this doctor, it is important to remember he needs a little longer to wake up and get his thoughts together. In an emergency, nurses will sometimes speak in a fast and anxious tone. The conversation will go much smoother if you take a deep breath and slow down when you are speaking with them. If possible, call from a quiet area, so you can hear him. Briefly clarify new orders and then wait for him to confirm. In my experience, the mumbling doctors often change their orders in the middle of the call, It will be easier to keep track of his orders if you write them down while he is still on the phone.
In any case, it is good practice to write down orders and read them back to the doctor every time you receive a telephone order.
Calling the Doctor at Night: The Difficult Doctor
My first preceptor gave me one piece of advice for which I have always remembered. She looked at me with a very serious and urgent expression on her face and then stated, “If you only remember one thing I have told you, whatever you do, make sure you have a really valid reason to call Dr. W. He’s a real bear.” Dr. W. was notorious for hanging up on nurses at night. Rumor had it, he once yelled at a nurse for calling to inform him his patient had passed. The first time I called him to report a new arrhythmia on a patient; he blatantly asked me if I had graduated from the Mickey Mouse School of Nursing! I did let him know it was my responsibility as the patient’s advocate to report the change and given the opportunity, I would do it again. I felt confident my call to this doctor was appropriate. Before calling, I sought a second opinion from the ICU charge nurse and notified the house supervisor of the impending phone call. As a new nurse, I wanted as much guidance as possible to “survive the experience.”
Remember to have back-up before you call this doctor in the middle of the night.Using the SBAR format will help you organize your thoughts before calling the doctor. Click To Tweet
Above is just a sampling of some of the physician personalities you might encounter during a night-shift call. As you become more familiar with each individual doctor, you will learn how to engage him or her in a way that satisfies their unique preferences. In spite of the differences in personalities, there are a few golden rules you should follow when calling a doctor during any shift. Always, check standing orders and become familiar with the physician’s protocols and preferences. Consult with other nurses prior to making the call. Have recent vital signs, assessments, the medication administration record, labs, allergies, and graphics in front of you, that way if he or she asks you for information, you will have it readily available. Using the SBAR format will help you organize your thoughts before calling the doctor. SBAR stands for Situation, Background, Assessment, and Recommendation. This technique can help you deliver a clear and concise message — the doctor will surely appreciate. Don’t be afraid to stand your ground and respectively advocate for your patient. Follow these golden rules and you will soon earn the trust and respect you deserve from the physicians you work with and have to call in the middle of the night.
ZDogg, MD a physician comedian gets a category all his own in personalities…be ready!
We would love to hear about your experiences with calling a doctor during the night-shift or any shift. Do you have any tips you would recommend to a new nurse? Let us know in the comments.
About the Author:
Elena Owens, possess an MBA from Valdosta State University and a Bachelor in Science in Nursing from Florida State University. She held two nurse management positions in Critical Care and Coronary Care. Elena also served as Director of Managed Care and Health Marketing for a regional medical center in Southwest Georgia.