Most ridiculous question from a nurse while on call

[SoCuteMD]

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I actually got a text page on Sunday night reporting (as the RN is required by hospital policy to do) a "Critically Low Calcium" as well as the albumin and the calculated corrected Calcium value (which was calculated correctly). It ended with a "Sorry to bug you." It may have been the best page I've every gotten.

Best page I've ever received:
"Pt L--- in 315 had headache. Given 325 mg Tylenol PO. SLeeping now. Can you enter a Tylenol order."

Why yes, yes I can!!

 

[meister]

Heh this thread is like catnip for allnurses.com or something, the last page was kind of brutal. Oh well, still enjoyable.

 

[deleted109597]

n00b: "Dr. T! You need to come here RIGHT NOW, he's having Intermittent Asystole!!!" 😱

I have intermittent asystole between every beat as well. Thankfully I sleep with an AED attached.

 

[efex101]

I do think that a lot of these calls are generated by the asinine charting and rules that nurses have to abide by which would truly drive me bananas. Also, I think that a lot of them are unaware of the hideous hours that we are exposed to. Night float can be a nightmare of 14 hour nights for 30 days straight and these folks have no clue. They may think we are there for a regular "shift" like what they experience.

One of my goals in life is when I get a page that I think is inappropriate I actually let them know and if they do not understand explain it (low BP with SBP of 80, low UO for the past two hours in a 90+ LOL, paused beats in a 100+ year old on telemetry for God knows why, etc)...hopefully this will diminish pages for others....

 

[diel]

I'm in the ED seeing a consult for surgery. Later on, after admission and all, was browsing through the electronic chart of the patient. One of the ProgNotes from nurses from the ED sts the following:

"Tall blonde female russian doctor in to see the patient".

So professional. In a chart, which is a document after all.

Names don't matter. Haha! 😀

 

[zenman]

I'm in the ED seeing a consult for surgery. Later on, after admission and all, was browsing through the electronic chart of the patient. One of the ProgNotes from nurses from the ED sts the following:

"Tall blonde female russian doctor in to see the patient".

So professional. In a chart, which is a document after all.

Names don't matter. Haha! 😀

Well, duh. Not if you're a tall blonde female Russian....😀

 

[MOHS_01]

I'm in the ED seeing a consult for surgery. Later on, after admission and all, was browsing through the electronic chart of the patient. One of the ProgNotes from nurses from the ED sts the following:

"Tall blonde female russian doctor in to see the patient".

So professional. In a chart, which is a document after all.

Names don't matter. Haha! 😀

This thread is worthless without pics......

 

[MOHS_01]

I've got one for ya -- first night as an intern on call. 3am pager goes off... nurse eventually answers the call back and proceeds to give me the life history of someone who was going home in the morning and was only in for some stupid reason after a late in the day upper GI. In any event, the patient's throat was dry.

"No problem" I say, "I got this. They're probably NPO after their procedure."

The nurse interrupts "No, she's not NPO."

Pause.

"OK, OK, I got this. I'm just an intern, and this is my first night of call and all, but I got this. Here's what we do -- and we'll just do what I do when I have this problem in the middle of the night."

Nurse chuckles.

"So here's what we do -- get her a glass of water. Have her drink from it. Now that's what I do when I have a dry mouth in the middle of the night. What I do not do, however, is call my MD up and ask him what he thinks I should do to satisfy my parched throat."

Click.

Yes, I was written up for being "unprofessional". When questioned, I inquired as to why being a dumba** was not a punishable offense.

True story. I still remember dufus' name on 8 South.

 

[cali-ob]

Yes, I was written up for being "unprofessional". When questioned, I inquired as to why being a dumba** was not a punishable offense.

True story. I still remember dufus' name on 8 South.

That was worth the write up.

 

[NarcolepticRN]

I'm in the ED seeing a consult for surgery. Later on, after admission and all, was browsing through the electronic chart of the patient. One of the ProgNotes from nurses from the ED sts the following:

"Tall blonde female russian doctor in to see the patient".

So professional. In a chart, which is a document after all.

Names don't matter. Haha! 😀

This is hilarious! Wow. Just wow.

 

[error404]

One of the things that drives me crazy is when a nurse calls for a completely appropriate reason, but presents it in a completely inappropriate way. Two examples with the same complaint:

"I'm pretty sure your patient just died."

Episode 1: I run up to see the patient, who is sitting up in bed eating jello. A tele lead fell off and the nurse did not assess the patient. (Nor did she call a code, oddly but thankfully. This may not actually have been an appropriate call.)

Episode 2: Nightfloat. Nurse omits that the moribund patient is on comfort care and morphine drip, and the death was very much expected. Patient is indeed dead. But I'm still booking it up the stairs because of a total lack of information.

 

[jonb12997]

Just happened this morning...

Nurse who is actually really nice and I get along well with, but at 3am while on floor call: Hi Jon, so-in-so's antibiotic was sent up in 50 ml of D10 instead of 100ml.

me with the best I could come up with: was it precipitated out or anything?

nurse: yes, definitely, it was fine. I called pharmacy and they said it was fine to go ahead and give, but i just have to let you know

me knowing that this is a small program and we have to do lots of calls with the same nurses wanting to keep them happy: thanks for letting me know! click thinking: what in the world was that all about??

Later in the morning I talked to her and she laughed and said she felt really bad calling me, but just one of those things she has to tell me about.

 

[chimichanga]

Shouldn't it be the nurses job to know basics like that especially when the previous values were out of range as well.

Nope. Not an inherent part of the job description. Being able to catch a critically low lab IS part of the job, as is notifying the doctor about it. If you're not satisfied with how nurses are trained, don't work with them.

You are sadly mistaken...If an RN doesn't look at trends (in lab values), then he's an idiot, and was POORLY trained, period.

 

[error404]

I know that this one has been said before... but I've gotten two calls for "low urine output" in the last week.

Both were ESRD. One was actually getting HD at the time of the call.

urgh.

 

[gutonc]

Both were ESRD. One was actually getting HD at the time of the call.

urgh.

OK, that is just awesome.

 

[Substance]

A nurse called me at 3AM about a patient who had a potassium of 3.3

Being suspicious of the competence of anyone who will call me in the middle of the night for such a ridiculous lab value, I checked the rest of the lab report just in case she forgot something.

What she didn't tell me was that the patient's new troponin result was 0.73.

I don't get angry often, but this was one time that I did. Seriously. Who trains these nurses?

On another note, do you find that the new, young crop of nurses think they know more than they actually do?

 

[45408]

I know that this one has been said before... but I've gotten two calls for "low urine output" in the last week.

Both were ESRD. One was actually getting HD at the time of the call.

urgh.

"No, doc, I haven't peed in a few years now."

 

[chimichanga]

...Seriously. Who trains these nurses?

On another note, do you find that the new, young crop of nurses think they know more than they actually do?

A big part of the problem, is the primary focus of community colleges (ADN): Skills...

These schools are churning out skill hounds, not thinkers...
Sad times...

 

[Substance]

A big part of the problem, is the primary focus of community colleges (ADN): Skills...

These schools are churning out skill hounds, not thinkers...
Sad times...

Funny you say that, but I find medical schools are also becoming skill and algorithm factories. This is part of why NPs think they can do medicine as well as we can: they learn lists and skills, just like us, so why not let them to the job?

 

[telenurse]

I actually got a text page on Sunday night reporting (as the RN is required by hospital policy to do) a "Critically Low Calcium" as well as the albumin and the calculated corrected Calcium value (which was calculated correctly). It ended with a "Sorry to bug you." It may have been the best page I've every gotten.

Unfortunately, I've been paging like that for awhile. Per new policy, ALL "critical low and high value lab results" have to notified to the MD covering the service within 30 minutes of the nurse recieving notification of the result.

Much of my time between 0300 and 0500 is spent thusly
Sub H.O.: you paged
Telenurse: pt in 350 has a troponin of 3.76 which is a trend down from 4.84, and he is still on heparin and integrelin, NPO and going to the cathlab today, but I have to notify you for the chart.
Sub H.O.: ok
Telenurse: don't hang up! pt in 356 has a K+ of 3.2 which is up from yesterday of 2.9
Sub.H.😵k,
Telenurse: and 358 HGB is up to 10.8 fro 7.9, which I have to report to you as it is a significant increase, but she got 2 units of blood yesterday, and she's only 40 kg...
Sub H.O. : why do you have to report all that,
Telenurse: the lab considers it critical...it's policy, and I'll be reprimanded if I don't
Sub H.O." that's idiotic, there's nothing I'm doing for any of these.
Telenurse: I know.

 

[Neogenesis]

0330. Cross cover pt.
nurse: are you covering Mrs X?
me: yes
nurse: she normally gets a vitamin D supplement every week, and was wondering if she would be getting it in the morning.
me: (nicely) let her know to make sure to mention it to the primary team.

Really???

 

[DonStracci]

I'm usually really patient and the nurses' silly calls don't bother me but...

"Hi, Dr. ****? Do you know how to spell Robitussin? Someone wrote an order for it and I can't figure out how to spell it."

Arizona's finest, I guess...

 

[putzeled]

Paged at 3:45am ...
Nurse: Dr. can I get an order to give this patient a sponge bath?
That one was too bizarre to even get mad about.

The worst are pages to ask if a standing order should be followed...
"This patient's sliding scale says to give 10 units, should I?"
"This patient's K is 3.0, should I follow the K replacement protocol like you ordered already?"

 

[smq123]

The worst are pages to ask if a standing order should be followed...
"This patient's sliding scale says to give 10 units, should I?"
"This patient's K is 3.0, should I follow the K replacement protocol like you ordered already?"

Our chief resident said that he got a LOT of pages like that at the beginning of the summer. Apparently, a batch of new nurses, fresh from graduation, had been unleashed in the hospital, and were asking for a lot of confirmation. "When you say to give him Tylenol for a fever, and his temp is 101...should I give him the Tylenol?"

 

[Miami_med]

At 7:00 PM while I'm on call on a cross cover patient relating to a drug ordered by infectious disease as a consultant.

Nurse: The patient had a Tobramycin trough of 4 this morning, do you want me to give the dose.
HO: Did they give the dose this morning when they drew the trough?
Nurse: I don't know.
HO: Could you check?
Nurse: OK. Oh there was no dose scheduled then.
HO: It can't be a trough if there is no dose scheduled then
Nurse: It says trough.
HO: When was the last dose given?
Nurse: (after the sounds of some typing) Yesterday afternoon. Does that mean that this is actually a peak instead of trough?
HO: No.
(At this point, I stop what I'm doing, go to a computer, and pull it up on the EMR)
HO: Are you referring to the trough drawn 2 days ago?
Nurse: Yeah
HO: It looks like the dose was already held 2 days ago (remembering that I was the one who held this dose 2 days ago the last time I was cross-covering this patient)
Nurse: Oh yeah
HO: You do not need to hold the dose of medication based on the trough from 2 days ago.


Then there are my favorite types of pages:
Nurse: Could you come down here and order this medication that the attending just said the patient couldn't have (also on a cross-cover).
HO: No, the attending already said no
Nurse: Well, you need to come down here and explain to the patient's wife who is a nurse what the attending (who already spoke with the patient) was thinking.


And finally my favorite from last night, which wasn't a stupid page, just a stupid problem:
Nurse: Could you come up here and talk to this patient. She's refusing to sign her paperwork for surgery tomorrow, because it's Friday the 13th and she thinks it will be bad luck.

 

[docB]

I got a voice mail the other day at my home number (I have no idea. If I did you'd have heard the sounds of ass kicking where ever you are) from a home health service wanting me to provide them with a bunch of info so they can bill properly for my orders. I haven't bothered to call them back to explain that I'm an ER doc and they don't need my info.

 

[Apollyon]

(If I did you'd have heard the sounds of ass kicking where ever you are)

Roger that!

 

[FutureInternist]

2am page

Nurse : Doctor, pt is asking if she can have something to help her relax before her scan as she is claustrophobic
Me : Ummm....I guess so. What time is the procedure?
Nurse : 10am
Me: 😡....So why is it that this could not be discussed with the intern whose patient this is when I am sure they will be here around 7 am to pre-round. "Slams the phone down"

 

[exPCM]

Let's stay on topic please, and not endlessly go back and forth on one particular case. Thanks.

Remembering that we are doctors and future doctors here, why is analyzing a particular case in detail a bad thing?

 

[Acherona]

I love it when they ask you to d/c orders you never wrote

nurse: the patient is very uncomfortable in the C-collar, can we d/c it?
me: Why is he in a C-collar? I never ordered a C-collar
nurse: the pt fell OOB last night so we put it on for precautions
me: ok so just take it off now, I have nothing to do with it
nurse: we can't now that it's on we need a doctor's order
me: ahhhhh

 

[Winged Scapula]

I love it when they ask you to d/c orders you never wrote

nurse: the patient is very uncomfortable in the C-collar, can we d/c it?
me: Why is he in a C-collar? I never ordered a C-collar
nurse: the pt fell OOB last night so we put it on for precautions
me: ok so just take it off now, I have nothing to do with it
nurse: we can't now that it's on we need a doctor's order
me: ahhhhh

 

[Droopy Snoopy]

I was called this am around 2 because a crosscover pt had refused his zocor... at 9PM.

 

[Ashers]

Last night while being inundated by admissions and other urgent cross cover:
"Pt in Rm X having coughing fit. Please assess Now." The pt has PNEUMONIA and mom didn't want him to cough because it hurt.

Another series of pages involved one particular mom that would freak out the nurses despite my best efforts to assure mom and the nurses. Baby was in the NICU for 4 months of life, had ROP and the laser surgery to correct it and was on 1/8L NC to maintain O2. Pt came in with increased WOB.
--I got several pages to the effect of "Mom in Rm X upset and crying that pt is satting 100% with NC, pt has ROP, wants O2 alarm to be changed to 80%. Please change O2 alarm level, so we keep him above 80%"

Another one from yesterday
"Baby in Rm X vomiting and abdomen distended. Please order simethicone."

 

[SocialistMD]

Last night while being inundated by admissions and other urgent cross cover:
"Pt in Rm X having coughing fit. Please assess Now." The pt has PNEUMONIA and mom didn't want him to cough because it hurt.

Another series of pages involved one particular mom that would freak out the nurses despite my best efforts to assure mom and the nurses. Baby was in the NICU for 4 months of life, had ROP and the laser surgery to correct it and was on 1/8L NC to maintain O2. Pt came in with increased WOB.
--I got several pages to the effect of "Mom in Rm X upset and crying that pt is satting 100% with NC, pt has ROP, wants O2 alarm to be changed to 80%. Please change O2 alarm level, so we keep him above 80%"

Another one from yesterday
"Baby in Rm X vomiting and abdomen distended. Please order simethicone."

I like how all of your pages come with orders. At least they said, "please." 🙄

 

[Ashers]

I like how all of your pages come with orders. At least they said, "please." 🙄

I know... the "pleases" make me soooo much happier to run up to assess the patient for a coughing fit, and explain to another nurse how ROP works, or run upstairs, and see the distended abd and vomiting kid, and the nurse didn't know why I was concerned (not concerning exam btw, but the page was concerning).

 

[Rorympb]

Some of these are pretty funny...I have a kind of funny
one but it's a RN to RN. When I was a staff nurse
way back in the mid-80's, I worked on a surgical floor
that was the old 'eye floor'. But with modern times, we
didnt get a whole population of eyes, we became more
adult surgery, oral, plastics, uro, overflow from other
surgery services etc. Anyway, we RN's on that floor
still had the rep of being "eye nurses" lol.
Unfortunately, for the eye
residents, all hell would break loose when
an eye pt would be assigned to another floor. On such
a night, a preop eye was admitted to one of our froo-froo
private floors, the "tower" as its called. Luckily for our
wonderful residents, they were spared this little phone call:

Me: Hi, Floor whatever..
Tower: Can i speak with one of the "eye nurses"
Me: well this is one of the "nurses"
Tower: ok, can one of you "eye nurses come up
here, we have an eye patient who needs help
Me: uhhhhh...what kind of help? 😕
Tower: the patient is going to surgery in the am
and she has soft contact lenses on, what should
we do?
Me: well, take them out? Im sure the pt brought
their supplies with them? If they arent extended
wear, take them both out, if EW just take out the
operative eye.
Tower: well that's why we need you to come up,
you're an eye nurse and you need to come and
take them out for her.
Me:😕😕😱

Yup, I kid you not...maybe only ophtho's will find it
funny?

Funny one with one of our chief's who started his
fellowship as well with us...Sat am, lots of d/c's...

Phone rings...
Me: Hi, Floor whatever, how can I help you?
Caller: Hi there Rorympb, this is "Bob"
Me: Hey Bob, whats up?
Bob: Im in the medication room, eating a roll, can
u put Mr so and so in the treatment room for me so
I can do a SLE before d/c?
Me: what? you're where? what?
I proceed to lean over the nurses station to look literally
10 feet down the hallway, to the medication room, to
see "Bob", at the doorway, on the phone, waving hello
to me, with his roll....lolololol

That has cracked me up for oh, 25 years lolololololol....

I got more lol....

 

[LeemerDO]

1 AM Hawaii time: Phone rings
Me: Hello?
Nurse: Hi Dr Lee, you taking care of the patient (insert name here)? (no pause to allow me to say that I'M NOT ON CALL, just dives right into the problem) He's got a potassium of 3.4 from the lab. You want to come down and write an order for something?

Me: Oh sure, I'd love to, Dear, but there's one problem. I'm on vacation, and as much as I would loooove to be at the hospital now, i'm not gonna swim 3,000 miles to write you an order. How about you try this instead? Read the call schedule again and CALL THE OTHER Dr Lee!

(CLICK)

 

[Apollyon]

1 AM Hawaii time: Phone rings

+3000 miles puts you in either Pacific or Mountain time zone. Now, with and without daylight savings, that's anywhere between 3am and 5am in the time zone from which the nurse was calling. Ugh.

 

[psychforme]

seriously what the hell is wrong with them? And why do doctors not have the power to kick out incompetent underlings? The system is flawed at its core.

 

[Miami_med]

You have to be really careful with the idea of trying to make it so that people can't call you with "stupid" things. I've had things identified to me by these same people over the phone as "stupid" that have turned out to be everything from post-op MI to ARF when you dug a little deeper. Using the above as examples, knowing at night and early is absolutely the right thing. If the UOP has been low for 10 hours, and someone only noticed at 3 am, the problem is that the system allowed the patient to wait 10 hours, not the phone call or page after the discovery of the problem. The last thing that patient needs is 3 more hours of shock until morning rounds.

Once upon a time at a certain affiliated hospital, the nurses couldn't directly page a physician at night. Each floor had a nurse manager, and the manager had to page the physician. That sort of system does atleast add a layer of triage to the system. It also might mean that you got phone calls with more complete information. If you call me and tell me that the patient is sick in some way, I will ask you for vital signs. It would be helpful if people had some clue what they had been in the last 8 hours when they call me.

 

[Rorympb]

seriously what the hell is wrong with them? And why do doctors not have the power to kick out incompetent underlings? The system is flawed at its core.

Hmmmm...I would hazard to guess it's because you probably aren't their employer? But it's only a guess lol

 

[Krazykritter]

I have to say that my most ridiculous page to date (although I've been getting rivals of this lately) occured just last week:

POD#7 guy from an Ex lap, small bowel resection for high grade obstruction who has had a prolonged ileus w/ no bowel function at all:

Nurse: Hello, doctor. You are taking care of Mr. Ex lap?
Me: You bet. What's up?
Nurse: Well, he just passed gas. (I was actually thrilled about this b/c I have too many rocks on my service already)
Me: Fantastic.
Nurse: Well...he says that he became nauseated while he was passing gas.
Me: ............
Nurse: Do you think that his passing gas is making him nauseous?
Me: ....(suppressing a laugh & wanting to give an order for a clothes pin applied to nostrils PRN)...No, but please renew the order for Zofran as previous & please give him sips of clears.

 

[Tigerz_Fan]

So I finally have a couple to share. So far, I haven't been able to contribute because our nurses are stellar, but this one was new...

Pager goes off:
Me: ICU fellow returning a page.
Nurse: Yes, Dr. TF, the patient in bed 2 just had a bowel movement.
Me confused, but thinking maybe there really is something wrong: Um, so is it bloody or something, are you thinking Cdiff???
Nurse: No, it's normal, I need to know what I should do.
Me: Huh?
Nurse: Well, should I clean up the patient?
Me: Well, would you like to lay in your own feces?
Nurse: No.
Me: Then please clean up my patient, thank you.
Click

And same nurse gets a new patient, a respiratory arrest transferred from the floors. Intubated now, in shock, you get the picture. I am about to place an emergent line.....
Nurse: Dr TF, the patient's temperature is 100.2
Me as I am draping the area: Thank you, and what are the rest of the vitals?
Nurse: HR 144, BP 65/32, and temp 100.2!
Nurse: And I need an order for tylenol!
Me: Um...can you pls hang more fluids and increase the dopamine?
Nurse: But I need to give him a tylenol rectal sup now! Let me turn him and give the tylenol.
Me: No, I am placing a line.
Nurse: But can't you stop for a second?
Me: No, and please call the charge nurse so I can have another nurse for this patient.

 

[dpmd]

It never ceases to amaze me how some nurses seem to think that fevers are caused by acute tylenol deficiency. When I have patients who are NPO and I get a call about elevated temp I always ask if the patient is uncomfortable from it instead of subjecting them to a suppository. You would think I was suggesting we withold air from a patient from the responses I get sometimes.

Got a call the other night about a cross cover patient who was receiving D5W for hypernatremia wanting to know if it should be given. I asked what the last order was, and it was to give it at x ml/hr (written that day), while she looked for that I looked up the Na-still high. Why on earth she would page me at 2 in the morning for this?

Not a page because I was walking by
Nurse: Can you write a new order for the levophed drip. It's written for concentration x and concentration y is hanging.
Me (not quite understanding): What?
Nurse: Well the MAR says concentration x, but last night they hung a bag with concentration y. I want you to write an order for concentration y.
Me: Well, I really don't want to change the order since we were using a double concentrated drip so the guy wouldn't get as much fluids since his kidneys don't work. And I don't think that the last shift doing a medication error is a good enough reason to switch. Please hang what was ordered.

I keep forgetting they aren't orders, just suggestions.

 

[SoCuteMD]

It never ceases to amaze me how some nurses seem to think that fevers are caused by acute tylenol deficiency. When I have patients who are NPO and I get a call about elevated temp I always ask if the patient is uncomfortable from it instead of subjecting them to a suppository. You would think I was suggesting we withold air from a patient from the responses I get sometimes.

Hahaha, seriously!

Beep beep beeeeeep beep!
Me: Yes?
Nurse: Mr. X has a temp of 101.5.
Me: Please draw blood cultures, get a sputum culture if you can, send a UA and urine culture and I'll order a chest x-ray.
Nurse: Ok. Can I have an order for Tylenol.
Me: No, no Tylenol.
Nurse: Why?
Me: Um, because he just had half his liver resected.

 

[docdaname]

Hahaha, seriously!

Beep beep beeeeeep beep!
Me: Yes?
Nurse: Mr. X has a temp of 101.5.
Me: Please draw blood cultures, get a sputum culture if you can, send a UA and urine culture and I'll order a chest x-ray.
Nurse: Ok. Can I have an order for Tylenol.
Me: No, no Tylenol.
Nurse: Why?
Me: Um, because he just had half his liver resected.

there really is an obsession with treating fevers: this patient for some reason i forget couldnt have tylenol.
nurse: Dr, Mr X has a temp of 100.5, but he cant have tylenol, can I institute cooling measures?
ME:...what cooling measures?
nurse: like a cooling blanket, cold compresses/ice packs in the axilla...
ME (perplexed): is the patient uncomfortable from the fever?
Nurse: not really
Me: have you ever had a fever? would you really want cold blankents and ice packs on you? please dont do that!

I also think that some "policies" of things that nurses claim they are required to do are made up. example:
I once had a nurse refuse to put SCD's on a patient, because it was hospital policy that no SCD can be placed, unless they have had bilateral ultrasounds to assure they didnt have a DVT. (and no, they had no signs or symptoms of one. and we can all argue the efficacy of SCD's, but thats really not the point). I asked her if she could show me that policy, but then she got angry, and the resident (quite wisely) cut me off before I could really do to much damage and just d/c'd the order.

 

[zenman]

there really is an obsession with treating fevers: .

It's really easy to write an order on every patient to call you if temp reaches 102 or whatever and what you want done about it...meds, cultures, etc.. Or not call, just do whatever. Anyone figure that out yet?😀

 

[psychbender]

It's really easy to write an order on every patient to call you if temp reaches 102 or whatever and what you want done about it...meds, cultures, etc.. Or not call, just do whatever. Anyone figure that out yet?😀

Yeah, and that often does not work. I used to get paged all of the time for vitals that were within the stated allowable values. Our standard admitting order set (that is on every patient that comes in to the hospital) say to call for temperature > 100.5, and I cannot even tell you how many times I used to get paged for horrible 99.5 fevers ("but doctor, I thought you would want to know!").

 

[Ashers]

Yeah, and that often does not work. I used to get paged all of the time for vitals that were within the stated allowable values. Our standard admitting order set (that is on every patient that comes in to the hospital) say to call for temperature > 100.5, and I cannot even tell you how many times I used to get paged for horrible 99.5 fevers ("but doctor, I thought you would want to know!").

At least you got paged. Last night I didn't get paged on a patient who we were monitoring for fevers, and had her first new spike in 3 days. I heard nothing about her overnight, and when I checked her vitals this morning "38.5, Tylenol given." So, I had to go ahead and d/c the tylenol, so now every time she spikes, the HO gets called. The call order was to call for everything over 38.0, but nope, not a word. She would've gone home tomorrow too. =(

 

[Rorympb]

I don't get the temp obsession either, when I used to work on a
surgical floor in my former life, we never paged unless temp was 38.5 and over.