This is year 4 of the night shift for me, and I think I have finally gotten comfortable with balancing the autonomy of the night shift and working with doctors. For a while, I’ll admit, I had the whole “doctors chose this job so I don’t care if I have to wake them up” attitude–which didn’t really endear me to my doc-co-workers (not that I want to be buddy-buddy with them, but it does make sense to try and have a good working relationship). We all know that good working relationships between doctors and nurses increase patient satisfaction and safety.
So, here are my doctor-rules for NOC nurses in hopes they help someone who maybe is new to this whole night-shift-world:
1. Most nurses never wake a doc for a tylenol, a Tums, or a fever under 100.4 (to name a few). To do so equals an almost guaranteed chewing-out. Expect it!
2. Think hard before calling a doc at 3AM–can you use your autonomy or critical thinking to work out a problem, or do you REALLY need them?Can you bounce stuff off your charge nurse or do you REALLY need a docs input?
3. If a patient wants to see or speak with their doc at say, 2AM, it IS totally appropriate to call the doc/wake them, IMHO. Yes, try to problem solve w/ the patient, but the reality is that you shouldn’t come between the doc and pt relationship. That type of behavior not only goes beyond the nursing scope of practice, but it will bite you in the butt big-time in terms of doc-nurse working conditions.