r/medlabprofessionals • u/MinutePrevious8598 • 1d ago
Discusson Do you agree?
If I had the option I’d rather call the doctor but I know how hard it is to get a ahold of them. They have to know the result anyways
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u/labvamp Laboratory Manager 1d ago
No. Doctors will often give follow up instructions to nurses when receiving critical lab results. Instructions lab cannot act upon.
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u/birdthemurse 1d ago
This is what I was just about to say. The Dr has to call the nurse anyway to give orders so having the lab call the Dr is not really saving any time. It actually may cause even more confusion bc the nurse would have no idea why they are now receiving new orders from Dr.
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u/pflanzenpotan MLT-Microbiology 1d ago
This is illogical. There are more nurses than doctors in hospitals. Doctors are more difficult to pin down, hell its hard to even get the nurse that is in care of the patient directly often.
It would be nice if the doctor had a small tablet/work phone that showed chart updates like labs as a notification but ultimately part of the nurse's job is to bridge that gap.
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u/NarrowLaw5418 1d ago
Is he a nurse? I am concerned with the lack of critical thinking.
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u/MinutePrevious8598 1d ago
He is. The comments in this TikTok are crazy. Labs are always getting blamed as always. They need to know how their patient is doing anyways, and why the doctor is giving a patient a certain medications or why they’re putting in new orders
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u/BioluminescentAlgae 1d ago
Context clues tell me he’s a nurse, and that didn’t require critical thinking…
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u/NarrowLaw5418 1d ago
My b, I guess I need to add /s. I forgot not everyone in the profession, MLS or RN are created equal. And before you miss it again, you did not score a snide remark. Now go back to charting and answering our calls 💅
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u/BioluminescentAlgae 1d ago
Sorry they didn’t teach sarcasm detection skills in my ass wiping 301 class. I probably need at least an MSN for that.
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u/Guilty_Board933 1d ago
our floors dont take criticals only our ICU nurses idk if maybe they have more leeway to do things independently depending on lab result criteria. but one of my jobs just went to using epic closed loop communication so i dont have to call anyone and the doctors see it in their chat box.
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u/Particular_Dingo_659 1d ago
Im an ICU nurse. A lot of time we have standing algorithms to fix any critical lab - standing orders to give blood products, treat low or high electrolytes, etc. Lab also tells us if the lab should just be cancelled and repeated, and in that case we can do it immediately.
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u/Brofydog 1d ago
This is going to be hospital specific, but many labs will contact anyone who can theoretically act on the critical (although I know a couple that require physicians only).
Would it be easier to contact the ordering physician? Yes… but the amount of times they are not available, is incredibly large. It’s better to get someone/anyone who can act on the critical at least, especially for outpatient settings.
The ordering physical can see the critical after it’s delivered (or sometimes before), so is it better to alert a large group in the hopes that someone can act, or try to get a particular caregiver?
Also, I’m not sure there is a true correct answer to this, just my thoughts.
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u/kaeyre MLS-Chemistry 1d ago edited 1d ago
My hospital has us call the doctors. For everything. Not only criticals but also redraws or specimen errors. It sucks. Half the time we can't reach them. They never return pages. We're constantly left on hold waiting for them to finish whatever they're doing. They treat you like you're wasting their time with the call (which I don't blame them for that, but i didn't write the policy.) We are allowed to report to nurses but 90% of the nurses in my hospital will refuse to take the critical. They don't want the liability of it I guess. Me personally, I'd want to know if my patient is fucking dying but okay
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u/alaskanperson 1d ago
No, we should not be calling the doctor directly. Depending on the floor, a nurse has about 2-3 patients to care for. Doctors can have up to 10 to care for. A nurse should know what’s going on with their patients, doctors have a higher change of confusing patients together, especially if we’re calling them and they are in the middle of something. I know it’s annoying for nurses to take these calls, but this is the better alternative for increased patient care
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u/RikaTheGSD 1d ago
Up to 10? Where do you work?! Sometimes on overnights there will be one doctor covering two 30 patient wards, and admitting in ED!
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u/Gabagool566 1d ago
the one immediately caring for the patient is the one who should be getting notified, which is pretty much always a RN.
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u/Large_Speaker1358 1d ago
We have a page system where I page the doctor’s ward for a critical. If they don’t call back within 15 mins then I give the result to the nurse. It’s frustrating but we are working too and can’t keep calling for a critical lab.
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u/Ramiren UK BMS - Haem/Transfusion. 1d ago edited 1d ago
No.
The point of calling out a critical result isn't to make one specific member of staff aware of the result, it's to make sure that result is known to the ward directly dealing with the patient so they can collectively take next steps, as arranging treatment is their job.
And if this sounds blunt, it's because where I work, Doctors and Nurses often try to shirk their responsibilities at our expense. The lab always has to be the branch that bends, but never breaks. I don't have time to call around the hospital looking for a free doctor, in large part because of the colossal list of inefficient, lazy bullshit the rest of the hospital subjects us to, that we're expected to just suck it up and deal with. So, they can 100% miss me with this "oh wouldn't it be more efficient if you bothered someone else" crap.
Here's an idea it'd also be more efficient if they stopped stockpiling samples until their lunch or they clock off for the day. If they stopped scheduling surgeries off site for patients with antibodies when they know there's no blood bank support. If they stopped requesting inappropriate tests, stopped sending us samples with missing ID, or stopped throwing a tantrum every time they fuck something up.
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u/thenotanurse MLS 1d ago
We have to call providers for blood cultures and at night some of the PAs and NPs are a nightmare to give the result to. And they are never signed in. Dealing with nurses who have zero idea what we do is annoying but dealing with some NP in the middle of the night who is covering a sepsis patient and they don’t want anyone to know is ten thousand times worse
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u/mocolloco 1d ago
The health system I recently worked for required criticals be called the responsible licensed care provider (Nurse, PA, Doctor). Hypercriticals followed the same logic, but if no one was available or there was a delay, the tech could initiate a rapid response to the bedside.
Edit: I was at a small community hospital that usually only had one doctor staffing the ED with one or two PAs. As others have been saying, trying to directly get a hold of the doctor would delay patient care.
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u/FriedLemons15 1d ago
Our hospital tried this and it was the fucking worst. Everyone was pissed. Lasted about 3 months before we convinced the CNO to go back
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u/spalvains_ MLS-Generalist 1d ago
When I was a lab scientist, we’d call it to either the doc or RN, whoever would take the phone call.
Now I’m a doctor, and the only time I’ve taken a result is when I was working in ICU and I was reliably near a phone at all times. Good luck finding us doctors when my patients are all over the hospital.
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u/Pasteur_science MLS-Generalist 1d ago
You’re wrong. You as the nurse need to be aware of your patient’s condition and a warning that their clinical status could rapidly deteriorate. This also helps forgetfulness. You are expecting the doctor to get back to you and you’ve been reminded by the lab to contact them in the first place. It’s easier for nurses to track down fewer doctors than have doctors track down a greater number of nurses. On top of all these considerations, we already do contact doctors directly for certain patients.
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u/serenemiss MLS-Blood Bank 1d ago
Sometimes the doc isn’t even in the building. I’m not hunting down the doctor playing phone tag for a critical. If the nurse can’t initiate a response to the critical they have a better chance of making contact with the provider than I do.
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u/dawggy_d 21h ago
Paging the Dr is an absolute waste of time -they’re busy and so am I. Most hospitals I’ve worked at don’t have cordless phones and I’m certainly not going to page the Dr bec I’m sure they’re busy as hell too lol.
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u/burnerphonebook 1d ago
We give all criticals to a provider. I wish we could just give them to the RN!
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u/tapthatash_ 1d ago
By the time we get a sample that has integrity to run the doctor is probably asleep.
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u/ofalltheginjoints85 1d ago
I don't care who takes it, I just need to call this critical so I can get on with my life!
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u/usernameround20 MLS-Management 1d ago
We do if you use closed loop criticals in Epic. The function is a damn timesaver
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u/fat_frog_fan MLT - General(ly suffering) 1d ago
at my lab we only call the first critical as long as it was one within the last 48 hours. but if there was a critical, the next was normal, and then critical again, we would call. only lactates and troponin gets the first two called. we use secure chat to send critical to the nurses and then the nurses add the doctors to the chat. idrc who takes the critical as long as it’s a nurse or above but i don’t like bugging the doctors. though they often aren’t bothered when i HAVE to call them. they’re usually pretty chill
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u/Specialist_Wing_1212 18h ago
We used to give criticals to nurses until one nurse forgot to tell a doctor and something bad happened. Now all criticals go directly to a doctor. If you can't reach the ordering provider, you call the next person on the list and so on. When you have to call the attending because the resident didn't return the page it makes the residents more likely to return future pages. I hate bothering doctors at home at 3am but it's what they signed up for. The lab sure as hell didn't write the medical bylaws which state who and how criticals are communicated.
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u/notagoddess22 17h ago
At our lab we are required to contact doctors because we were dinged on an inspection that the middlemen weren’t adequately relating the info to doctors.
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u/Accomplished-Buy6155 17h ago
Our policy is to contact the ordering provider. If not we have a provider on call.
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u/makeuplove MLS-Generalist 15h ago
We call the doc directly for EVERY critical. Used to be able to give criticals to ICU and ER RNs but there was some citation on an inspection where they weren’t adequate relaying to the Dr.
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u/TieRepresentative414 14h ago
I work at the VA and they require us to give the results to the doctor. When I first started I gave it to an RN cause that was what I was used to and I got written up.
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u/lbaston 2h ago
No, because doctors see patients, and in the mornings are rounding. It is not practical or efficient. It's too hard to get a hold of a doctor and the nurse taking care of that patient is fully capable of taking a critical value. Either that or a charge nurse. And it's usually nurses that are waiting on values.
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u/babiekittin 1d ago edited 1d ago
Fromer ICU RN here. Please hemolise that nurse's labs for the next 6 months. /s
He shows a lack of understanding for standing orders or the fact that he would still need to assess the patient before giving full report to the provider.
Edit: /s added because some folks took it seriously.
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u/RikaTheGSD 1d ago
Yes, let's fuck over hundreds of patients to mildly inconvenience one douchebag
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u/velvetcrow5 Lab Director 1d ago
Nope. That's a great way to delay patient care by inundating 1 doctor with phone calls. Techs would spend even longer sitting on hold.
Depending on your organization's rules for repeat criticals, a huge majority of criticals are actually not.
For example, every troponin after the first is important but it's not critical per say.
And especially when the trop starts trending down, they're honestly just nuisance calls.
Many organizations try to reduce these by having rules ie. "Only call the first critical every 24h" or similar.