Phone advice in the ED

[abgmaine]

I work in a small hospital ED where the nurses are expected to give advice to patients over the phone. Not patients actually, but folks who call and want medical advice over the phone without having been seen in our ED. Having working in other EDs where the company line was NO PHONE ADVICE because of the liability to the nurse and the hospital, I have found this aspect of the job very uncomfortable. We had a computor program for a while, but it was slow and ineffective and they finally got rid of it. I'm wondering what other small hospitals do about the phone advice thing. I feel like I have to choose between my licence or my job here. Any thoughts?

[cougarnurse]

Originally Posted by abgmaine

I work in a small hospital ED where the nurses are expected to give advice to patients over the phone. Not patients actually, but folks who call and want medical advice over the phone without having been seen in our ED. Having working in other EDs where the company line was NO PHONE ADVICE because of the liability to the nurse and the hospital, I have found this aspect of the job very uncomfortable. We had a computor program for a while, but it was slow and ineffective and they finally got rid of it. I'm wondering what other small hospitals do about the phone advice thing. I feel like I have to choose between my licence or my job here. Any thoughts?

I am under the impression that the majority of places have the No phone advice in effect. Like you said....your license and job.

'Cat'

[AmandaWIRN]

I used to work in an ER where some of the nurses would give advice over the phone. The only advice I would ever give anyone is "call you primary care physician."

[nightstar3dp]

I work in a small hospital ED as well and when someone calls and asks for medical advice I'm told to reply like so: "I apologize 'ma'am/sir', but it is against hospital policy to give medical advice over the phone, if you think this is a medical emergency and you need to be seen, we have a doctor on staff 24/7. If not you can follow up with your family doctor tomorrow morning."

[abgmaine]

Thanks for the input everyone. I guess my frustration is that we DON'T have a no phone advice policy as we SHOULD. We are expected to assess someone over the phone and give advice based on their responses. (Crazy!!) So I am the bad guy in the department for refusing to do this! I have politely explained to them what other hospitals do and sited studies that show the danger of giving phone advice. Thanks for listening!

[hppygr8ful]

I would first check with your state board to see if this is even within your scope of practice. If not have the board send you a copy of the nurse practice act for your state. Then you canrefuse based on the "OUTside my scope" clause. Any hospital that expects a nurse to perform outside his/her scope is looking at serious liability and the board won't care if patient gets hurt it's your license on the line.

Peace and Namaste
hppy

[CaseyLynn.ER.RN]

Roger, Roger....Is that you??? OMG! Since we work in the same ER. I ditto his reply. Call me sometime. Chocolate gravy...

Originally Posted by nightstar3dp

I work in a small hospital ED as well and when someone calls and asks for medical advice I'm told to reply like so: "I apologize 'ma'am/sir', but it is against hospital policy to give medical advice over the phone, if you think this is a medical emergency and you need to be seen, we have a doctor on staff 24/7. If not you can follow up with your family doctor tomorrow morning."

[MRS. ERNURSE]

I agree. We have a no phone advise policy and sometimes it's difficicult because sometimes it seems like an obvious situation that the patient can easily wait until their PCD's office can see them in the am but we never really know..because we are not sitting across from the patient. The caller may be leaving some "minor" detail out that they do not feel is important. If something happens to them because they did not come in (because I told them to wait) then they could have my license and all that I own. Are you willing to give your life to them or your co-workers? I would just tell your co-workers you're just not comfortable responding with telephone advise and if that's what they want the patients to have then they can answer all the nurse calls. Let them have the glory!

Your awesome nursing skills will shine through and none of the rest will matter. Just something to think about: I believe that Jesus died on the cross for us and gave up his life already. Jesus doesn't expect us to do the same for anyone or any job.

Mrs. Ernurse