It is understandable to be nervous about dealing with a doctor. And it’s understandable to be nervous about calling a doctor. But, with any nurse-physician interaction, there is something important to keep in mind: You may be nervous (or you may not even like the doctor) but you are contacting them on behalf of your patient. You are the patient advocate, and you want to make sure patients receive the best care possible.

I learned how to best interact with the doctors by watching my preceptor and other nurses on the unit. I think I am successful because I use a technique called SBAR that my hospital has implemented as a communication roadmap. It is a helpful guide that can lead you through a successful conversation with a doctor whether it is in person or on the phone. (I mostly use this when I am contacting a doctor at night over the phone.)

SBAR stands for Situation, Background, Assessment, Recommendation. But, before calling the physician, there are a number of duties to complete:

1. Assess the patient
2. Review the chart to find the appropriate physician to call
3. Know the admitting diagnosis
4. Read the most recent progress notes and the assessment from the nurse of the prior shift
5. Have the chart, allergies, meds, IV fluids, and labs with results available when speaking with the physician

Then, it’s time for SBAR. Let’s take a closer look at each step:

Situation: State your name and unit. I am calling about (patient name and room number). “The problem I am calling about is . . .”
Background: State the admission diagnosis and the date of admission. State the pertinent medical history and give a brief synopsis of the treatment to date.
Assessment: Provide the most recent vital signs: BP, pulse, respirations, temperature, and oxygen saturation. Let the doctor know if the patient is or is not on oxygen. Also, relay any changes from prior assessment such as mental status, skin color, neurological changes, respiratory rate/quality, pulse/BP rate/quality, pain, retractions/use of accessory muscles, rhythm changes, wound drainage, musculoskeletal (joint deformity/weakness), and/or GI/GU (nausea/vomiting/diarrhea/output).
Recommendation: Make a plan. “Do you think we should (state what you would like to see done) . . . transfer the patient to ICU or CICU, talk to the patient and/or family about the code status, ask for consultation to see the patient now?” Or, “Do you want to come to see the patient at this time? Are any tests (portable chest x-ray, ABG, EKG, CBC, BMP, etc.) needed?” If a change in treatment is ordered, then ask: “How often do you want vital signs? If the patient does not improve, when do you want me to call again?”

A new nurse may not know what suggestions to make to the physician, so he or she will rely on a preceptor to guide them in the right direction. Before you make the call, you and your preceptor should work out a game plan and come up with suggestions to make to the physician. And, don’t forget: Once you have the patient stabilized and everything is under control, you need to document the change in condition and the physician notification.

I hope this will guide you toward better, more positive interactions with physicians. Once you do it a few times, you will gain confidence!

Editor’s note: Send questions or share your experiences with Sarah Jane, the columnist behind The Preceptor Place, at janesarah18@hotmail.com.