I know it’s confusing, but this is how a doctor’s schedules works, from an experienced nurse. It’s not always the same, but this can help.
If you are a new(er) nurse, then one of the most confusing parts about working in the hospital is locating the doctor. What is a doctor’s schedule? When should they be around?
That’s why I am sharing this guide. I’ll explain how a doctor’s schedule works and what you can pretty much expect when you work in a hospital.
How Doctor’s Schedules Work
This guide includes how these schedules work most of the time. There are always variables that change it, but this pretty much what you can expect.
One thing to note before diving into this guide is that I continually use the word “doctor,” however, your hospital may have things set up a bit differently. (We chose to use the word “doctor” because that’s what people tend to search for on Google.)
Some hospitals will have teams of residents (who are doctors, but with varying levels of experience) or use advanced practice providers (APP), like nurse practitioners or physician assistants. They may prefer you call the APP or the residents first.
As we get into discussing things like “being on call” they may not allow residents or APPs to take call. It’s really important to know how your unique hospital functions before calling providers during off-hours.
Daytime Hours: Attending and Consulting Physicians
Monday through Friday, your patient’s attending and consulting physicians should round on your patient, write a progress note, and enter orders if needed. They usually do this between the hours of 0800-1700. After and before this time, it’s the on-call physicians and APP that you’ll be dealing with.
What “Being On-Call” Means
Doctors within their group or practice will rotate who takes call. “Call” basically means that one physician from that practice is available for the nursing staff to talk to during non-business hours for a specific amount of time. This enables the rest of their practice of providers to rest, as it would not be feasible for a patient’s physician to be constantly available 24/7.
It will not be the same physician or APP every time. Rarely are they in-house (unless it’s an intensive care team, hospitalist team, or you work at a major hospital requiring specialty teams to be in-house 24/7). Typically, when you’re speaking with the provider, they are at home.
Keep in mind when speaking to these providers that they probably aren’t the patient’s primary physician and may not be familiar with them at all.
Who To Call For Patient Issues
Ideally, you need to have the patient’s primary and consulting physicians address all issues during the day/business hours. The on-call doctors/APPs are available for issues as they arise and not for routine things that can wait for rounds.
They can help guide you and give you orders for urgent situations, or give you orders for important things that are needed overnight that cannot wait until morning (like pain meds for a patient in agony… or a unit of blood for a patient whose hemoglobin was very low on their 0200 CBC/labs).
For example, if’ it’s Tuesday at 0730, and your patient’s blood pressure is suddenly 72/45, you will call your on-call doctor (because it’s before 0800).
Similarly, if it’s Tuesday at 0730 and your patient has an 0800 dose of Coreg due that you’re not sure if they want held prior to their 1000 surgery, you will wait until after 0800 and call the attending (or consulting if more appropriate) doctor and ask. It is not an emergency (even though to you it may seem like it because you have 700 things to do now!) and it can wait for the patient’s primary doctor to be on again.
Therefore, it makes everyone’s lives easier if we get all of our questions/concerns/clarification done before 1700 on weekdays.
Now, if a doctor was on-call all weekend (so from 1700 on Friday until 0800 on Monday), then Monday will be their post-call day. Essentially, they were on-call for all of their partners over the weekend, therefore they get a day off where they are not on-call and one of their partners rounds on their patients for them. (Keep that in mind if you work Sunday and Monday.)
(Now when you accidentally page them at 0810 on Monday and they answer, even though they have to, and tell you that they’re “post-call” that’s what that means!)
If your patient’s primary doctor is Dr. Smith but he was on call all weekend, one of his partners will cover his patients on Monday, so you’ll have to either wait and see who rounds or call the office to see who is covering Dr. Smith’s patients. Don’t page Smith!
You should know where their call schedule is or how to access it. Most departments post the call-schedule for their discipline and/or most frequently used service line.
I hope this makes sense! It took me way longer than it should have to understand this because this was something it was assumed everyone just knew… and alas, I did not.
More First-Time Nurse Resources
Navigating a hospital as a new nurse can be daunting. I hope these other articles help you out!