It wasn’t an emergency. One of my patients had been accepted into an impatient hospice center. There was still enough time in the shift for me to prepare him to go so that the next nurse may only have to wait for his ride. The last few consults still seeing him had all agreed that he should go to hospice, but all progress notes included the words “stable at this time” and “considering hospice.” So I had no actual orders. I paged the three consults still rounding and the MD on call for his attending. All the consults gave me the orders I needed. Just the attending to go. I called the answering service again to find that that MD on call had changed. Ok, let’s page that person.
An hour later I paged again. Nothing. 45 minutes later I paged again. The answering service told me she had a new pager, and maybe it wasn’t working. They would keep trying and checking back with me to see if she called. Still nothing. This was getting ridiculous. I called the hospice center to let them know what the hold-up was and to make sure there wasn’t a deadline for when they could accept him that day. No time limit. They could accept him anytime. I told my charge nurse what was happening, and she paged the house supervisor. What if a patient had been coding?
While they worked on it, I went on with the rest of my work. When I got back to the station, I was told that apparently this doctor was not answering any pages since another MD was going to be taking over that evening. They had gone ahead and paged him. He called back soon and gave me the discharge orders as I was giving report to the next nurse.