01.07 Communicating with Other Departments
- Communication for help
- Communication with interdisciplinary team for patient management
- Reason for communication
- IV/lab draw help
- Medical Emergency → be CLEAR about WHERE and WHY you need help!
- Code team
- Rapid response team
- Lift team→ need help turning or your patient fell
- Pharmacy→ medication is due
- Missing result
- Lab work clotted and needs repeat
- Arranging to get the patient to testing
- Be direct with what you need
- Remember they have valuable time too
- Always thank → you will need them again at some point
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
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In this lesson I am going to help you understand the importance of being able to communicate with other departments and how to best achieve this.
Ok so you might be thinking, “I have the nurses on my floor I don’t want to talk to the other departments and won’t have a need to.” You also might think that they have no idea what goes on on your department so they wouldn’t get it. You will communicate with other departments more than you think. It is good to have open communication with them for several reasons. Some of the reasons you might communicate with them is for help. We have had patients that lose their IV and need another and they are very difficult to stick. So we have phoned our friends in the emergency department. They might not love that but sometimes they have a free moment and can run up and help. And you make friends with these nurses so you can call them to come help at other times. ICU calls us to come to fundal checks on postpartum patients for them or other departments to get fetal heart tones and monitor the patient that is pregnant but hospitalized for another reason. We had a case where a pregnant patient was on the med-surg floor for osteomyelitis from an infection caused by heroin injections in her foot and the labor nurses were to go up every shift just to get fetal heart tones. The labor nurse that was assigned this on the night shift had already gone and completed this. The nurses called hours later from that floor because the patient was having some pain and acting different and they couldn’t figure out what was going on and wanted the labor nurses to come get heart tones again and help them. So they did. The fetal heart rate was 40 and she was immediately rushed by nurses from the med surg floor and our labor nurses to the OR where she started yelling she was going to die. Unfortunately she and her baby both coded and did not survive. In this situation communication happened because help was needed. It was needed between the different units, the ICU and ED departments that sent code team members, anesthesia department, and the NICU. It is necessary for patient management and for help. Make sure you are clear on communication of where and why you need help so they get to the right place especially if it is an emergency. For example Code blue room 315 gives better information than code blue third floor.Now let’s look at the communication with other departments specifically.
So there are so many departments within a hospital system and there is no way you will go through a few shifts without needed to communicate with them. I had already mentioned that you might need to contact another department to get help with IVs or labs be drawn. So just politely asking if they would have time to help. The code team or some hospital systems have rapid response which are the people you call when your patient is deteriorating but hasn’t coded might need to be communicated with. This communication is huge because they are responding quickly and it is an emergency so they need the facts about your patient because they haven’t been caring for them. So they need quick important facts and then constant communication between the departments needs to be occurring so everyone is aware of who is doing what. The lift team department might be needed to help turn your patient or help lift your patient off the ground if they fall. So communication on what is going on with your patient and clear direction on what you need. Pharmacy is a big one. I feel like I am constantly calling them because a medication is due and we need it stocked. This can be frustrating so trying to explain “Hey this medication is due now, when do you think you will get it up here?” sounds better then “why haven’t you stocked this medication? It is going to be late now and I need to give it?” The lab is another frustrating one because you’ll suddenly notice there is missing results and you call and they say they never received it. Now you are behind because you need the lab result for dosing medications or something like that. Or you send blood that was hard to draw and they call to tell you it clotted so now you have to draw it again. So take a deep breath and just be respectful in your response like “ok do I need to put a new order in?” or “I did send that lab, can you please check around and make sure it isn’t there?” The imaging department might need to be communicated with to arrange when you can get the patient to x-ray or whatever testing. So just saying “when do you think you will have time to get this scan done?” Remember, they have other things going on that you may not know about, we can’t assume we are the priority.
Ok so just some little points for communicating with other departments. Be direct with what you need. They need to know what exactly it is you are asking for. Be polite and always thank them. You are going to need them again at some point for something so you want to be able to phone a friend and get the help you need. And last be respectful of their time to. So acknowledging that you know they are busy but… or asking “when will you have time to…” helps also. Other departments have staff being pulled in multiple directions as well so remember that.
Alright so let’s review this now. Communicating with other departments is a huge part of the daily routine. One of the big reasons is to get help or assistance. So help getting an IV started, help because your patient fell and you need lifting help, or your patient coded and you need the code team. You might need to talk to other departments for scheduling. So this would be imaging department to see what time they think they can accommodate the patient. It is important to be direct and say exactly what is needed and always thank them for any help because you will probably need their help again at some point.
Work on incorporating this communication into your practice. Now, go out and be your best selves today. And, as always, happy nursing.