When to call your registrar

You will never be criticised for a clear, early call about a patient you’re worried about. Registrars worry about the juniors who don’t call, not the ones who do.

Call now if

You never need to wait for a patient to meet the criteria. If you or the nurse are worried, call.

How to make the call

Before you dial, have the observations and their trend, the chart, the latest results and your own plan in front of you. Then use ISBAR:

Identify yourself and the patient. Give the Situation in one sentence, the relevant Background, your Assessment, and your Recommendation: what you need, and by when.

Lead with what you need:

“It’s Alex, the intern on call. I’d like you to review Mrs Tran on Ward 6 now. I think she’s septic: her blood pressure has dropped and she’s newly confused.”

End by saying back the plan: what you’ll do, what they’ll do, and when you’ll call again. Write it in the notes with the time and the registrar’s name.

If you’re not happy with the answer

• Say it again, more clearly, starting with the finding that worries you most.
• Make your concern harder to miss using CUS: “I’m Concerned… I’m Uncomfortable… I think this is a Safety issue.”
• If you’re still not happy, call the consultant, or make a rapid response call if the patient meets the criteria.
• Write down who you called, when, and what they advised.