When to Call the Physician and When to Monitor
One of the most difficult clinical judgments in home-based care is determining when to call the physician and when to continue monitoring. In a facility setting, abnormal findings often trigger structured escalation protocols, but in the home environment, the nurse frequently makes that decision independently. There is no rapid response team readily available, no immediate laboratory access, and no colleague down the hall for quick consultation. The decision to call carries weight because calling too frequently may be perceived as overreaction, while delaying communication can compromise patient safety. Navigating the space between those extremes requires disciplined clinical reasoning. Recognizing the Difference Between Change and Emergency Not every change requires immediate provider notification because chronic illness often involves predictable fluctuation. Swelling may increase slightly at the end of the day, blood pressure may vary within a reasonable range, and appetite m...