As the NP on call for the night, who should you direct a nurse to contact if a patient is decompensating?

Directing the nurse to contact the attending MD who is at home is appropriate in a situation where a patient is decompensating. The attending physician has the most comprehensive understanding of the patient's overall care plan, medical history, and current treatment protocols. This knowledge is crucial in determining the best immediate interventions necessary for the patient's stabilization.

In acute care settings, the attending physician typically retains responsibility for patient care even when not on site. They are trained to assess high-risk situations and make decisions about escalation of care. By contacting the attending physician, you ensure that the nurse receives guidance from someone who is fully aware of the case specifics, allowing for prompt and appropriate management of the patient's deteriorating condition.

Other options may not be suitable for various reasons. The ER physician may not have detailed knowledge of the patient's history unless they have been involved in recent care. Anesthesia might not be appropriate unless there is a specific procedural need, and an NP from another unit might not have the context or authority to make decisions regarding urgent patient care without direct supervision.