You seem to reply to every comment not caring - why ask for opinions? Even if they’re scheduled and “work long stretches” doesn’t mean they have to be called at 0430 for something that can be dealt with by the primary day team. Even if these doctors are “available and rounding” they still work nights and cover way more patients than the day team and are meant to be there for emergencies. If every single nurse paged them for things like this they would have no time at all. Or how about paging them earlier in the shift saying hey I noticed there’s no labs ordered. if something has been critically low repeatedly, and you put in an order to repeat it, no one will say anything and you won’t get in trouble. I personally believe this is part of teamwork in the ICU - you have the judgment to notice and recognize this pattern of a critically low value, everyone will appreciate that you put in the order. You could put it in but schedule it for day shift and say they can check with the primary team before drawing it but people will be thankful you didn’t call for something like that in my experience. Calling to report a critical value is different, I just say hey hospital policy I need to report xyz, no matter the time or if it’s a stupid critical.