Dr. not responding

This is not and ESSAY: READ The case study below, and then answer the questions
Dr. Smith has a patient on a surgical unit in your hospital. Dr. Smith performed surgery today on Mrs. Able. You are the administrator-on-call from 5 pm to 8 am. At 2 am you receive a call from a nurse regarding the patient’s status. The nurse discloses that the patient's vital signs are not within normal limits and she feels that the doctor is not responding appropriately to her request that he return to the hospital. She has called the doctor twice and he states that the patient is fine and he isn’t coming in. You are responsible to make the decision.
Please explain:
What are your immediate steps and why?
What are your follow-up steps and why?
How does the clinical chain of command impact this situation?