Matt, here is what you need to say:
1. Hit the call button and ask for the 'charge nurse' when someone comes ask if they are the charge nurse. If they saw no, then repeat your request. Don't discuss your concerns until you get the charge nurse.
2. Once you get the change nurse, tell him/her that you need to speak to the on-call attending. They will probably balk, refuse to negotiate. You will finally get a Dr are the nurse is legally obligated to call a Dr.
3. You will very likely get a resident, at most large hospitals, politely explain your concern. BUT tell them you still expect them to call the attending. Don't let them walk out of the room w/o a plan to address your issues.
The only way you are going to get the care you deserve is to demand it, politely, and not take no.
Tom