Anesthesia leaves room, normal??

fracturenurse · May 11, 2009, 05:08 PM

Re: Anesthesia leaves room, normal??

Well, where I am currently employed our anesthesia team is pretty good. They sometimes will run and grab a warm Isolyte, (our warmers are right near the rooms). Usually they ask us to run and get it. We have a lot of CRNA's and they usually ask us to find the float MD if they have to pee. I have never had them take off where I couldn't find them though. One hospital I worked at, they would stand outside the door between OR's and talk to each other. Drove me crazy, but I could always manage to steer them back in the room.

I once worked at a surgery center and they were awful. One doc would always take off and go chat with someone and I couldn't find him. Once he even asked me to push a little propofol (it was a MAC), while he was gone. I was like, "No way!!! (Talk about endangering your license). We had to get a handle on that quick, but that was really the only problem I've ever encountered.

Seriously, if your anesthesia provider is taking off for long periods of time and you have no idea where they are, talk to your director and tell her you are uncomfortable with it. Maybe they have just been getting a little carried away. Try talking directly to the anesthesia provider if you feel comfortable, or the head of the group. Good luck, it's a touchy situation.

lindaloo51 · May 12, 2009, 12:02 AM

Re: Anesthesia leaves room, normal??

WHAT ARE YOU PEOPLE THINKING????? You don't think that if your patient goes down the tube while your anesthesia provider is MIA and you have done nothing about it that a lawyer isn't going to rip you to shreds?? In 40 years I have had 1 provider that did this. He lasted about 2 weeks because each circulator notified management each time it happened and wrote him up. It only takes seconds for a patient to go bad. I had a patient throw a PE during ortho surgery recently. In a matter of minutes he was gone inspite of all that we tried to do. If my CRNA had not been there, where would I be now?? I'm quite sure that I would be preparing for a huge law suit.

This is not the normal standard of care!!!!!

Run, don't walk to risk management. DO NOT PUT YOUR PATIENT AT RISK!!!!! You are your patient's advocate. Put yourself, helpless on the table and tell me that it is all right to be ABANDONED by your anesthesia provider.

OHSUBSN05 · May 12, 2009, 12:43 AM

Re: Anesthesia leaves room, normal??

Wow, this is a touchy subject. Well, I thought about it and after an incident I brought the subject up in our unit council meeting. We had a few minutes to spare and I put my head on the chopping block and told them what was going on. When I told the manager what was going on there were about 4 people that said "yeah" someone is saying something about it. One nurse who has been in the OR a very long time just starred at and said " what are you talking about?" She was so surprised and said they never leave her room. Then everyone chimed in, it was awesome. My manager will be bringing it up in the next big meeting where the attendees are the head of anesthesia (guilty of leaving) doctors, charge nurses, directors, etc.

So, the incident that happened last week...the patient was just intebated, I was prepping, the surgeon was gowning up and anesthesia was headed for the door. The patient was not fully under anesthesia because the patient started to wake and was trying to grab things with both arms, including the tube in the mouth! I called out to anesthesia, he didn't really acknowledge me until my voice was raised on the second call out. Umm he ran back to his machine and......did something to stop all the movement. Good thing he didn't make it out the door, I would not know what to have done but hold the patient down as I did. No harm to the patient. I got another prep kit out and continued.

So, what would anyone else do in that situation? What if anesthesia WAS out of the room?

Oh yeah I wanted to mention that we usually have a float crna like we do RN's. They do come in and give breaks, so it is not like they are forgotten or neglected. If they have to pee they page the float crna.

Heogog53 · May 12, 2009, 02:48 AM

Re: Anesthesia leaves room, normal??

That should have been written up on an incident report for several reasons.
First, your patient may have been much more aware of what was going on than anyone realizes. That could be grounds for a law suit.
Second, the doc did harm to his patient by leaving him.
Third, it is a gross violation of patient safety/patient trust
Fourth, I bet it's a violation of policy of your institution.

The more often the docs/CRNA's get written up in incident reports, the faster risk management will take note of what's going on and will investigate the docs/CRNAs- and will also start auditing charts to see if there is any kind of pattern of complications that develop because of thise practice.

Aneroo · May 12, 2009, 01:57 PM

Re: Anesthesia leaves room, normal??

I'm glad you felt comfortable enough to bring this up at your meeting and hope there is resolution!

openheartmary · May 12, 2009, 09:51 PM

Re: Anesthesia leaves room, normal??

The anesthesia provider does not leave the OR, period. They accompany the patient into the OR with the RN, and they stay with the patient until transfer of care occurs in Recovery. We usually have one CRNA who is assigned to give breaks and lunches. The MDA's sometimes have to help out. Bottom line, none of the RNs I work with would ever tolerate that kind of negligent care.

MamaCheese · May 13, 2009, 04:53 AM

Re: Anesthesia leaves room, normal??

Our CRNA's bring the patient to the room and stay with them until they report off in PACU when all is said and done. We're lucky enough to have plenty of anesthesia staff. We have anesthesia techs who each cover a few rooms. They're responsible for turning over the equipment, setting up for the next case, and running for anything anesthesia needs during the case. I rarely need to step out to get anything for them. In the 2+ years I've been there I've never heard of a patient being left unattended by anesthesia. And believe me, I'd hear about it

VACRNA · May 17, 2009, 01:40 PM

Re: Anesthesia leaves room, normal??

I am a CRNA with 15 years experience and anesthesia professionals need to be monitoring the patient second by second. These anesthesia personnel are extremely negligiant and are endangering your patients. I am amazed that the surgeons condone this practice. Please, please, please contact the risk management people at your hospital. If they choose not to pursue this your next option is the State Medical Board. Your patients deserve to receive good care and you must advocate for them

maeyken · May 18, 2009, 08:47 AM

Re: Anesthesia leaves room, normal??

I work in a teaching hospital, and so sometimes our anesthesia docs will leave a senior resident with the patient... but usually they let us know where they're going, and are always available to come back right away. But that doesn't sound like what's happening at your hospital. That's scary that they disappear!!

babs123 · May 18, 2009, 08:00 PM

Re: Anesthesia leaves room, normal??

I've been in the O.R. for over 30 years. I work in a hospital where all of the anesthesiologists leave the room --for whatever reason they choose. This is the first place I've worked this occurs. My previous experience has been in hospitals and ambulatory surgery centers. In one hospital, one of the anesthesiologists would bring a thermos of coffee and stand in the sub sterile room to have his cup of coffee. Rest room breaks were provided by other anesthesiologists that were between cases. So, needless to say, I was very surprised when I started working at my current hospital.
Another issue with anesthesiologists is the practice of bringing their personal lap top to the O.R. and surfing the web or watching a movie during the case. Yikes!

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Anesthesia leaves room, normal??

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