I've always worked in a teaching facility, but I just recently went to a small hospital that is totally different. Where I come from, anesthesia is not to leave the room for anything. Here, they'll walk out for 5 minutes and not even tell anyone where they're going or that they're even leaving. They also don't get into the pyxis for anything. The nurses have to get them all of their controlled substances, and that doesn't seem right. I can understand if it's in the middle of a case and they can't leave, but I don't want to be responsible for their medications when I'm not the one giving them. Sometimes the nurses will even give patients versed before they go back to the OR, yet they still have the patients walk all the way to the room instead of getting them a wheelchair! I've even heard one of the anesthesiologists hint that this is a bad idea, but it still keeps happening. Another thing I recently discovered was that the surgeons never do the consent forms with their patients. The nurses fill them out and get the patient to sign them, and the surgeon doesn't even sign them until after the case is over! If they're looking at it in pre-op and need to make a change, they won't even tell the nurse unless the nurse asks, even though we are the ones who have to change the set up if there is a big change in procedure that we didn't know about. The latest thing I discovered is that the nurses fill out the med rec forms and I'm pretty sure no doctor ever even looks at them. It's the nurses who fill out what medications can be continued after discharge, and the last time I checked, nurses can't write orders! Everything about this place screams to me to run as far and fast as I can, before something happens. Is my fear of staying at this place justified or am I just suffering from a huge culture shock here?