Advice for overtime dilemma

[Mariererenata64]

I work in a preadmission testing department. My role is on the day prior to surgery I have to review an average of 85 charts per day to ensure all H&P's,clearances and diagnostics are in the chart and day of surgery labs ad any resolutions are noted. There is a nurse who reviews some of the charts 2 days prior to surgery and will call for any outstanding labs or clearances. It helps somewhat, but usually only about 30 chats get looked at and I still have to review them the day prior. I start a 0730 am and usually work 12-14 hours 5 days a week. By 9 am I m supposed to have laid eyes on all the charts and know which cases cannot be first cases due to resolutions and missing documents. There are about 20 first cases mind you. My day is spent calling specialists, primaries and labs for results and then identifying people who nee an additional clearances but don't have it and scurry to get them an appointment s to not have their cases canceled. Some surgeon's offices are good, but most just dump it in our lap thanks to a previous manager kissing the surgeon's a##. we have a new manager who knows we are short and works just as long as everyone and has been hiring new staff- but they are just doing the interviews. My dilemma is if I just leave after 8 hours the charts wont be done and it would create total chaos the next morning, cases would be cancelled which places the poor patient at a disadvantage. The director has been in the position for under a year and has no OR experience which is just crazy. the process from booking to surgery isn't working and we are working on improving and streamlining it. But in the meantime... my manger is fully aware and gives me a break some days in which I do the 2 day out calls in order to reduce my OT but whatever I don't get done that day rolls over to my next day doing the day before. The staff that are interviewers stay over since we are supposed to get 10% interviewed so they are staying over as well. It'll be 8 pm and they will be told to keep trying... that I could easily go home..the pre op nurses can interview them the next day....thoughts suggestions for leaving on time or if anyone can share how their PAT department works. having a NP is not an option. Also the have a RN sign off of any abnormal EKG...which I refuse to do. Anesthesia will not review them so if we believe its abnormal enough we fax it to their primary, their cardiologist, or surgeon Never have I worked in a place where a physician didn't review it and then coordinate with the patient' physicians. Sorry so long winded..

[roser13, ASN, RN]

Paragraphs would help enormously. My current position deals totally with PAT issues, but I am having trouble with your post.

[Mariererenata64]

Basically, my role in the department is to review all the charts for the following days surgery. The caseload runs anywear from 75-105 cases/day. Most of the charts are missing clearances, labs performed outside the hospital which I need to obtain. Many days I will be identifying at 5 pm that a patient needs a cardiac clearance etc. That is one part of the problem..the process they have is not working.

[Mariererenata64]

The actual problem I have is that if I left at 3:30 pm like I am supposed to, there isn't anybody to take over my position, therefore many charts would be sent to the OR not reviewed for patient optimization. Things would be missing etc.. and patient safety would be at issue. Thats why I stay and work 12-14 hours.

[NickiLaughs, ADN, BSN, RN]

Are you getting paid hourly or salary? There are two issues, that job will result in burn out for any person and it sounds like they're trying to run on minimal staff. I would seek another job, get an offer. The. You have a bargaining tool. "I got offered another position and unless up you start searching for another person to assist with this role immediately I'm giving you my notice." The job sounds dangerous, RNs should never be signing off on EKGs, it's outside our scope.

[iluvivt, BSN, RN]

Sometimes you must let the problems occur before someone with the power realizes that the current process, including staffing is nor working.You are fixing it by working OT and I imagine getting stressed out.I know it is difficult but I would do as much as I could making sure each component of the job or the work you do is complete. Then when the problems start occurring ii eill be evident that a change must occur.This is a great time to introduce any ideas you have . I have successfully used this strategy to change things. I think you should leave on time and keep a daily log of all you do in case they try and blame you. Let the chaos happen...