Anesthesia woes

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Specializes in Operating Room.

I've noticed a trend in the past month or so regarding the anesthesiologists in my OR.. I work evenings and it is myself and a tech-we do have a call team also. These anesthesiologists will shut me down, meaning I can't have two(or more) rooms past a certain point. However, I have been told not to keep call staff if they aren't actually doing a case. So, I send them home.

Anesthesia charge changes hands at around 8pm..and now whoever is in charge is rushing me to start whatever case is next to follow. However, myself and the tech are in a room working on a patient. Last time, the doc wanted me to leave the patient I was caring for, and go and open the next room, set it up etc. Told him no, because that is not acceptable or fair to the patient. He was nasty about it. I will write it up but anyone else deal with this? any advice?

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Specializes in O.R., ED, M/S.

Our guys are from 7a to 7a the next day.We do run two rooms with one closing at 8pm and that is usually using call people. There have been times where that one has gone over the 8pm cutoff, but not that often. I do try to get everything into one room and will run util 11pm or later. Anesthesia is pretty good about it and want to close the second room as soon as possible. Your problem is you have a fresh individual coming in and wanting way to much. Tell him to cool his jets and you will try to move the cases along as well as you can. My boss hates to use call people to run that other room but sometimes it can't be helped.

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Told him no, because that is not acceptable or fair to the patient. He was nasty about it. I will write it up but anyone else deal with this? any advice?

1. You would be abandoning your patient.

2. You would be opening sterile supplies in another room and then leaving it unattended.

3. If something goes wrong with the case in progress and you are not in the room, they will blame YOU. Protect your license.

4. Anesthesia is not your boss. Your nurse manager is. In fact, since you are the only RN there, you are the charge nurse. YOU decide when rooms get set up.

Try to find laws for your state. Here is one for NY:

"New York RN Circulator Bill was signed into law by Governor David Paterson on July 7, 2008. This law ensures that a Registered Nurse (RN) is present in any and each separate operating room where surgery is being performed for the duration of the procedure. This law shall take effect on October 5, 2008. The public health law is amended by adding a new section 2805-s to read: The actual language of the law is as follows: 2805-s. Circulating nurses required. A registered nurse, qualified by training and experience in operating room nursing, shall be present as a circulating nurse in any and each operating room where surgery is being performed for the duration of the operative procedure."

http://www.aorn.org/applications/GvtAffairs/stateinfo.asp?state=NY

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"the "recommended practices for maintaining a sterile field" state that "a sterile field should be maintained and monitored constantly. (12)" sterile fields should be prepared as close as possible to the time of use, and when prepared, the sterile field should be guarded continually to protect against inadvertent contamination. when sterile supplies have been opened, they should be used at the earliest possible time."

http://findarticles.com/p/articles/mi_m0fsl/is_1_77/ai_97058874/pg_3

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By the way, it's not your fault that anesthesiologists have to work long hours. That's the lifestyle they chose. If he wants to go home as soon as possible, he should have picked a different career. There's a reason he gets a huge salary.

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Specializes in Operating Room.
Our guys are from 7a to 7a the next day.We do run two rooms with one closing at 8pm and that is usually using call people. There have been times where that one has gone over the 8pm cutoff, but not that often. I do try to get everything into one room and will run util 11pm or later. Anesthesia is pretty good about it and want to close the second room as soon as possible. Your problem is you have a fresh individual coming in and wanting way to much. Tell him to cool his jets and you will try to move the cases along as well as you can. My boss hates to use call people to run that other room but sometimes it can't be helped.

The problem too is that not all the anesthesia docs are on the same page...some want to keep things moving along, others find out that it's a case for our team and they put the brakes on...I've gotten more mouthy. I flat out told the guy last week that he can't shut me down and then be breathing down my neck the whole night because he's changed his mind. I had the people to run that second room, he told me no, and now he wants to rush the one remaining team. :banghead: We are a trauma hospital so our cases are never cut and dry and we have to replace our own implants before sending the trays down. People have gotten in trouble for not doing this.

One of the docs wrote an email to the head of the OR complaining that we don't all scramble to do cases on anesthesia's timetable. I figure I'm there for the patients not to kiss someone's butt. If it were his kid on that table, he sure as hell wouldn't want me off in another room setting up. Good way to lose your license too, if something goes wrong.

Just needed to vent:D

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