Can you keep up with fast pace?

[Pam RN]

I'm working in a free-standing surgicenter and I feel like the quick turnovers are at times unsafe or more conducive to making mistakes. For instance I got a call tonight from my supervisor asking me about a specimen that was sent out on a patient last Friday. She was a local gyne case which ran over into another doctors time who does epidural pain injections. I didn't have some insurance paperwork to send with the specimen because the doc had the chart and we needed to quickly turn the room over and start the pain doctors six cases. After the six cases were done I ran and got my paperwork and had the secretary at the desk call for a pick up for the specimen all the while I was at the desk and saw she made the call. Even later I noticed the bag with the specimen was gone. There was some question about the specimen and she was inquiring if I had sent it. I didn't log it in the spcecimen book because frankly I forgot. I assured my supervisor that I did not leave the specimen in a corner and had the courier pick it up. I'm slightly paranoid now wondering if something got messed up. I just feel like all these fast turnovers don't let me have a chance to think things through and make sure all my t's are crossed and i's are dotted. Did I get my out times? Did I leave any blanks? Did I really see that the consent was signed? For such a responsible job and our license on the line I think it's such a crap shoot if we remember to do what we have to do. Thoughts?

[Pam RN]

"You need to write faster!" exclaimed the doctor. I was keeping a record during a Discogram and she, the doctor was reading numbers and information to me and shouted at me in a snotty tone of voice, twice, that I need to write faster. Well, I guess I'm just too slow for this job then. Call me what ever you want but I guess I can't keep up anymore. I can't multi-task, I write too slow, I can't get the patients to the room fast enough. Maybe I need to go back and do long cases in the hospital rather than short quick cases in the surgicenter. I feel like I can't keep up and now I've been shouted at for it. :angryfire

[grimmy, RN]

"you need to write faster!" exclaimed the doctor. i was keeping a record during a discogram and she, the doctor was reading numbers and information to me and shouted at me in a snotty tone of voice, twice, that i need to write faster. well, i guess i'm just too slow for this job then. call me what ever you want but i guess i can't keep up anymore. i can't multi-task, i write too slow, i can't get the patients to the room fast enough. maybe i need to go back and do long cases in the hospital rather than short quick cases in the surgicenter. i feel like i can't keep up and now i've been shouted at for it. :angryfire

that's when you ever so slowly put down the pen and paper and demand an apology. what's she going to do, go pick up the phone and find someone else? that's just plain assinine on her part. there once was a surgeon i worked with who was as impatient as could be, and i am a single person who can load one needle at a time, and i keep ahead quite well - but with 2 residents and a surgeon calling for 4-5 different items, they're going to be handed up one or two at a time. he yelled at me for being too slow. i leaned over and said very clearly, "are you yelling at me?" i have had to pose this question to him as a circulator, too. it positively frosts him. he knows about the need to be a team player, and he knows that i could and would walk at any time. i would be very clear to this particular surgeon that yelling is not acceptable behavior. abuse should never be tolerated, and i would write it up immediately every time it happens.

[Ferret]

I write what I want to remember in my own notebook with dates and details that does not specify a patient's identity as I have heard that these can be deposed as evidence if there is a lawsuit.

In the Law components of the nursing degree in Australia, it is strongly stressed that "Contemporaneous Documentation" ie something written down as it happened or as soon as possible after is considered one of the strongest forms of evidence in a lawsuit. By all means, write an incident report and boot it to management, here all incident forms have to go up through the channels and be investigated. But also write details up in your diary, which allows you to keep a contemporaneous log of all that goes on that affects you, and, unlike incident reports, can log minor situations and irritations that build up to create a comprehensive image of the real situation.

Ferret