cath lab; drs late for cases

Editorial Team / Admin · Nov 11, 2003

I don't have any answers for you, sorry. IMO, those persons who show up that late ALL THE TIME display poor time management skills, disrespect and selfish disregard for the patient (the captive audience), or a chronic bad habit they don't wish to change. Some are late with good excuse, i.e., emergencies arise, the last pt to be seen in the clinic needs to be admitted, etc. One Radiologist I worked with was late about 50% of the time but whenever I checked on him (to try to "hurry him up") he was finishing up on another case or finishing reading a set of images. I wanted him to take as much time and be as careful with my pt as he was with the other task he was finishing, so I usually didn't hassle him. A Cardiologist I worked with, on the other hand, was always as you described: at least 20-40min late. Over the years we tried complaining to him, complaining to his superior, cajoling, teasing, hard-nose, soft-nose, using logic in a calm and nonthreatening manner, pointing out how unfair it was to the pt, ---- WE TRIED EVERYTHING!!! Nothing worked. He'd improve for awhile then slip back into being late.

I think, with someone like the Cardiologist above, you have to have a strong cath lab admin who will lay down the rules, setting enforceable limits. Causing this kind of delay really wastes department resources, tying up the room when it could be turning over to another case, and increasing department costs with increased staff overtime. Have you been documenting the delays? It's always wise to have "hard evidence." We started documenting delays (date, time, reason given, MD causing delay) but nothing ever came of it, even when we presented all to "the powers that be." MDs who are late for exams, as well, torture patients and wear down morale, frustrating the staff who have to deal with anxious patients.

I wonder if there is any literature available that documents harmful changes to pts who wait unnecessarily ----- you know, deleterious changes caused by undue stress (especially in CARDIAC pts!!) . . . this could be used as ammo.

Perhaps if more patients wrote letters of complaint to admin they might come down on the offender (poor customer service).

I heard of one OR that took pts off the table and sent them back to their rooms if the MD was 15 min late. (Now, that wouldn't work in my dept cuz we'd have to just do the case later and set up everything again . . . )

Most effective might be to fine the offenders, though I really don't know how that would be done. Hitting 'em in the pocketbook always seems to effect change, know what I mean?? Except it's, again, a political thing = they bring the "business" in that makes the money . . . BUT, if the customers are unsatisfied, that's poor business.

Tough problem. Would like to hear anyone else's input. Good luck.

CCL"Babe", BSN, RN · Nov 11, 2003

Same issues in our lab. We have tried everything. Unfortunately the worst offender is the director of the lab. We have had patients get up off the table and refuse the procedure. It affects the whole schedule. We sit around all day doing nothing, or having hour long delays, then he wants to stay late to finish the cases. We feel that it is very direspectful of the staff, the patients and their families.