Our current policy states an RN will be assigned to monitor the patient, 2 other staff members, a scrub & circulator needed for the procedure. Current policy does not distinguish what is done after hours & on weekends. Policy needs to be revised. Surgeons do not want Anesthesia involved in straight locals after hours, anesthesia agrees. Staff concerned about lack of support personnel if case goes bad. Does anyone have a policy they can share regarding how many staff members needed for local cases? Is Anesthesia involved in any local cases after hours, weekends? If you an attach policy in e-mail, please do so. If I need to supply a fax number, I can do that also.Thanks in advance for your assistance.
porsch65 37 Posts Jun 2, 2005 In our facility, locals are not done after hours or on weekends when we are on-call. The rational behind this is that we are "on-call" during those times for emergencies only. Anaesthesia is our gate-keeper so to speak during these times, as he/she is the one that surgeons must book their cases with. It would not bode well with our administration to have to call in another team should a genuine emergency come through the door. Doing "local" cases using "on-call" staff after hours and weekends is considered a mis-use of the call team and is not permitted.Hope this is helpful.Porsch 65
ShirleyM 101 Posts Jun 2, 2005 The only procedure we do strict local on are iliac crest biopsies, which are elective, thus only done mon-fri. During that case an RN monitors the patient's BP, HR and o2 sat levels plus gives support to the patient. A second RN circulates plus an RN or tech to scrub in. I don't know if AORN has a guideline re: local anesthesia, but it might be worth checking out.
sharann, BSN, RN 1,758 Posts Jun 2, 2005 The only procedure we do strict local on are iliac crest biopsies, which are elective, thus only done mon-fri. During that case an RN monitors the patient's BP, HR and o2 sat levels plus gives support to the patient. A second RN circulates plus an RN or tech to scrub in. I don't know if AORN has a guideline re: local anesthesia, but it might be worth checking out.This is the way our OR does locals as well.
Julie5173 3 Posts Jun 12, 2005 At my hospital we have no policy for this. We have 1 RN to circulate the room and monitor the patient, and 1 person to scrub. Local cases are something we all dread to have assigned to us for that reason. I usually leave my charting go till after the case and spend my time with the patient. We have been trying to get a policy that requires 2 RN's in the room but as of now, and I've been in these OR's for 3 years, we still have no policy. But one thing we do have is no local cases will be done after hours or on the weekend.
mcmike55 369 Posts Specializes in surgical, emergency. Has 40 years experience. Jun 12, 2005 Our local anes. policy sounds a lot like the one's you all have in place.Our policy states that there be a RN monitoring the pt, and that's all. That means a RN circulator and scrub tech too in the room.In real life, most of the times, our locals are rare, small "ditzel" things, and the "circulator" is really our float RN who is just outside the door, pulling cases or whatever, but is within earshot.We have not done a local after hours or on weekends in years. Cases after hours or on weekends are "emergency", and by definition are not locals, maybe a local/mac, but not straight local. Our docs are pretty good about not putting us on the spot trying to squeeze one through, we fight back if we don't like the idea!!! And our boss support us on these.One doc tried years ago on me, when anes. canceled the case, he tried to do it anyway under local. We (I) fought back saying that it didn't make sense to take a doc away from the top of the table, putting an RN there, because the pt was "too sick". Eventually did the case, cause it had to be done, but we did it local/mac with anes. there. Mike
