Just want to vent a little. Today, we were more short staffed than usual(4 people left early-they were on call and worked until 5:30am) so my supervisor asked if I felt comfortable enough to take a room on my own. I told her yes, as the cases in that room were somewhat familiar to me and not complicated(a hydrocelectomy, a D&C and 3 podiatry cases). Everything went smoothly until it came time to do the first foot case. Anesthesia was short as well, since they had to send staff up to do C-sections. I assessed the patient, the doc did his thing and we were pretty much ready to go. Except...no anesthesia person to do the case. The podiatry doc starts getting antsy and wants to bring the patient to the room anyway. Keep in mind, we had no ETA for the anesthesia person and have been specifically told NOT to bring the patient to the room without anesthesia being ready. Next thing I know, one of the anesthesia docs comes flying into the holding area hollering that he is my anesthesia person(when I last checked 2 minutes earlier, we still had nobody) and I "don't need to know if anesthesia is ready" to bring a patient to the room. He was very rude and boy, I got so mad, people said I turned purple! I then told him that we most certainly do need anesthesia to be on board before proceeding, and that the manager backed me up on this. He storms off to confront her and bless her heart, she actually stood by me. Granted, podiatry patients are usually healthy, stable people, but if something had happened to that patient, and I had taken that patient to the room without anesthesia, I think I'd be in big trouble, not to mention the poor patient. It turned out it was a lack of communication on their part, but as a new grad, they've gotten pretty snippy towards me. I look at it this way-I do not answer to anesthesia for my orientation process and I WILL NOT be rushed when it comes to providing proper care for my patient. That's when mistakes happen and these same people would throw me to the wolves if they thought it would save their fanny. I guess it was kind of an epiphany though-I always wondered if I'd be assertive enough to stand up to a doc when I knew I was doing the right thing..Guess I'm OK on that front!!
Just imagine how Mr Anesthesia looks with his knickers in a knot.....literally. You did the correct thing. He did not. You protected your patient, your license and your integrity.
Good On You!!
Hospital policy is one thing, but simply taking a patient to the OR without an anesthesia provider has absolutely nothing to do with protecting the patient or your license.
hospital policy is one thing, but simply taking a patient to the or without an anesthesia provider has absolutely nothing to do with protecting the patient or your license.
i would disagree. hospital policy is a part of your scope of practice. if you violate hospital policy, then you are operating outside of your scope of practice. if you are outside your scope of practice, you put the patient at risk and your license on the line.
Interesting. At my hospital, its different. Anesthesia always brings the pt down to the room. The circulator does not. We have a problem with them coming down too early, before we have counted, set up, etc.
The circulator goes down to holding to meet the pt and interview, then goes back to the room to wait for pt and anesthesia to come barrelling throught the doors!!!!!
ewattsjt
448 Posts
Yeah, sometimes it's bad!