New procedures without training: Irresponsible or unavoidable?

[Rose_Queen, BSN, MSN, RN]

My facility has been planning to start a new procedure that involves new equipment. We were supposed to be trained on it a week and a half ago by the company rep, but he had to cancel because his flight was delayed too long. We had one of these cases scheduled today, and not a single person in the room was happy that we were doing this case without adequate training. However, the surgeon insisted, and as the surgeon is the moneymaker, the surgeon won. Fortunately, the patient got through the surgery just fine, but were we unreasonable to expect training before starting a brand new complicated procedure with new equipment? This was not an emergency situation, although the expectation is that this procedure will almost exclusively be done as an emergency situation.

[WhoDatWhoDare, BSN, RN]

This sounds like a sticky/uncomfortable situation. Did the operator's manual come with the equipment or had the surgeon been trained or used it previously? Does your facility use a service such as OneSource Docs?

This is after the fact since the case is done, but in preparation of another emergency, perhaps someone can go over the manual so they can get more familiarized and then show others until the Vendor/Rep can do the in service.

Don

[Rose_Queen, BSN, MSN, RN]

Don't know about the surgeon being trained or using it previously- all of the surgeons were supposed to attend the training with the staff. No operating manual, but we did find a semi-helpful video on the manufacturer's website. Never heard of OneSource docs, so wouldn't know if we have something similar, but I doubt it.

Actually have another scheduled for tomorrow- certain people (who the case can't be done without and who aren't employees of the facility but contract) are refusing to do this case without the rep present at a minimum, so we'll see what happens.

[MeiLana]

What was the outcome?

[mhy12784]

I think the biggest thing is how complicated the procedure and or equipment is, and the potential risk/severity for injury

I mean working in the OR, you could expect to get pushed outside of your comfort zone. And you'll always have to deal with with stupid things you've never been trained adequately with.

But I think there's a huge difference between using something like a stapler or special single port grasper that comes apart. And getting thrown into something with advanced complicated equipment that requires significant training and or risk for injury

[schnookimz]

Why wasn't the rep present for the scheduled case??

What was the equipment? What type of case? Was there backup equipment to use instead?

[Rose_Queen, BSN, MSN, RN]

I think the biggest thing is how complicated the procedure and or equipment is, and the potential risk/severity for injury

I mean working in the OR, you could expect to get pushed outside of your comfort zone. And you'll always have to deal with with stupid things you've never been trained adequately with.

But I think there's a huge difference between using something like a stapler or special single port grasper that comes apart. And getting thrown into something with advanced complicated equipment that requires significant training and or risk for injury

Very complicated procedure with not only new equipment and new devices, but no explanation of all the additional supplies we would need. We spent quite a bit of time running around to other departments to gather all of the necessary supplies that we don't normally use.

Believe me, me, this was far beyond going outside of our comfort zone; it was borderline dangerous to the patient. I don't want to go into much detail about what the procedure was and what all didn't go smoothly because it would really identify me, but it wasn't just bringing in a new brand of device or equipment. When we've started other new procedures in a similar manner, certain team members and the surgeons actually went to training facilities and did these procedures on cows- that's how serious this new procedure is. And it's also potentially got fatal consequences as the patients undergoing it are literally at death's door.

[caliotter3]

Sounds like someone (the doc) is putting the facility and other employees, not to mention the patients, in harm's way. Liability, liability, liability.

[TheGooch]

What was the outcome?

The patient was fine-it was in the OP post.

[MeiLana]

I was actually asking about the 12/10 surgery for "next day" that Rose Queen mentioned, "Actually have another scheduled for tomorrow- certain people (who the case can't be done without and who aren't employees of the facility but contract) are refusing to do this case without the rep present at a minimum, so we'll see what happens."

[dianah, ASN]

Just because things turned out well doesn't mean the risk and potential for injury and things to go wrong was mitigated.

I would be interested what your Risk Management people's opinion on this is. Any way of contacting them with your concerns?

[Rose_Queen, BSN, MSN, RN]

I was actually asking about the 12/10 surgery for "next day" that Rose Queen mentioned, "Actually have another scheduled for tomorrow- certain people (who the case can't be done without and who aren't employees of the facility but contract) are refusing to do this case without the rep present at a minimum, so we'll see what happens."

It did go okay, although the rep showed up late so we were late to get started. Even though we had written a list of what we needed from the first case, we still had to go hunting for some supplies since they aren't yet in the computer system and can't be added to the preference cards so that we would have everything already available in the room (case supplies are picked by night shift). Still not comfortable with the procedure; neither are the other people who were in on both cases with me. And as for the rest of the team who will be doing these cases, they have still received zero training, not even a quickie walk through by the rep.