No one dies in OR

2006RNCS · May 24, 2008

I am not yet an RN (hopefully in a month or two). I work in the ICU as a tech, and have for close to a year. It seems that the OR doesn't let anyone die. When someone is headed south the quickly send them to the ICU so we can code them and deal with the aftermath.
I really hate this. Maybe because it is a teaching hospital and residents to quite a few procedures and don't want to take the blame? I know patients sign consents about all the possible risks and such, but I feel that I have seen way too much of botched procedures.
Am I just jaded because of the area I work in and don't see the "good surgical procedures"? I was petrified when my dad told me of his colonoscopy (which did go fine thankfully) because of my experience with several patients that was perferated and went septic in the same procedure.
In some ways I feel like I have lost a bit of faith in surgery/other procedures.
Am I alone in this feeling?

Hi! You are absolutely right. I worked for a while in ICU, and one night we had this formerly healthy, robust 65 yr old male come to us from OR. They claimed he was fine, and that in the elevator on the way to our unit for recovery that he coded. I do not believe it at all. This man went for a lap. cholecystectomy, and coded. Well, he suffered irreversible brain damage, and lived for 7 weeks. He was so bad off that they tried several times to wean him off the vent to perform a tracheotomy, and the gentleman coded every time. He coded a total of 4 times in 7 weeks, but he was a full code.

His daughters had just recently lost their mother to cancer, and they couldn't let go of their dad. He had zero brain activity. He did have some reflex movements. He had to be kept one a Propofol drip for the 7 wks. that he lived. He had no health problems whatsoever prior to this, and this is what kept him alive for so long, is what his doctors said. It was amazing to us all to see someone go that long on a ventilator with no trach. He was a remarkable man. There was a will to live in that man somewhere. I will never forget him or his family.:heartbeat

Squaw · May 24, 2008

I have seen hundreds of successful procedures and lives improved by us in the OR. :yeah: The few that we have taken to ICU knowing that they were going to die, came from ICU knowing that surgery only improved their chance of survival by a small percent, and yes, we rushed them back to the UNIT to die with their family. As for a Lap Chole going bad....that is a whole other story that you may want to find out what was really wrong with the procedure/surgeon. :nono:

CaseManager1947 · May 24, 2008

Perhaps I can shed a little light here... used to be an OR nurse in another life, a loooong time ago; All areas of service, whether it be OR, ICU, amb surgery whatever, where high risk problem prone issues are addressed have statistics kept on the #'s of deaths that occur in those areas. JACHO looks at those stats. Also, the morbidity/mortality stats are reviewed by Hospital admins. Just to let u know... doesn't make it any better, righter, or more humane.. just a little info for ya.

DoulaJane · May 24, 2008

Nobody dies in the OR because DNR orders are suspended in surgery. Because the patient is under anesthesia (risky) doctors and staff must do all they can to keep the patient alive, as the emergency may be due to the anesthesia. Make sense?

Cindy-san · May 24, 2008

OR deaths are a reportable statistic and no one wants their numbers up. So ICU's get dumped on.

I hate it too. They're major disasters. If the OR can't fix the problem, we really can't much more that'll help. All we can really do is let the family say goodbye. :cry:

allnurses Guide · May 24, 2008

Nobody dies in the OR because DNR orders are suspended in surgery. Because the patient is under anesthesia (risky) doctors and staff must do all they can to keep the patient alive, as the emergency may be due to the anesthesia. Make sense?

Nope...doesn't make a lot of sense, because the majority of times it is the surgery/patients response to surgery that is ultimate cause of the "emergency" not anesthesia.

Anesthesia has one of the highest safety records of all specialities.

Just a thought from one of my instructors: "Anesthesia providers keep you alive while surgeons do things that would normally kill you".

As the other posters have already said it all has to do with JC and statistics.

Altra, BSN, RN · May 24, 2008

You're correct in your observation that *almost* no one dies in the OR.

However, a death or other poor outcome does not necessarily equate to a botched procedure.

widi96 · May 24, 2008

My one experience with this (I worked in an ER at the time) was a patient that was traumatically injured - they took her to the OR and when they realized that there was nothing more they could do, they sent her to the ICU so she could die surrounded by her family instead of a room of strangers in gowns and garb. They were doing what was best for their patient and the patient's family.

TX_ICU_RN · May 24, 2008

I work in the ICU and this frustrates me as well. However, OR deaths are a HUGE issue as far as reporting and I am 99.9% sure that an autopsy is required of anyone who dies in the OR. An autopsy will be done if the patient needs it, but there are many patients who don't need an autopsy that would needlessly be subjected to it (well, there families would). I have prepped patients for the OR knowing they would die for sure without the surgery and that the surgery was a last ditch effort. It sucks for the ICU...but I really believe it is best in the end.

SandraCVRN · May 24, 2008

i don't know where that old saying comes from. i've been in the or for 2 1/2 years now and have had 3 deaths. of course doing hearts, emergency aaa's and chest trauma might have something to do with that.

i have seen way too much of botched procedures.

just because someone dies does not equal "botched" i'd be very careful with how you word things.

BluntForceTrauma · May 25, 2008

It's all about JCAHO and statistics as the previous poster mentioned....not being surrounded by family when dying in the ICU like they want us to believe.