Anesthesia leaves room, normal??

Editorial Team / Admin · May 7, 2009

Wow- that is wrong on so many levels. Last time I checked, OR nurses did not have the training to troubleshoot anesthesia machines, give drugs without orders, so forth. What happens if a patient codes while the provider is out of the room? Big liability for the hospital- perhaps a call to risk management or the legal department?

As for not having fluids in the room- how far away are they stored? We keep about 5 bags each of NS and LR in the room. We also have anesthesia techs who are responsible for stocking anesthesia supplies and drawing labs.

Either way, I'd be looking for a new job- this is putting not only your patient at risk, but also your license.

jwk · May 7, 2009

Either way, I'd be looking for a new job- this is putting not only your patient at risk, but also your license.

First, your license is not at risk because the anesthesia provider deserts their patient.

That being said - your anesthesia provider, whether CRNA, AA, or MD, should be fired. This is simply unacceptable. If the chairman of the department or chief anesthetist won't deal with the problem, take it to your hospital's risk management department. And I can't believe the surgeon is OK with this behavior.

IVyPush-her · May 7, 2009

Thanks for the input. I knew these were the comments that I would be getting. I know what is wrong and what is right. I originally started at this hospital fresh out of nursing school. So at the time I thought that it was pretty normal. I left to go to a big teaching hospital after about 5 months into my training. I returned 3 years later with a wealth of knowledge, it was a great experience that included 2 trips to Guatemala.

So, returning to this hospital as a nurse with more experience my eyes are wide open now. Umm, the head of anesthesia leaves the room too! The surgeon has never really said anything about them leaving. One vasacular surgeon got ticked that I left the room to get something that wasnt on the card. But he doesnt say anything about the CRNA's leaving. I think I will talk to my manager first before I talk to risk management. It is a small hospital, word travels fast.

I am also committed to this place for a few more months, or I pay back the sign on bonus. However, I believe I only pay back a portion of it since my 1 year is almost up. If you stay 6 months you only pay back this much, if you stay 9 months you pay back this much. So it might not be to expensive to leave early. My sign on was $4000.

I am so torn because I want to do what is best. I want people to not worry when they come to our facility to have surgery. I feel like I am lying to them when I bring them back to the OR.

shodobe · May 8, 2009

Sorry, I haven't worked at a location that anesthesia didn't leave the room for something. I guess if they have to pee they have to hold it until the 4 hour lami is through? What if there is no one to relieve them. I guess I have no problem if they leave for a few minutes and the other 30-40 RNs I work with have no problem with it either. Our anesthesiologist always tell us when they are leaving and only are gone for a few. Fire them? I don't think so. If I need them I can find them in seconds, so being alone with an anesthesized patient doesn't bother me. This doesn't jeopardize your license, so don't worry about it. I guess to put it another way, this is a non-issue. Now, if you have no confidence in your anesthesia provider, then that is another problem. Good luck with that.

jwk · May 8, 2009

Sorry, I haven't worked at a location that anesthesia didn't leave the room for something. I guess if they have to pee they have to hold it until the 4 hour lami is through? What if there is no one to relieve them. I guess I have no problem if they leave for a few minutes and the other 30-40 RNs I work with have no problem with it either. Our anesthesiologist always tell us when they are leaving and only are gone for a few. Fire them? I don't think so. If I need them I can find them in seconds, so being alone with an anesthesized patient doesn't bother me. This doesn't jeopardize your license, so don't worry about it. I guess to put it another way, this is a non-issue. Now, if you have no confidence in your anesthesia provider, then that is another problem. Good luck with that.

No offense, but this is NOT acceptable practice. It doesn't matter if you've always done it that way, or that no one seems to complain, or that they're only "gone for a few, or how many places you've worked that do this. IT DOESN'T MATTER. If something happened to the patient while they were out of the room, they have absolutely no leg to stand on when a lawsuit is filed. ANY attorney would bury an anesthesia provider that did this because there simply would be no defense.

shodobe · May 9, 2009

No offense, but this is NOT acceptable practice. It doesn't matter if you've always done it that way, or that no one seems to complain, or that they're only "gone for a few, or how many places you've worked that do this. IT DOESN'T MATTER. If something happened to the patient while they were out of the room, they have absolutely no leg to stand on when a lawsuit is filed. ANY attorney would bury an anesthesia provider that did this because there simply would be no defense.

Chill out. Every place has their way of doing stuff and I don't care if you percieve this isn't exceptable or not. It seems strange that I can go to different places and this takes place and ALL of the nurses, with collective years of experience, don't find it a problem, but you do. 32 years, and counting, and there has never been an issue with this. So you will find that this isn't a big deal in most places, except your's of course. By the way, how long have you been in the OR?

Editorial Team / Admin · May 9, 2009

Do you want to be the patient on the table who codes while anesthesia is MIA?

Aneroo, LPN · May 10, 2009

Chill out. Every place has their way of doing stuff and I don't care if you percieve this isn't exceptable or not. It seems strange that I can go to different places and this takes place and ALL of the nurses, with collective years of experience, don't find it a problem, but you do. 32 years, and counting, and there has never been an issue with this. So you will find that this isn't a big deal in most places, except your's of course. By the way, how long have you been in the OR?

I have yet to work in the OR (will be), but I wouldn't be comfortable with this practice. So from the outsider POV, not cool (meaning a jury, lawyer, judge, and the JC might would think the same way).

Heogog53 · May 10, 2009

I've been in five different OR's since 1984. Two were academic, one was military, and two were community hospitals. I never saw anesthesia people leave the patients alone at any time at any of the hospitals.

My recommendation is to discuss it with your boss and definitely risk management. You need to make up a bunch of anecdotal notes with dates, procedure, surgeon, pt's med record number or name, how long anesthesia folks were gone each time. If you decide to stay, you want what's best for your patients. If you leave, you want to know that YOU did the best you could for them as a patient advocate.

I'd be extremely uncomfortable watching any patient left alone after being anesthetized for even a second. An old friend of mine once defined anesthesia as, "Hours of boredom punctuated by seconds of absolute terror" which was a joke, but certainly underscores the importance of minute to minute attendance.

I'm very sorry that you found yourself in such a place. What do the other nurses say? Or have they ever worked anywhere else? It seems odd to me that no one has ever made a fuss about this before.

$fracturenurse$ · May 11, 2009

Well, where I am currently employed our anesthesia team is pretty good. They sometimes will run and grab a warm Isolyte, (our warmers are right near the rooms). Usually they ask us to run and get it. We have a lot of CRNA's and they usually ask us to find the float MD if they have to pee. I have never had them take off where I couldn't find them though. One hospital I worked at, they would stand outside the door between OR's and talk to each other. Drove me crazy, but I could always manage to steer them back in the room.

I once worked at a surgery center and they were awful. One doc would always take off and go chat with someone and I couldn't find him. Once he even asked me to push a little propofol (it was a MAC), while he was gone. I was like, "No way!!! (Talk about endangering your license). We had to get a handle on that quick, but that was really the only problem I've ever encountered.

Seriously, if your anesthesia provider is taking off for long periods of time and you have no idea where they are, talk to your director and tell her you are uncomfortable with it. Maybe they have just been getting a little carried away. Try talking directly to the anesthesia provider if you feel comfortable, or the head of the group. Good luck, it's a touchy situation.

lindaloo51 · May 12, 2009

WHAT ARE YOU PEOPLE THINKING????? You don't think that if your patient goes down the tube while your anesthesia provider is MIA and you have done nothing about it that a lawyer isn't going to rip you to shreds?? In 40 years I have had 1 provider that did this. He lasted about 2 weeks because each circulator notified management each time it happened and wrote him up. It only takes seconds for a patient to go bad. I had a patient throw a PE during ortho surgery recently. In a matter of minutes he was gone inspite of all that we tried to do. If my CRNA had not been there, where would I be now?? I'm quite sure that I would be preparing for a huge law suit.

This is not the normal standard of care!!!!!

Run, don't walk to risk management. DO NOT PUT YOUR PATIENT AT RISK!!!!! You are your patient's advocate. Put yourself, helpless on the table and tell me that it is all right to be ABANDONED by your anesthesia provider.