DKSH

A trick I was taught is to leave the LMA inflated and attach the syringe for air inflation to the cuff without the syringe plunger. As you insert the LMA the appropriate amount of air for easy insertion will be expelled through the syringe. So far this has worked like a charm.

Thanks everyone for your feedback. Most CRNA's we've contacted have never heard of this situation occuring. We've spoken with the AANA, our state association and our hospital risk management dept. Risk management and the AANA inform us that it is within our scope of practice to assist as a PACU RN, however we can't act in two roles at the same time. So if we're working in PACU and an emergency arises we have to prioritize and determine where we need to be. The first two nights this policy went into effect, the CRNA on call was helping recover a patient in the PACU and three different emergencies requiring their assistance arose. Fortunately there were no disastrous outcomes. After reviewing this situation the Administration has decided to put the practice of CRNA as PACU RN on hold until further notice! Two of our CRNAs have resigned. Rather than saving overtime pay for a 2nd PACU RN, the hospital is now going to pay a lot more for locum tenens CRNA.

In the ongoing quest to save hospital money, our hospital administration has instituted a new practice. Has anyone else had this experience? As a bit of background: We have one, 24 hour, in-house call CRNA every day. The PACU has two RNs on beeper call every night (11PM - 7 AM) and 24 hours on weekends. Both PACU RNs are called in to recover a patient during these hours. Hospital administration has mandated that rather than call in and pay overtime for the 2nd PACU RN, the 24 hour, in-house call CRNA will stay with their patient post-op to assist 1 PACU RN in recovering the patient. The rationale is, why pay a 2nd PACU RN overtime when the CRNA is already here and is getting paid to go upstairs and sleep at the end of the case? The majority of the CRNAs are unhappy at the prospect of working all day and into the night and then being expected to recover the patient as well, not to mention the possibility of other cases occuring during the rest of the night. Is this becoming a common expectation?

I interviewed at Montgomery Hospital in 1988 and am a 1990 graduate. I'm sure many things are much different now, however I received an excellent education, have been able to work competently and comfortably in many different settings and highly recommend this school. Best of Luck!