Scheduling

Who makes out the schedule of what cases you do in the OR for a given day? When is it done, when do you know what you're doing?

We have a huge department, and some patients are scheduled weeks to months in advance. Patients are sometimes seen in the PACE clinic up to a month before their scheduled surgery. With nearly a hundred ORs, its a big job, so we have several department coordinators who make out the schedule of which anesthesia provider goes to which case. The coordinators post it the day before, usually around lunchtime, so you know the day before which cases you will be doing the following day.

i believe it tends to depend what school you go to as well as to what clinical site you have.

i generally don't know what my first day of the wk will be like - they don't post schedules on the computer or by phone so i am in the dark...and generally the schedule isn't done until 3-4 pm...so that is when i know what i am due for the next day.... others in my program are told ahead of time - it is just site dependent.

Site dependent.

At my previous clinical site, you showed up in the morning and got your room assignment. They are a site my program signed up about a year or two ago.

At my current site, you get your room assignment off a phone in recorder and you prepare for your cases the night before. The recorder gets updated at about 1400hrs the day before. Apparently this is the main clinical site, where the program is housed, things are build in for students here.

SRNAs:When do you do your pre-op assessment?

If you get your assignments by phone/computer, what are the expectations for pre-op rounds? If the patient is in house, are you expected to go in the night before to do the assessment?

If you don't see the patient until they get to anesthesia holding, do you do the assessment then? (Of course, experienced clinicians do it this way all the time. But I would think students would need a little more time, at least until they gain some experience.)

If the patient was assessed by someone else during a pre-admission work up, are you still expected to do your own assessment, for learning purposes?

Just interested. Health care systems have changed since I was a student, so I would not be surprised if things are done differently now than back in my day.

loisane crna

Loisane,

the first day of clinical each wk - i have no idea what cases i am doing - but i get there early enough that if it is something new i can look it up and prepare - and although the MDA's do the pre-op assessment - i do one as well - if they haven't done it yet - we fill it out for them when we do it....

as for the next day i am at clinical - yes - we are usually aware of our cases and prepare - we are in our second year and still having to do care plans....

although there are pro's and con's to not knowing your cases - in the second year - i appreciate not knowing - it makes me more prepared for how life will be out of school -

SRNAs:When do you do your pre-op assessment?

If you get your assignments by phone/computer, what are the expectations for pre-op rounds? If the patient is in house, are you expected to go in the night before to do the assessment?

If you don't see the patient until they get to anesthesia holding, do you do the assessment then? (Of course, experienced clinicians do it this way all the time. But I would think students would need a little more time, at least until they gain some experience.)

If the patient was assessed by someone else during a pre-admission work up, are you still expected to do your own assessment, for learning purposes?

Just interested. Health care systems have changed since I was a student, so I would not be surprised if things are done differently now than back in my day.

loisane crna

If the patient is in house, we go in to do the pre-op. However, if it is a day when you aren't there normally (such as a Sunday) then you let the on-call SRNA know, and s/he goes and preops your patient. We are always responsible for our own preops that are in house - otherwise, for planned surgery, the patients are seen through our PACE clinic.

So sounds like SRNAs are still doing preop rounds.

Since fewer patients are inhouse, I was concerned this had adversely impacted student opportunities to gain these skills. Glad to hear we are working around this change in the system.

Preparing for the case itself is an important part of planning. But you aren't compleletly prepared until you have individualized your plan for that specific patient.

loisane crna