Surgeons "go ahead" problem ?

[OR male nurse]

So... here's the rub.

You have an 8 am scheduled case. The patient is brought to the surgery holding area. The OR case is opened and counted. The anesthesiologist is ready. However, you haven't heard from the surgeon. No one has seen him/her, he/she hasn't called to let you know you can "go ahead" with the surgery.

How does your hospital handle this situation ? Do you automatically bring the patient back to the OR 15 minutes prior to the scheduled starting time and hope that the surgeon shows up? Do you wait in the holding area until you actually see or get the phone call from the surgeon that you can "go ahead" with the surgery.

Is it OK at your hospital for the surgeon to call you up from his cell phone and tell you that he/she is 10 minutes away at mile marker XYZ on the interstate and they will be there and you can go ahead? Or, does your hospital require that the surgeon actually be "on campus?"

I'm interested in knowing how you handle this situation and what the policy is at your hospital.

Thanks in advance

OR male nurse

[Jarnaes]

I'm also an OR nurse- our policy is that we do not bring any patients to the OR until we know the surgeon is in the hospital. I don't care that he/she is 10 min away on the highway.. anything could happen. I'd hate to have a pt intubated on the table just to find out that the surgeon was in a wreck and the case cancelled. Do you want to explain that one? You have no defense and of course it will all be blamed on the nurse who brought the pt to the OR.

[OR male nurse]

I would like to add that while at our hospital we are accustomed to having the patient in the room 15 minutes prior to "cut time." We don't actually put the patient to sleep until we have a "go ahead" from the surgeon. Just wondering if at your hospital it is acceptable to bring the patient back to the OR 15 minutes prior to "cut time" without the "go ahead."

OR male nurse

[tessa_RN]

Our policy says that we cant bring the patient to the room unless the surgeon is in the hospital..The front desk at my hospital is nice enough to give us a ring when they see the doc..When they see him I will usually bring the patient to the room

[staceyp413]

I've worked in 3 different hospital OR's. In all 3 we waited to go back until the surgeon was in the building. They could not be "on there way or close" to the facility. In each facility we had the problem of surgeon's being late ALL THE TIME. You had your few that were always on time but they were the minority. Then, those who could never be to the OR 15 minutes before the start time were the first ones complaining about the turn over time:nono:

I tell all my staff the same story when asking about surgeon's being in-house!! I once worked in a hospital where the surgeon took advantage of a "newer" RN. She paged the MD to see if he was at the hospital (he never called in and it was already time to go back) and he said, "I'm ready, go on back and page me when the patient is asleep." Well, he was hit by a van while riding his bike into work (injured his hand/wrist) and couldn't operate. By then, the patient was already asleep and had to be woken up and the situation explained to them. The surgeon's excuse was that no one specifically asked if he was in the hospital nor did he say he was or was not.

Rest assured ALL of us learned something from that one and we NEVER went back without hearing that the MD was in the building directly from his or her mouth!

[CuttingEdgeRN]

We don't take our patients back until the surgeon has spoken to the patient in the holding area and signed the permit.

[Loni]

Most hospitals I have worked in, we do go ahead and bring the pt. to the room, but do not go to sleep until the Dr. arrives to the O.R.

[CaseManager1947]

Again, this is from on Old Or circ/scrub/rouster--- check with your policies include risk management and your sup. staff in such a discussion. In our OR's. patient must be identified by the surgeon. that can happen in pre-op, whatever everybody is calling it these days, or it can happen in OR proper. Patients are not to be anesthetized until surgeon is on premises. Seek JHACO's web site they may have the appropriate standard #

that'sjust what we do here in Middle America. ;-)

[elcue]

Our surgeons must mark the patient's site before we can go back to the OR. If laterality is not an issue, I still won't go back till someone has seen the surgeon in the department.

Personally, I can't believe a patient would consent to going back without seeing the surgeon first!

[Lara911]

Where I work, (well I must be leaving after last week but this is another storie)...we were used to bring the patient in the room when every body is ready, surgeon and anesthetist...Two weeks ago, we receive a complaint of the medical comitee, cases are often delayed and it would be, of course the nurse's fault...we now had a new order to bring the patient in as soon we are ready, last friday, a patient wait 1 hour on the table because the anesthetist was not there!!!

[elcue]

Isn't it routine there for the anesthetist to interview and assess the patient and review the chart prior to providing care?

[Lara911]

Yes, it is...

After, something will happen in the room and guess who's fault it will be??

Anyway, I made my decision, I'm leaving. I have a new job starting on tuesday, still in the OR but another hospital, let see if it is better...