Time Out

That is scary that your managers aren't letting the surgeons know that the "time out" issue is not negotiable. At my hospital, a time out is always done and for the odd surgeon that thinks he/she is going to out shout me..not gonna happen. We also will absolutely never, never, never take a patient to the room if it's a case where laterality is an issue and the proper body part or side hasn't been marked by the doctor. Yes, they whined like crazy at first but in the past we have had the wrong leg be operated on and at another hospital in the state, they did a crani on the wrong side of the head. Recently, at yet another hospital around here, a doctor took out the ovaries of the wrong patient. Interesting that the nurse in the room did mention that she thought it was the wrong patient, the surgeon went to the charge nurse, who then backed the doctor. OOPS!!! Unfortunately, sometimes it takes a tragedy for management to sit up and take notice.

When i'm scrubbed, the surgeon doesn't get the knife untill we time out.

We actually don't have a problem with the surgeons and timing out, really. Most will even say "may we have a reading of the consent please?"

We did have one new surgeon who whined about the consent ("aw they did this **** at the other hospital, i gotta do it here too? I just read it on the chart for God's sake.). My mentor happened to be circulating that day and told him "In the time it took for you to whine, i could have had that sheet read and over with." He never whined again.

Our surgeons are getting better and better about it. They almost always initiate the time-out now.

We had 2 wrong side surgeries at our hospital before the time-out process was begun, so most of us take this very seriously. The surgeons are cooperative, if not all enthusiastic. Some of them will read the consent aloud themselves, sometimes the anesthesiologist will read it, but it always gets done. If they won't quiet down and pay attention, I stand right beside the mayo before plugging in the bovie/suction and say loud and clear, "Time out, folks". It always gets their attention and the scrub will not pass the knife till the consent has been read in a QUIET room.

If your department has a medical director, ask your nursing director to have him/her send a memo to staff docs reminding them that this is taken seriously and is nonnegotiable. Good luck. Linda