for those of you who work offshifts...

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so normally I work days, but as of late I have been scheduled afternoons and midnights on the weekends cause there is no one else to do it. Well, anyway this past Saturday I clocked in at 10:45p.m. to find that there was a case going on. Fine...my issue is as I was circulating my case I got a phone call from a doc wanting to board an emergency ectopic. Fine again. The problem lies in the fact that I am trying to circulate a neuro case BUT I have to leave the room to go to the front desk to board the case (all computerized, it's not like I just write it on paper) this takes me 10 minutes alone cause I am slow at it. needless to say, I have to call in "on call people" wait for them to call back. put in transportation for patient which wasn't working, trying to coordinate anesthesia cause there is no one to do case, etc...all this went on for 45 minutes, while I was supposed to be in on a surgery.

How do you people handle off shifts with/without clerks to do all the odds and ends. I feel my license is on the line. What if my case was all crazy. who would have done it?

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Specializes in OR, Nursing Professional Development.

Our team who works night shift don't actually do the cases. We have two teams on evening shift plus the charge. On nights, unless it's life or death, the call team comes in to do the case, leaving the night shift team free for traumas. If it is a true life/death emergency, they will start it but the call team will take over when they arrive. We're a level 2 trauma center, and we are required to keep a team free 24/7/365 for when those traumas come flying up to the OR. I'm guessing you aren't a trauma center?

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Specializes in Trauma Surgery, Nursing Management.

I think that the charge nurse should have called in the call team when it was clear the neuro case was going to be extended. You should not have to go out of the room, and you are right, it is totally unsafe for you to have to do that. Do you not have a charge nurse on nights? When you say "board a case", do you mean that you had to post it? Again, that is the charge nurse's responsibility. When I am charge nurse, it takes me AT LEAST 20 minutes of uninterrupted time (and we all know that interruptions are the nature of the beast) to post a case, call Central Sterile, gather the team, alert anesthesia and call various places to get the patient ready and transferred to the holding area. This is not something that you should be held accountable for if you are circulating in a case already. Even the most stable cases can run into problems of all kinds, and you have to be there to coordinate things. Afterall, it is YOUR name on the chart.

Talk to your manager about it. Maybe this would be an opportunity to do some restructuring.

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Specializes in NICU, ER, OR.

well, where i work has someone at the desk 24/7, and there is always more than one team on... so this wouldnt happen... yes it is unsafe...but I work at a level 1, do you? that cant be going on, it has to be adressed.... either they staff accordingly, or dont be able to book the cases...

so you were the only team there?

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Specializes in NICU, ER, OR.
Our team who works night shift don't actually do the cases. We have two teams on evening shift plus the charge. On nights, unless it's life or death, the call team comes in to do the case, leaving the night shift team free for traumas. If it is a true life/death emergency, they will start it but the call team will take over when they arrive. We're a level 2 trauma center, and we are required to keep a team free 24/7/365 for when those traumas come flying up to the OR. I'm guessing you aren't a trauma center?

wow thats interesting. at our place it the opposite.... at nights 2 teams, two RNs two techs. one of the nurse is charge. they do everything that comes up, only calling the call team if there are rooms running and a trauma comes in...but again its a level 1.... but the way your place does it makes more sense to me....

plus between all this, we have to get all 28 rooms "ready" to a certain degree for the following days first case.....

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starting from Saturday morning through Monday 7 a.m. there is only 1 nurse and 1 tech on so she is the charge nurse. We are not a trauma o.r., but it is constant. There is no down time. There are times I walk in at 7a.m. saturday and there are 8 BOARDED cases and just me. So guess what...I don't eat. awful. just awful. so any "emergencies" that come in and believe me they do get the call team. I have been bringing this up for the past 5 years that it is unsafe and scary, but they pretty much tell me that is the way it is.

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Specializes in Peri-Op.

Plain and simple, nothing will happen unless surgeons complain. What I did is get a cell phone for the main or line to be forwarded to I keep a call team list with me as do other nurses. I had computers put in every room. Never Have to leave the room.

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Specializes in OR.

If I'm on call on the off shifts (11p-7a Mon-Fri, or after 3pm on Sat/Sun), our facility policy is to contact the nursing supervisor to coordinate things. I'll take the pt info/type of surgery, and call CSP for a case cart to be picked. But as for getting another team/anesthesia/etc, the nursing supervisor handles it. She may call me with a hundred questions as very few of the superviosr are very knowledgeable about OR, but its usually things I can manage from the case I'm doing. The crazy calls about what time a pt is scheduled for OR or docs/assts wanting to know when they start the next day--I tell these callers I'm in an emergency and can't get that info. If I can, I will call them back later, otherwise they know they can call at 6:30am when the day charge RN arrives. As for working weekends, we always have a manager on call who will come in if we ask them too to help with any issues or to free the charge nurse up so that everyone working (2 teams) can get a meal break. If its too much to get it all done, know your resources and ask for help. I've even enlisted the help of PACU (if they are available) to make the phone calls or come in the OR and help when things are going bad--they are a very valuable asset to helping anesthesia manage a pt while I stay with my scrub nurse and the surgery itself.

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