Four times in the last week.
That is the last SEVEN days I have had to inform new surgeons the number to call the call nurse, the hours the front desk is available and the process for adding on cases.
Not the least the conversations I’ve had managing expectations of how long it takes to get a case started when half the team is coming from home.
Last night I told a surgeon who called me at 2225 that we would try to get the patient on the table by 2330. She pushed back and asked why it would take so long.
Even during the day it would take 45 minutes from the call to the patient in pre-op and hopefully they are getting prepped by one of the faster nurses.
Because the half of the team that is responsible for picking the case, preparing the room, preparing the table, getting the patient, preparing the patient, counting the back-table are not physically in the hospital.
And we have 30 minutes to respond and get to the hospital.
That leaves us thirty minutes to do all of the case preparation work.
And this is one of the biggest case set ups. I need stirrups, and the bed has to be prepared. I need to make sure that all of the electrical equipment is in the room, ready to go.
I have to get the patient, who is writhing in pain, and do an emergent pre-op prep. And I see you’ve ordered an oral medication, and a type and screen. And then SIGNED and HELD IT. That means the gears are not put in play until I prepare the room, pick the case, get the patient and begin the pre-op work. I also have to notice that there are signed and held orders. And the type and screen was not put in properly and no, I do not have 15 minutes to sit on hold during the beginning of the case while I am plugging in cameras, and hot stuff, after I attended the intubation. It would have been much more useful to have the ED start on that before we even got there. Alas, no.
Don’t bitch to me when I missed our 2330 on the table by 3 minutes. I’ve moved mountains here, lady. Your expectations need to be brought down just a smidge.
So, yeah, on Monday I am going to go to my boss and inform them I will be creating a welcome letter for new surgeons with all the numbers they need and realistic times and procedures with doing a call case. This will lessen their frustration about not getting to the right people to schedule cases, and lessen my frustration with re-treading the same song and dance that I go through every time there is a new doctor. You’d think the medical staff office would have something like this, but you’d be wrong.