You can’t do what?

Here we go again.

Last night, while some of the staff were writing the board (yes, this is a daily task) an emergency case came in.

There are very few true emergencies.

Bleeding.

Blocked ureters leading to urosepsis.

Fournier’s gangrene (if you’ve smelt it you know).

Compartment syndrome.

Volvulus of all sorts that are threatening the integrity of the bowel.

All of these cases are life threatening.

Last night’s was the volvulus.

It is 1810, people are starting to think about going home.

One of the CRNAs certainly was.

Dr. C called about a cecal volvulus, a true emergency.

I had a case due to come off the table in 45 minutes.

And a spare team.

And what I thought was a spare CRNA.

I stopped the CRNA on their way out the door and told them there was an emergency and I would need them to stay and start said emergency while the charge CRNA was finishing up the case.

They went to the room and asked how much longer that first case was going to take and then proceeded to come tell me they would be off the table in 30 minutes (lie) and they were going home.

I could not stop them.

eye roll and a heavy sigh (internal, of course)

Next I turned to the two staff members at the desk and asked them to please pick the case that had just been added on.

The case card was on the printer.

I turned back to the phone and called the pre-op and told them there would be an incoming case and they needed to be prepped with all due haste.

I went back to scheduling the case.

The staff I had asked to pick the case said they needed a preference card, because the one that had printed was blank.

I stared dumbfounded at them and repeated “You need a card to pick an ex lap?”

One of the knife and fork cases that EVERYONE needs to know how to pick.

The reply I got was “well, yeah. this card is blank.”

They were not kidding me.

Deep cleansing breath.

I quickly attached a card and reprinted the case before they got on the elevator to go pick the case.

I scheduled the case, got off the computer and went to fetch the patient.

Because this is an emergency, damn it!

I wanted to scream that they needed to stop being so married to the cards that they can’t make a step without them.

But I did not.

I went to get the patient.

I fully expect to be called to the office about this.

To be told that other nurses are not me and I should not expect them to be.

Um, I don’t.

I do expect them to be able to pick a basic case without a card.

I will be creating an education around this for the staff.

I will take them down to the case make up area, tell them they have 3 minutes to pick an ex lap.

On your mark, get set, go.