Prepare before case ends

I have heard it from many surgeons.

“I want an evening shift turnover.”

For a long time I thought that meant that evenings could skip from room to room.

However, we usually stay in the same room and just turn it over.

Monday, I relieved in a case that was finishing at 1500.

There was a case to follow.

When I relieved the day nurse, I looked around.

There was trash everywhere.

The irrigator had not yet been taken down, although they were past that point.

The bovie was still plugged into the generator, although they were past that point.

A trash can had not been readied to receive the drapes and back table supplies.

I set about picking up the trash, taking down the irrigation, emptying one of the large barrel trash cans, putting a new liner in the same large barrel trash can, unplugging the bovie.

Just, you know, generally tidying up the space to make turnover easier.

And it hit me.

One of the reasons that evenings has such a fast turnover has everything to do with the fact that I begin preparing for the next case while still in the previous case.

Trash is picked up.

Equipment that is no longer in use is pushed aside.

Furniture that is no longer in service, such as prep tables and basin holders are placed to where they will be used for the next case.

There is always a trash can that has enough room for the drapes and back table supplies, even if I have to empty a trash can and put a new liner in.

The suction canisters, if no longer in service, are taken off the suction tree and treated with thickening agent to thicken the suctions.

This is done as the surgeon or PA is finishing closing.

At the same time I am making sure they have their dressings, and that PACU has been called.

All that remains is to wake the patient up.

Finishing getting the trash together and taking it out.

And turning over the room after they have left the room.

As we were wheeling the patient to PACU I looked at the CRNA at 1510 and told them, “The wheels in goal for the next patient is 20 minutes. Which makes it 1530.”

And we were.


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