Post-it Sunday 4/10/22-running to HR every time you are given feedback

The post-it reads “running to HR every time you are given feedback.”

And this doesn’t have to be feedback about your job performance, a la the yearly performance review. Although I have heard of it happening then too.

This is gentle correction of a dangerous situation.

Let us pretend the patient, who is on the table, is left unattended.

This is a recipe for disaster. A patient and a CRNA should never be left unattended. At the beginning of the case, at the end of the case, those are the times when it is crucial that at least three people are in the room. The CRNA, the patient, and the scrub tech. Or the circulating nurse. Never just the CRNA and the patient.

What if there is an emergency with the patient that the CRNA has to attend to? There is no one else in the room to summon help. A third person needs to be in the room at all times. The circulator needs a last minute supply that the surgeon has asked, again at the last moment. He wanders off to scrub his hands. The scrub tech also has to leave the room to answer nature’s call before being chained to the table for the duration. And the anesthesiologist, although notified that the patient is in the room, has not yet made an appearance.

This is an unwritten rule. Especially on the evening or night shift when there is only the team in the room. And emergencies do happen.

It happened in this instance. Again, the set-up is the CRNA is attaching leads and other things, the anesthesiologist has not yet made an appearance, the scrub tech needs to go the bathroom. But the circulator is getting a last minute requested supply.

The patient starts to de-sat, or has an allergic reaction to the pre-med. The what does not matter for this story. What matters is the CRNA has been alone with a patient in extremis.

After the patient has been stabilized and the surgery performed, both the circulator and scrub tech get a coaching about not leaving the CRNA alone with the patient. One of them goes to HR because they feel that the coaching was unwarranted. The other makes a mental note to never do that again. For the example set either role can be filled by either team member.

The point is that instead of internalizing the issue, and seeing the problem that could have arisen, one of the two went to HR because they were corrected. Do you see the problem?

This not the first time this team member has been corrected. And not the first time to HR. Too often what should have happened, the delaying of the quick bathroom trip because the circulator was out of the room, was not. Communication tools might have helped here to. The scrub tech could have told the circulator that they would get the item, whatever it was, on the way back from the bathroom. Instead of deciding to go at the same time, knowing that the circulator was not in the room.

Two take homes today.

1) be aware of why the other team member has to leave the room

2) don’t go to HR for every little thing

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