This is the concluding part of the what does it mean to be called in journey.
But all call cases are not lap appys.
But a case, any case, follows the same steps.
- there is a call/page
- you answer it and take down information on the case
- you call the supervisor to inform them there is a case
- you head to the hospital
- you schedule and pick the case
- you go to the ER to pick them up
- you do all the preop checklist with them for surgery
- the surgeon arrives, they and the anesthesiologist talk to the patient
- consents are signed
- patient enters the OR and undergoes induction of anesthesia
- the patient is prepped and draped
- pre-incision timeout
- incision and beginning of case stuff
- the object of the surgery is identified
- you pour the medications on the field
- the surgeon begins to close the surgical incision
- the patient emerges from anesthesia
- you take the patient to PACU
- if there is another case, rinse and repeat
Delivering the patient to PACU means that I am handing the patient off to another nurse. There is information that I have to impart to the PACU nurse that sums up the entire case in an info dump.
The PACU nurse needs to know who the patient is, why they have had surgery, what the surgery entailed, where they are going after PACU, and any concerns that you have about the patient and their expected course.
To report off on Patient A, I would start with his name and birthdate. I say that he has appendicitis, and which surgeon performed the case. I discuss the dressing, dermabond in this case, and the three port sites on his abdomen. I say there is no drain and that 30 cc of marcaine 0.5 % was injected to the port sites. Finally I say that Patient A is going home after PACU. By this I mean that the patient is not being admitted and, after the acute PACU phase, the nurse should get him ready for discharge.
All of this info dump is being performed while we are hooking the patient up to the monitors: blood pressure, cardiac waveform, and pulse ox.
After asking if the PACU nurse has any questions I pick up the specimen to take it to the lab. Specimens are not to be left in the PACU, except during the day when the lab rounds on the specimen holding area. I check the holding cart whenever I am at the hospital, and take specimens I find there to the lab.
And I log out of my OR phone and hang it up at the desk.
And prepare to go home myself.