The post-it reads ‘struggle for OR space, a tremendous fight with anesthesia.’
Or space is finite. It is extreme limited supply. After all, the rooms don’t get any bigger just because you wish it so.
In all the hospital I’ve worked in the struggle has been real.
The OR rooms themselves have been all sizes. From I can hear my echo big, to reaching the walls from opposite sides of the OR table small. The last was a converted closet. There was just enough width to fit a gurney beside the OR table. All the equipment, like the bovie and the suction had to be plugged in by the anesthesia team as there was no way to get to the head of the bed after the patient was prepped and draped. But needs must.
In this itty bitty room there was no room for anesthesia to expand.
And the CRNAs HATED that room. They could not stretch or kick their feet up. What? You know you’ve seen it in an OR before.
Because it is the natural inclination of the anesthesia team to take up as much room as possible. No, I don’t know why. I guess the CRNA and their TWO pieces of equipment (pyxis and anesthesia machine) just expands to fit the space, like rising dough. And however much room they have, they want more.
Back when I was the evening charge nurse, I did a nightly reset of the rooms.
Invariably, during the day the bed would be moved, giving the CRNA more and more footage to do their thing. This would cramp up the rest of the room. Sometimes it would make it impossible for the circulator to go behind the sterile table to accomplish tasks on the far side of the room.
Leading to the nightly reset.
Every night I would move the anesthesia machine and the pyxis toward the back wall. I would move booms and video towers, suction machines and tourniquets. Just to get a little breathing room for the team. And the next night the anesthesia machine and the pyxis would have encroached on the working space of the patient and the sterile team.
I may have ceded the battle bit by not being the evening charge nurse anymore. But I will not lose this tug of war. Every night I am called in I move the machine and the pyxis and the bed.
Trying to give the OR team a bit of needed room.
I used to tell the anesthesiologist that I worked with in California that he had enough room for an easy chair, feet up, and a cup of coffee. And could he share a bit? Hmmm? And he would grumble and move the anesthesia machine an inch, maybe two. And every night I would reset the room to give more room to the actual working sterile team.
21 years I’ve been doing this tug of war. And I imagine I will do it 21 years more.
Dispatches from the Evening Shift 