For years when I was the evening shift charge nurse, I kept a curated list in my head of people who would be willing to pinch hit in the event of an emergency. The reinforcements, to call them by another name.
And carry the battle theme of life in the operating room still further.
I knew who to call to ask for help.
More importantly, I knew who would not come in to help under any circumstances.
No shame to them, kids and other life commitments, including having healthy boundaries, can mean that not everyone is available to help at the drop of a hat.
I utilized the list when the scrub tech was in a car accident on the way to the hospital to do a call case.
I utilized the list when it became apparent that the patient needed another set of hands because they were that complex.
A facet of the list is knowing if the PACU nurse on call will be able to help if they were called in prematurely. Frankly, some are not able to help do the nitty gritty gross stuff. Again, that is okay; the OR is not for everyone.
In PACU terms, I have utilized the list several times, most often in hemorrhage cases where blood has to be ordered, and labs sent, and suction cannisters changed, and a higher level of care than med-surg has to be arranged for WHILE taking care of the field and their needs. In a true hemorrhagic emergency, the field needs a lot, such as suction, and lap sponges, and not to mention the needs of the anesthesia team.
Sometimes cases are nerve-wracking.
Sometimes the blood wells up after incision too fast for the suction to clear it.
Being evening charge with limited staff is curating a list of your own of people to call in as reinforcements.
Because, if when you call, they will come.
A story to end the post today, the longest day I’ve ever worked was 1030-2300 for my normal shift, call from 2300-0700 with four add-ons with just enough time between to get home and lie down for 10 minutes before the pager went off again, and the beginning of the Saturday call shift, with another four add-ons ready to go on. At the 27-hour mark, I called in one of the nurses who I knew would come and they allowed me to take a MUCH needed nap for 2 hours. I got up after a desperately needed nap and finished the last case of the marathon. Is such a stretch advisable, no, or against policy, yes but the cases were emergent and had to be done. BTW, this was YEARS ago and several policy changes since.
Know your reinforcements. Recognize that using your reinforcements is good for the patients and good for you.
Dispatches from the Evening Shift 