Excuse me, I need to bump

The surgeons are never that polite about bumping.

This is not the bump into you in a crowded elevator.

Bumping is the act of doing an urgent case in front of another surgeon who has an elective case on the schedule.

When a surgeon determines that their patient can absolutely not wait for surgery time, they ask for a bump.

Psst- nurses don’t bump.

Never.

Nuh-uh.

Nope.

Don’t even ask. I will refer you to the surgeon whose case it is you want to bump.

I will even give you their number.

But I will not make the call for you and ask that if they don’t mind, can surgeon #2’s urgent case go ahead of surgeon #1’s elective case.

Pretty please.

No.

Surgeons only talk to surgeons. The bump conversations must be had on a peer-to-peer level.

When I give surgeon #2 the phone number of surgeon #1, often they are mystified that I am giving them a number. I’ve even been asked, “Aren’t you going to do it?”

Nope. Policy says I am not the one to make the ask. Surgeon # 2 is.

After I give the phone number, I request a call when permission has been granted. Or not.

Most surgeon #1s (the ones with the elective scheduled case) are pretty cool with a later time slot. After surgeon #2 explains their reasons for asking for a bump. Usually something to do with deteriorating a patient and no time to transfer to a higher level of care.

I will get a phone after that conversation has happened and surgeon #2 says that they got permission to bump. The cascade and shift to a different surgery and a different surgen than planned begins.

But, yes, I absolutely follow up with surgeon #1, not to see if surgeon #2 is telling the truth (although a little bit), but to ask who is going to inform their scheduled elective case. I also give them a new timeline of their case starting and reassure them that they will receive a phone call when it is time to head to the hospital.

Take away of the story is that

1. surgeons bump surgeons
2. keep in contact with surgeon #1 about the new timeline of their case
3. be aware that surgeon #1 will ask you to tell the elective patient that there is an emergency and their case is being delayed
4. communication is key to this working

Don’t be afraid to get your higher-ups involved if there is a conflict and surgeon #1 insists that their elective case MUST go at the proscribed time. You have a lot of phone calls to make about getting patient #2 to pre-op and don’t forget to inform anesthesia of the new plan.