Call Secrets of the OR #5- Designated Call Room

This is it. The big call secret.

It’s not about how to make friends with people you wouldn’t talk to at a party. It isn’t about making nice with others of the opposite political divide. It isn’t about sleep deprivation or a cool, dark place to sleep. It isn’t about keeping all the procedures in your head so that you can pull out the appropriate one and get to work. It isn’t even about being on call.

It is about having a designated call room.

No, I don’t mean a room in the bowels of the hospital to chill in if your call is a twenty-four hour deal.

It is about having a designated operating room for call.

We like to think that all operating rooms are the same. We like to think that all operating rooms are a blank slate, just waiting for us to walk into and start the surgery.

We like to think about the call shifters as being separated from the rest of the OR crew. After all, we are a small cohesive unit. We work well together because we know the mission is to get in, do the case, and get out. No breaks, no water cooler moments, just case and be done.

In our perfect little world, every operating room would be the same. Each room would have exactly what it needs for the most common call cases. It would have a video tower, it would have an auxiliary monitor that shadow casts from the video tower. And it would be hooked up. It would have a full tank of carbon dioxide so that you can inflate the abdomen. It would have an irrigation module so that irrigation can be run into the abdomen. It would have a functional suction tree, with every “branch” that has a suction cannister. It would have the powered coagulator that you need to create access in the abdomen. It might have a tourniquet. The dilation and curettage machine would be in the designated spot. It would also be fully stocked. The irrigation would be warmed to the correct temperature of 104 degrees Fahrenheit and in the anteroom. The warmed blankets would be in the same warmer as the irrigation, steps away from the action.

The perfect little world call room is also close to help if you or the patient needs it.

But we don’t live in a perfect little world.

These operating rooms are workhorses. In the course of a day they can go from an OB-GYN case, to an orthopedic case, to a podiatry case, to a general case, and back again.

You will never be able to enact your will on every operating rooms. Don’t even try.

Because there are humans who inhabit the rooms during the other shifts. And their idea of a perfect operating room will differ from yours. The orthopedic rooms will have a tourniquet but will not have the power coagulator. The OB-GYN room will have most of what you need for a perfect little world call room, plus stirrups. The podiatry room will have a tourniquet and a bump for under the hip.

However, what is possible, is to have a dedicated call operating room that has all the equipment that the perfect little world operating room does. But you know that the dilation and curettage machine is fully stocked and where it should be.

This is imminently possible to have a conversation with your boss, or the boss before that one, or the boss before that one, about why having a dedicated call operating room is important.

Ideally invoking the wrath of a code blue in a surgery is not necessary. Remember what I said about close to help. Having a dedicated operating room allows those who would show descend on you if there was an actual code know where they are going.

I’ve done a code in the far flung cysto room. Now, do you understand why there are directional signs to that cysto room?

Having a dedicated call operating room will make your life so, so, so, much easier.

You won’t have to run around like a chicken, cursing day shift out loud as you search for the irrigation module, or the cord that connects the video tower to the auxiliary tower, or a video tower in the altogether. Or frantically searching operating room by operating room, in every store room, in the other store room, maybe it’s in the cysto room, looking for the dilation and curettage machine.

And that?

Is priceless.

And well worth the brow-beating you have to do to accomplish having a perfect dedicated call operating room.