Call Secrets of the OR- Call shift is great until you can’t find a supply at 0200

Job is still cool.

There are still a lot of positives. This is a post about the second negative- when day shift makes a massive floor move, ignoring why the rooms are set up nearly identically, and gets rid of half the shit that isn’t used every day but when you need it you need it.

Yes, the rooms are set up nearly identically. I am referring to the supplies in the supply cabinet.

But, but, we never do general surgery in room 1, it is an ORTHO room.

Wrong.

You have never done a general surgery case in room 1.

Lots of us have.

In the before times, long before you were a nurse/tech/surgeon at this hospital, room 1 housed the robot. And even then the cabinet was identical to room 2, room 3, and room 4.

This is the before times when the hospital only had 4 operating rooms. You wouldn’t’ve recognized it.

The cabinets were all set up to be identical.

And that was so that any case could be done in any room by anyone.

This is to decrease the amount of out of room time a nurse might spend during a case. Any case but especially a call case or an evening case when we don’t have the wherewithal to scream out the door for “somebody” to get us something.

By wherewithal I mean other people.

In the daytime there are lots of people rushing about cleaning rooms, turning over instruments, opening rooms, giving breaks, giving lunches, helping out.

Yeah, no such luck at night or even during the evenings.

I count that as a positive for evenings or nights. It makes you think on your feet and prepare your room better for the case at hand.

When I train people for the evening charge role, this is big selling point that I make. No managers, no charge nurse besides yourself, nobody is around.

When I train people for the call nurse role, this is a big selling point. No one is immediately around to help. There are people you can reach out to in a pinch and I’ve written about that before.

Day shift is just too… Too busy, too loud, too many people. All wanting to go home unless they want to ride out the clock.

Nights/evenings get it. It is mano a mano with the OR team. Except it isn’t a competition with the OR team, it is a competition with the reason the patient needs surgery in the middle of the night.

But I digress.

Day shift has all the time in the world to make changes to make the OR in the image of their last hospital.

Things get moved. A lot.

Things get deleted from stock. Things that are rarely used but are used all the same and is the only thing to work for scenario X. A lot.

The now 9 rooms are siloed into specialties.

But not every case is that specialty and not every case “fits” in that room. I do except the robot room. The robot room is highly specific to the specialty and the robot. I agree with this. But the rest causes me to run at night.

And don’t get me started on the dismantling of the identical suture carts that had been in every room. The suture on these carts are basic suture that every specialty might need. And an emergency sutures like 3-0 silk for a stitch to stop bleeding.

This entire post boils down to “If you move it/delete it/there has been a change in supply” tell the night shift call team. Because how else would they know except for when a surgeon asks for it in the middle of the night?

The operating room recently changed out some of the GI staplers. And didn’t tell us. Which led to me running around like a chicken. In an emergency.

I am not asking for much. A friendly “hey they got rid of X and replaced it with Y” would’ve sufficed. Instead of making the call team look like idiots at 0200.

Yes, yes, there are communication papers everywhere. In the elevator, at the desk, in the year binder. But did you write it down? So that the call team could read it and be prepared?

No?

That’s what I thought.

Pretty, pretty please stop making changes to the OR supplies and not cc-ing the call team with the information.

With sugar on top.

That would really help us give better care to the patients. They deserve a circulator that is present for the surgery, not off fetching and carrying because you couldn’t be bothered to inform us of changes.

TTYM.