What a week

Ugh.

This week has been particularly hateful.

I believe the best way to synopsize the last three days is a little story.

We are about to start a 3 hour jaw revision.

At 1900.

Hark, the phone rings and it is OB telling me there’s an ectopic in the ED.

Well, an ectopic is an emergency.

I told the OB to see the patient in the ED and get back to me, because we would hold the jaw fracture.

He hemmed and hawed and said he’d go the ED after he finished the delivery he was on.

I went to tell the team and the surgeon who was being delayed about the ectopic and that I anticipated hearing something soon.

Cue me and the CRNA checking on the rooms.

Each of us not wanting to go past the surgeon at the desk with no news.

FINALLY, after 45 minutes I sent a query text to the OB doc. ???

A little sheepishly I got a reply to start the revision.

Because the patient wasn’t even in our ED.

They were at another hospital.

You made me delay a case for 1 hour and you’d been consulted on the wrong ED.

Sheesh.

Incoming!

The new six week schedule is complete.

It has to be published two weeks before the start date.

So, essentially, it’s been done for three days.

And here comes the bomb to blow up the carefully prepared schedule.

I don’t know what it is.

I don’t know when it will come.

But it will.

I am waiting.

Budgeting time

There are many, many things to account for in the operating room.

A seldom thought of one is time.

There are lots of packets of time to budget.

The time it takes to drive to work. Or take transit. Or walk.

The time it takes to walk in to work, especially if the car/bus stop is far away from the OR.

The time it takes to walk to the lounge, use the facilities, have your break, and walk back to your room. All within 15 minutes.

The same for lunch. Except you get 30 minutes.

The time waiting for the surgeon to arrive.

The time waiting for the patient to wake up.

The endless time it takes the elevator to come up from the basement. And you’re on the 1st floor. Why, oh, why didn’t they build stairs next to the OR.

The time waiting for your relief to show up so you can go home.

And get ready to do it all again tomorrow.

Sunday’s Theme: past patients and coworkers

This will have to be quick.

I am working at 0630 in the morning.

For the third morning in the row.

Argh.

One of my favorite anesthesiologists was waked on Saturday.

Well, it was his funeral day.

But his family ordered people who went to wear brightly colored shirts.

In his memory.

And, hearing that, I laughed and laughed.

Because, of course.

Dr. C was an amazing man.

He was gifted as an anesthesiologist.

He put everyone at ease, including the staff AND the patient.

He handled emergencies with compassion and the right word after the crisis had passed.

I will miss him.

Saturday’s theme: Call Matters

Saturday’s theme will be call matters.

This will be a combination of call stories, why call is important, and call obligations. Tonight’s will be money matters.

Call is important.

It allows a department to not be staffed 24/7.

This saves the hospital money.

It also allows the department to bring in extra people, in case they do work 24/7 and an emergency comes in.

It allows for flexibility in staffing.

It can be costly, though.

Usually the person on call is paid a set dollar amount per hour while they are on call, for the disturbance of their life and the necessity of being 30 minutes away from the hospital at all times. My current call pays is $3 per hour. Plus call-back pay, which is roughly time and a half, if I am called in. This is an hourly rate.

I get my call pay and so does the scrub on call.

The anesthesia team is in-house regardless if there are any cases.

Today, I am on call. For 24 hours.

I went in at 0650 to prepare for an 0800 case. This allows me to pick the case, to prepare the room, to get the patient, and to do the prep for the patient.

I thought I was going to be home by 0900.

LOL.

No.

Four cases later: a cysto emergency, a facial laceration, a broken bone, and an APPY. I was home by 1630.

For some people the call-back pay doesn’t make up for the disruption in their weekend.

I am not most people.

WTAF

A coworker and I were talking this week and she said she would no longer say WTF. Instead it would be WTAF.

The A is for actual.

I thought that was perfect and I, too, would be adopting the phrase.

This week on WTAF: work day after holiday BS.

Oh, there’s another acronym.

Today is the first day after a holiday.

I was on call last night. Yeah, I know.

And a surgeon called and asked for the 0800 slot in a room that was not slated to start until 1200.

I gave him the time slot. And, because I’m nice and thorough, I texted the day shift charge of the change.

Who informed me that he told an entire team to come in at 0930. Because their case wasn’t until 1200.

Let’s pause and let that sink in.

The day after a holiday, he told an entire team to come in at 0930.

There were two techs slated to be out. But not nurse.

An ENTIRE TEAM 0930.

Thud, went my head against the desktop.

Fine. I’ll come in an start the case until the nurse gets there. But I was not to do that either.

Oh, oh, oh. And he told the CRNA that there would only be two rooms after 1700.

I repeat, on the DAY after a holiday.

Sheesh.

Politics is built into Nursing Practice

There are many ways that politics is built into Nursing Practice.

You have to be political to your bosses.

I got stopped this week in the cafeteria on my way back to the OR while I was on a break.

The president of the hospital stopped me after I paid for my baked chicken tenders.

He wanted to introduce me to some muckety-muck he was squiring around.

He was with two men, one who he introduced me to right away. The first man was something in finance. And Matt said very nice things about me.

We waited, kind of awkwardly, while we waited for the second man to finish the conversation he was having with the family of a patient.

I am still clutching my chicken tenders.

I was introduced to the second man who was the new doctor in charge of the region. Matt said very nice things about me again.

He introduced me as the Shared Governance Queen, as a Great 100  nurse and a recent recipient of the Corporate Nurse of the Year award. And that I was a hell of a team player in the operating room. And that he had worked with me when I was at another regional hospital.

I am awkward and smiling and I shook his hand.

And bid them goodbye as I was sure there was more important people to meet and I had to get back to the OR.

Matt continued on with his tour with the finance man and the chief regional doctor. .

I can be political when it suits me. I like Matt, he’s done really good things at my hospital.

And, still clutching my now cold chicken fingers, I went back to work.