Tag: operating room

Counting basics #14- yes, the specimen must be counted

I finished the counting basics series in September but I missed one. This past week, I was at the hospital for a call case when I, as a routine part of the evening shift charge nurse duties, checked the cart where specimens stay until they are picked up by the lab. 

I know that this was on the list that I left behind for the next evening shift charge nurse. Oh, wait, they have lost four of the five that have been hired to replace me in the last two years. To other hospitals mostly. Because being the evening shift charge nurse is hard!

The list I left behind got lost somewhere. I have to reprint it. But on the list was to check the specimen cart to make sure that all the specimens had been transported to the lab for processing.

There were 9 cases worth of specimens in the cart when I checked it before taking the case specimen that I had to the lab. NINE!

My sister the pathologist was crying and didn’t know why. There were specimens that didn’t even have formalin on them for over 12 hours. Thankfully there were no cultures. Makes my blood boil; you bet I wrote an email to the manager explaining how checking the cart is an expectation of the evening shift charge nurse.

But, Kate, if they didn’t know… Bah! The specimen cart is not magic, drop off the specimen and never think of it again. Specimens have to be treated carefully. Which is why it is the 14th counting basic.

Care and handling of the specimen was also the subject of my master’s thesis and project, the standardization of specimen hand-off.

Imagine if you are that patient whose specimen goes missing but there isn’t any more tissue left in your body to test. Imagine if you are that patient whose specimen is not handled correctly, with formalin, or put in the specimen refrigerator promptly if there is no formalin and the specimen is unusable for testing. Heck, imagine the nurse who failed to collect the specimen correctly and caused all this furor.

Think of how badly you would or should feel.

This is why the correct specimen hand-off is the counting basic # 14. The surgeon has to name what the specimen is, the nurse prints the label, puts the label on the container, shows the label to the scrub tech and they both agree that this is the specimen that is going into the labeled container for this patient that is currently on the OR table.

In fact, the corporation changed its policy to reflect what I had done in my master’s project. Don’t think I didn’t notice!

Specimen hand-off is of utmost importance to the patient. Second is the handling of the specimen after the case. Whether or not it needs formalin, or is a frozen section, or needs to go fresh.

Know the rules of your particular OR for how the specimen gets to the lab, and who takes it, and the hours that the lab collects the specimen. Because they don’t have the manpower to be collecting at all hours of the day and night.

NOW I’ve done it

Deep breath.

In.

Out.

In.

Out.

Earlier in the week when HR called me to discuss my counteroffer and I presume to counteroffer the counteroffer, I was not in the headspace to speak to him.

My dad has been in the ICU for a week.

Things had gone south the night before.

He was very understanding and told me to call when I was ready.

The first day I was moving my flight.

The next day was my last full day in San Francisco.

The last day was a travel day.

I called him the day after.

To my utter surprise they did not counter my counteroffer.

I panicked, slightly, and told him I had to speak with my husband, who was at work, about the matter.

My husband called on his lunch break.

I told him they had accepted my counteroffer.

We had previously discussed the counteroffer and the basement that I would accept.

This was above the basement that I would accept.

I wonder if I left money on the table but I do not have the heart for negotiation.

No matter.

I called him back and accepted.

I got the call job!

All of my strum und drang was worth it.

(look it up if you have to)

This is a seismic shift in my entire life.

My brain is still trying to talk me out of it.

I keep telling myself that overtime will be leaving soon as they hire another for the call job if I do not take it.

Which is true.

And he told me that while I was free to take other’s call, including laser, on my days off, I would not be paid extra to do so.

This all of a sudden leaves me with 2 full days off a week.

It has been a LONG time since I had such a luxury.

I will, of course, have to work the 4 week notice that hospital policy demands.

I wonder if this will break my brain.

I have to get busy making lists.

Of what I am going to do with my evenings.

Of what room in the house I will be working on first.

Of what projects that I’ve been neglecting for the last year I will tackle first.

Of alternative income streams I can do.

I can write articles.

I can write fiction.

I could freelance as a copy editor.

I could freelance as a script doctor.

I can engage more with social media and this blog.

I can focus on a PhD program as soon as I pick one.

I could work PRN for the rival healthcare system in town. This will be my scorched earth option.

The possibilities are vast.

And a lot scary.

Deep breath.

Here we go.