Fooled

Fooled me, today. At least I had good company, good people to work with.

The hospital accrediting inspectors came through, to the ditherment of our managers, and everyone else caught up in their chaotic whirl. And guess which room they wanted to witness a Time-out in.

Yeah.

So, in addition to the announcements and botherers whispering "Jahco is coming! Jacho is coming!" I also got numerous calls and visits about what to do, what to say, forcing their anxieties on me. I was pretty impervious, until I got to a certain point, then I got deeply riled, because all the warnings had to be addressed, and began to affect my ability to care for that patient. Ancillary staff, terrified of making mistakes, insisted on all kinds of unnecessary tidying up that took needed supplies away from where they were needed.

Mind, this was on a heavy day, our surgeon running two total joint rooms - which works because he has a PA to do much of the paperwork, sew skin, and put on dressings, and on the other end, the spinal and block take sufficient anesthesia time, in addition to positioning, that he can do the actual surgery in the other room. And, this surgeon ain't slow. Which is good, he does good work. Today, he had five cases in my room, four in the other. I don't lollygag on these days. It takes planning, attentiveness, and staying on top of everything.

So, the inspector comes in, and I'm tripping over him, trying to stay polite. But this is a smallish OR, with a lot of equipment, and a long way to go before the Time-out. Time-out is a process, of double and triple checking that we have the right patient, and are doing the right procedure, the legal one is the last before incision, with a form I must fill out and sign. Fair enough, we are gradually getting the surgeons to take this seriously, and, once is too often to do it wrong. I look at the consent, check the name out loud with the surgeon and everyone else in the room, including the stupidly obvious "correct position", like pointing out the sky is blue, the grass is green and I still have my feet on. But I do it. Inspector guy hangs around and talks with the anesthesiologist for a while.

Then we hear back, we missed checking that we had the proper implants. I want to hit something. The implant rep had been working with the surgeon templating the correct components, before the patient came in the room.

If there had been any doubt, the surgeon would not have let us bring the patient in the room, his scrub would have stopped us if he didn't have what he needed, would have told me, and I wouldn't have even brought the patient over from the pre-op area. Saying it again is simply insultingly foolish, to all concerned. It's been enough of an uphill battle getting surgeons to stop a moment and confirm the right patient, right surgery, right side, to add several obvious statements is to invite righteous ridicule, and have them resist any kind of final check.

I missed a few other things, specifically because of having to deal with so much meddling attention. Nothing really critical to care, but the kind of marginal detail inspectors so often focus on, while missing the important functions. I am upset with myself that I let all the turkeys get me wrapped up in their bent reality. I stayed calm a long time, but once stirred, I could never quite regain my peace today.

My scrub, a Harley riding, sushi-loving, military guy, who I rarely just talk with, just because we have no common interests, was, I think, rather pleased when I swore*, sitting by him in the lounge, just after. I wonder if he thought perhaps I didn't have it in me. Oh, honey, I do know how to put words to obscene situations. I don't think we will ever come to like each other as friends, but we surely do love to work together. It took a while, but we have grown to trust and admire each other, there, in that place. Well, made him giggle today, at any rate.

Patient is fine, which is all that counts at this point.


*"Fuck" & "Christ on a Cracker!"