Tuesday, September 13, 2011

The Elephant In The Room

I was sitting at the nursing station the other day when I overheard our O.R. director having an impromptu meeting with the nurses. The subject of the meeting was why cases were not going into the rooms on time. There were many excuses volunteered. The nurses complained that all the preoperative paperwork slowed them down. The equipment sometimes didn't get cleaned in time. There were not enough transporters to bring patients to preop or take patients out of recovery, causing bottlenecks in the process. There was not enough staff to help get the patient dressed and IV started. The front desk was not registering the patients in a timely manner when they arrive at the hospital. My ears pricked up when I heard some mention that the anesthesiologists were sometimes late. And when they arrive take a long time to preop the patients and ask them questions.

What was missing from all these recriminations was an obvious target, surgeons who show up late. And why was that? The O.R. director himself was one of the main culprits. For this surgeon, a 7:00 AM start means he doesn't show up until 7:20 at the earliest. He thinks nothing of keeping people waiting for him. When he finally does arrive, he makes no apologies. Instead he offers a sly smile, a quick joke, and the nurses and patient just melt under his spell. The patient is promptly wisked into the O.R. and another case is tallied as being late getting into the room. One time I deliberately showed up late to the O.R., about five minutes after this surgeon arrived, to see what effect that would have. The results were not pretty. No amount of grinning or Jay Leno impersonations was going to appease him, who was, let's charitably say, one pissed off M.F.

So this charade continues. The support staff in the O.R. dance faster and faster but the patients don't ever seem to get into the rooms any quicker. Maybe one of these days the surgeons will finally figure out that the cause of much of the delays can be found by looking in the mirror.

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