Saturday, November 5, 2011

Worst Excuse Ever

Most anesthesiologists can testify to the frustration of waiting for a surgeon to come in and start a case. We and the operating room staff try our darndest to get a case ready on time. However, the one thing we have no control over is what time the surgeon finally decides to stroll into preop and start barking at everybody to get the patient into the room. Some of the nicer surgeons will apologize for being tardy. Most will not. It is the policy in our operating rooms to document the cause of a late start for a case, whether it be the surgical equipment was not ready, the patient was late showing up for his case, it was an anesthesia delay (the universally acceptable excuse), or the surgeon didn't show up on time. Therefore when the surgeon comes late, he is asked for an explanation. Some say they were delayed by office work. Another popular alibi is they were stuck in traffic, which everybody in Los Angeles accepts as a matter of fact. But for me, the excuse I most despise, and repeated by many surgeons, is that the operating room did not notify them of when the patient is ready.

Whenever I hear a surgeon say that, I can just feel steam rising out of my ears. Especially for a first case of the morning, why does the surgeon think we need to tell him we are ready for him? He knows what time his case is supposed to start. We are not their momma telling them to wake up to get ready for school. Imagine what would happen to OR scheduling if everybody pulled this stunt. The preop nurse finishes seeing a patient. She then calls the circulating nurse to let her know the patient is ready to be seen by her. Once the circulator finishes, she then calls the anesthesiologist. When the anesthesiologist finishes, he then pages the surgeon to let him know the patient is ready. We would maybe get two cases a day into the OR at this rate. The idea as a team is for everybody to show up on time and see the patient within a reasonable period to get him ready for the surgery.

By stating that the operating room did not tell him the patient is ready, the surgeon is passive aggressively blaming the OR staff for a delay in the case. He is totally absolving himself of any responsibility for causing the entire day's schedule to run late. Instead of just admitting that he overslept, or that he wanted one last quickie in bed before heading out the door, he blames the staff. When the patient asks him why his case is not starting on time, he'll repeat the same excuse thereby making himself appear the victim of OR incompetence.

I think all hospitals should institute a policy stating that everybody should show up on time as scheduled to prevent any delays in starting cases. There will be absolutely NO notifications sent out to let anybody know the patient is ready to be seen. It is the responsibility of the staff to call the operating room to find out if a case is starting on time. No one is going to be spoon fed the schedule. If a staff is tardy, he should let the operating room know ahead of time. Blaming the operating room for not keeping them informed of the starting time will not be tolerated. And no, you cannot blame the anesthesiologist for a case being delayed.

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