Protect yourself and your patients
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
I have always been fearful of making a big mistake that is going to cause pain or injury to others. I’ve had nightmares about it. As a nurse, a CRNA, and a consultant in the wonderful world of healthcare, my fear is probably not pathologically paranoid, but perhaps it is just a healthy fear of screwing up something that will hurt others.
Safety must be a priority. In my world, I look for three things to be successful in the operating room (OR) environment, regardless of whether the OR is hospital-based or in an ambulatory surgery center or surgeon’s office. They are:
• Is it a safe environment for patients and staff?
• Will we provide a positive experience for patients and staff?
• Is it increasingly profitable?
Increasingly The Joint Commission, the Accreditation Association for Ambulatory Health Care (AAAHC), and American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) are focusing on patient safety and outcomes, with good reason. Our goal is the betterment of our patients and not adding burden by mistakes or oversight. It’s lofty idealism, I know, but it’s doable.
What can you do today, right now, to protect yourself and your patients, and at the same time, avoid the nastiness of liability if you don’t? Consider these suggestions:
• Use common sense.
If it doesn’t seem right or feel right, go with your gut and question it. If you are working in the surgical environment, you have that sixth sense about what is right. Use it! We have timeouts to force us to look at the basics before we proceed with the case. However, we also need to pause and look at the bigger picture, the 30,000 foot level if you will, and just think about what we are doing.
For example, the patient is being wheeled back into the recovery area, and you notice the patient’s arm has slipped, is hanging off the stretcher, and the door is closing. Common sense tells you that the arm could get hung up in the door and cause injury. Another example: The IV line is snagged on the IV pole that is about to be removed as the patient is transferred. Tell someone, or reach out and free it.
• Read your policies and procedures.
Boring. Unquestionably boring. I write hundreds of them and hate each one, but they really are there for a reason. As a staffer, you need to have read them and understand them. It’s part of your job and continued employment. But when was the last time you did read them?
As I have found out over the years, not every staff member understands that P&Ps change and are updated constantly. So, instead of trying to reach the next level on your phone game, just get the manual and scan the table of contents. If you see something different or not what you expected (a good one is the policy on bullying), read it or at least scan it to get the flavor of what it is about. It is very satisfying to read something and then see it played out in real time.
• Question things that you don’t understand or that don’t seem to make sense.
Don’t be obnoxious and make people roll their eyes every time you open your mouth, but as a member of the staff it is your job to make sure what we are all doing is correct. Again, if it doesn’t feel right, it probably isn’t.
• Speak up at staff meetings.
In my world, silence means acceptance. If you don’t understand what is being discussed or it is just strange, speak up and let your feelings known. Too many decisions are made without complete understanding of the implications. I promise you, if you don’t understand it, others do not as well.
• See patients as family members.
It might sound weird, but if you can picture your patients as family members, it often is easier to empathize with them and show compassion as well as job skills.
• Quit your job.
Some of you don’t like your job anymore, and you are just going through the motions. Believe me, I have been there! I see so much apathy in our workplace that it is frightening. You can rededicate yourself to your career, or move on before you burn out.
What we are doing in surgery requires constant awareness and vigilance. If you can be honest with yourself and admit you are not doing that, then you need to let someone know and get some guidance.
We are fortunate to work in the healthcare industry. It is a much sought after place to have a job and a career. Let’s all make it a safer place to work! [Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates’ address is 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Fax: (512) 233-2979. E-mail: [email protected]. Web: www.earnhart.com.]
