It was near 9 a.m. on a Tuesday when she got the page. "Vangie, come to the front. An OSHA surveyor is here." As holy-bleep moments go, this one was a doozie.

Vangie Dennis, RN, BSN, CNOR, CMLSO, administrative director of the Spivey Station Surgery Center in Jonesboro, Ga., had been on the job for only 6 months and was preparing for a 40-case day when the surveyor showed up, unannounced.

Her first thought was that a staff member or disgruntled patient must have snitched on them for some workplace safety violation. But then she remembered that the Occupational Safety and Health Administration was conducting unannounced audits at surgery centers in Alabama, Florida, Georgia and Mississippi to review sharps safety policies. Today was her lucky day.

The surveyor, an industrial hygienist, wasn't an expert in surgery, as Ms. Dennis discovered early on during the 5-hour visit. "She asked how we handled major blood spills," says Ms. Dennis. "We have small spill kits here. If we have a big bleed, I'm in trouble." She was incredibly thorough, though, snapping pictures of sharps containers, gloves, safety syringes and guarded safety blades. After speaking to Ms. Dennis, she talked in private to 2 nurses, 2 techs and an anesthesiologist. "She wanted to know if what the manager says about sharps safety trickles down to staff," says Ms. Dennis.

Ms. Dennis senses that her facility fared well, but she admits that "it's hard for even a great administrator to be prepared for an unannounced regulatory visit." Surprise inspections are nothing new for surgical facilities. Medicare and accreditation surveyors practically invented the pop-in. What's one more intrusion into your business, right?

We're all for complying with reasonable rules and regulations that promote safety, rein in healthcare costs and keep the competitive playing field level. We approve of insurers using readmission rates as a yardstick to judge and penalize hospitals. And even though it narrows doctors' treatment choices, we approve of gynecologists in Sacramento being trained to perform less-invasive hysterectomies or risk losing their patients to doctors who know how.

But nobody likes being told what to do. Here are a few rules that border on being pointless.

• Your surgeons don't have to use safety sharps, but OSHA's Bloodborne Pathogens Standard makes it mandatory for them to trial them yearly (see "Keys to a Successful Safety Sharps Program" on page 24).
• Ambulatory surgical centers must appoint someone (anyone!) to serve as an infection preventionist (see "Who Should Be Your Infection Preventionist?" on page 52). To do what, we're not so sure.
• The Ambulatory Surgery Center Association is urging all ASCs to use a safe surgery checklist by the new year. Why? Not for safety's sake, but to comply with Medicare's new ASC quality reporting requirement.

Pretty senseless, right? Wouldn't it be nice to get the compliance monkey off your back?