teamwork
Don't Soak the Pans

When I was a teenager, my family had a built-in dishwasher. Two, actually: my brother and me. We both hated doing the dishes with a passion. One of us would wash the dinner dishes as quickly as possible, but let the pans soak in soap and water overnight. Of course, if I left a soaking pan for my brother, he'd have to wash it the next night. You can bet he returned the favor. Don't soak the pans is a term I use in surgery. It means fairly sharing the work, pitching in and helping out. When everybody helps pick the next day's cases, for example, it's like washing all the pans at the end of the day instead of leaving them for the next person. What if nobody on your staff let the pans soak?

• You'd interview the patient before the surgeon arrives. Murphy's Law will prove true: The patient will have to use the bathroom one more time, the patient or family has questions, or the consent is missing a key element. Better to resolve these issues before you retrieve the patient.
• You'd pick cases the day before surgery. Picking the case means instruments and implants, too. I've been stuck without an implant when the staff assumed it's in consignment or I assumed the rep was bringing it. If the rep is bringing an implant, supply or instrument, call the day before to be sure.
• You'd sign off on "the pick." Create a check-off form with 3 lines: supplies, instruments, implants. Also note on the form arrangements you've made ("Joe the rep's bringing bone putty.").

All OR staff should pick cases for the next day. No one leaves until cases are picked, which means the early room down and staff with down time pick. Before a staffer leaves, she should report to somebody that the pick is complete. And she can't soak the pans!

— Leslie Mattson, RN, BSHM