Some surgeons think nothing of operating past closing time. Way past. Your nurses and techs? Yeah, they can probably do without unexpected late nights in the OR. And you wouldn’t miss the overtime-inflated payroll that goes with after-hours surgery. Here’s a simple solution that will work for everybody: Create a 2-person late-case team for surgeries that end or begin past your normal quitting time. All you need is 1 nurse and 1 tech who are willing to work 3 12-hour shifts every week.

The key is getting your surgeons to agree to only schedule late surgeries on certain days. For us, that’s Mondays, Wednesdays and Thursdays. On those days, our late-case team works from 6:30 a.m. to 7 p.m. This not only ensures our physicians are fully staffed for surgeries that run late or start late, but it also promotes a better work-life balance for the other members of our OR team by letting them (almost always) go home at their regularly scheduled time. A dedicated late-case team can also help your bottom line by reducing unscheduled hours of overtime and increasing your caseload. An added benefit: You’ll reduce the late-case team’s 40-hour work week (5 8’s) to 36 hours (3 12’s).

One final note: Even though our physicians agreed to limit their late cases to 3 days, we know there will be exceptions. We asked our day-shift staff to pick 1 Tuesday or Friday each month that they could stay late on the off chance a case runs over on a day for which we don’t have late-case coverage. But with our new schedule in place, our RNs and techs are usually home in time for dinner.

Philip B. Binkley, MBA, BSN, RN
Houston (Texas) Methodist Willowbrook Centerfield Surgery
[email protected]