Behind Closed Doors: The Hunger Games: ASC Edition

May the odds be ever in your favor!

It is common knowledge that every single employee who is clocked in is in need of a snack. This universal behavior is in evidence each day in the high-stakes, fast-paced arena known as the Ambulatory Surgery Center. In this economy, caffeine is currency, snacks are proper nutrition and the breakroom fridge is a lawless land where yogurt goes to die.

District 1: Pre-Op. Pre-op is where the tributes, also called patients, are prepped for their battle. The nurses that work pre-op move in an organized fashion from bay to bay with structure and grace. Their expertise is placing IVs with one hand while charting on the computer with the other. These tactical geniuses can spot a bad vein from across the department and smell that “sip of water” the patient had in the waiting room. These pre-op warriors survive on sarcasm, energy drinks and the knowledge that as soon as you place the IV and EKG leads, the patient will have to go pee.

District 2: The OR. Once you step into the OR, your alliances are everything. The participants are the surgeons, scrub techs, circulators, anesthesia and sometimes environmental services. Each participant plays a role in a choreographed battle. Touch that sterile back table and you will be exiled faster than the business office personnel will empty a coffee pot!

District 3: PACU. Post-op is where the tributes rise again, dazed from anesthesia and speaking unfiltered truths. The confessions one hears would never make a seasoned PACU nurse blush; they have heard it all. The unspoken promise of PACU nurses is “what you hear in PACU stays in PACU.” It’s like Las Vegas ... except you win juice and a cookie.

The Capitol: Administration. While the frontline workers are battling on the field, the Capitol (management) watches from above. They are usually in their own personal version of Hades, where they battle policy changes and compliance paperwork minefields. Their language of “compliance metrics,” “key performance indicators” and “dashboards of data” can take years to perfect. Most are bilingual and revert back to normal language to type up that sign on the breakroom fridge that says, “Please throw your yogurt out, we aren’t in the business of making penicillin here.”

The Game Changers: The Sales Reps. Not the random ones who show up asking to speak to a manager, the regular ones who know the team by name and almost act like part of the staff. These shapeshifters bring breakfast tacos because they know that if they feed us, we will accommodate them. They also can be like paid actors that hype up the surgeons: “Wow Dr. Whoever, you make that look so easy.” These reps can be strong allies in times of need!

The Hidden Tributes: The Sterile Processing Techs. They stay in the warm chamber in the core of the operating room suite, but they hold all the power and staff will learn to dance the dance to get trays turned over in a timely fashion.

The Final Showdown: 3:59 p.m. As closing time approaches, the ultimate battle begins. What surgeon is going to add on a “quick” case? Does that last patient have uncontrolled nausea resulting in a prolonged recovery time? Everything is possible!

Remember, victory is never guaranteed. If you managed to survive five turnovers, irate family members upset about their wait time, or a surgeon asking for an item that has NEVER been on their preference card, then congratulations. You are the winner of The ASC Hunger Games! OSM