??? for OR nurses

[cassioo]

Yesterday at work the NM got a call just as she was leaving and boy was she mad. So she gave me the assignment of writing a policy for our OB OR. It seems that now before we start a surgery we are to yell TIME OUT and everyone is to agree on what the surgery to be done is. You have to document the time that TIME OUT was called. I guess this came from Joint for wrong site surgeries I don't know but I can just see me yelling TIME OUT when we are doing an emergency c-section to make sure a c-section is what we want to do. WE ONLY do c-sections, tubals and every now and then a D&C or cerclage (those to usually go to the main OR) I don't think we'll open a non-pregnant patient for a c-section or anywoman will willing walk to a scheduled c-section that isn't pregnant...oh sorry I thought we were doing a section on this 80 yr old woman I found out on post partum. We have 1 doc you can hardly keep up with anyway he's so fast with his sections I can just see me yelling time out step away from the patient I need to make sure what surgery we are going to do here..do you know doc???

[1mg.epi]

Ya. I can see the look on a surgeons face when the or nurse yells "TIME OUT". This should be a pre-op thing, or discussed when the surgeon walks in the room. But you know, you can never be too carful before cutting.

[cassioo]

But you know, you can never be too carful before cutting.

nope you never can but considering all we do is c-sections and postpartum tubals (from vag deliveries the previous day) you'd think if someone has a big pregnant belly that would tell us c-section and if they didn't that would say tubal. At least we did get out of site marking for these cause if you can't find it you're in trouble.

[Marie_LPN]

Well one thing to consider is making sure you have the correct pt., never mind if one or two procedures is all that's done in an area.

People in the L and D unit where i work thought that the time out was pretty stupid until they got a Hispanic pt. (whom the staff THOUGHT knew English) who almost got an unnecessary C-section all because her answers to questions were "yes" and "no".

Not to mention 'big belly' doesn't always equal "pregnant"

[cassioo]

It's still silly for OB but we do it. This is a small community hospital we have 4 labor rooms. We have not had a walk in patient for months. True a big belly doesn't equal pregnant but we also wouldn't take a patient to OR for a c-section if they hadn't been a scheduled procedure who was known to be pregnant or a labor patient who we'd been doing vaginal exams on and had on fetal monitoring and had fetal heart tones...we happen to have doctors who speak Spanish and a few of us speak a little enough to get by with OB questions...we did have a problem with a Spanish woman who was small in baggy cloths coming into ER and all the guy she was with could tell the admissions clerk was her stomach hurt so they thought gastro and she sat for 4-5 hours before they took her to the exam room and found her to be crowning and ran her to us. If I've been laboring a patient for 8 hours and she goes to my OR where I am the circulator (we do our own sections so we follow the same patient labor, OR and recovery) I probably wouldn't forget who I was taking to the OR or accidently go into the wrong labor room and get someone else. I know the timeout is important for the wrong site and patient surgery but for our little hospital it is just more writing to make sure the paper is filled out.