Please Tell Me!

In surgery, a huge amount of time and attention is devoted to the issue of on-time starts. Extra focus is often placed on the on-time starts for first cases of the day. This is due to the huge negative impact any lateness has, not only in the surgical area, but on house-wide patient flow.

As an OR nurse, I know that there are certain days and times I would prefer to have surgery. I don't want a Monday or a Friday, and I would like to be the first case of the day. Being the first case of the day is surely no guarantee of being on time, but the odds are generally better.

When I was scheduled at Giant Hospital for my own surgical experience, I was delighted to get a Tuesday at 9:15am. That was the first case time for the day due to the surgery department's morning meeting being held prior to 9. I was very pleased, as I knew folks would be fresh and would probably have had some good bagels and plenty of coffee at their meeting.

When the procedure had to be moved to Almost Giant Hospital, I was happy to keep the same day of the week, but obviously the time had to be changed. Now instead of a 9:15am opening, I was scheduled for 2pm. I knew the likelihood of that being my actual time was pretty slim. My surgeon would be operating all morning and the delay potential was huge. On the other hand, I knew that he would devote the time needed for each of his patients, and that's the kind of surgeon I wanted caring for me.

On my surgery day, I lay in the pre-operative area wearing one of those stylish gowns, watching the IV drip, and wishing time would move faster. At 1:45pm I saw the area's unit clerk approaching my stretcher. The minute I saw her, I knew what she would say. She stopped at the end of my stretcher to tell me "Your doctor will be at least an hour late; probably more like an hour and a half." I thanked her for the update.

Patient Satisfaction survey results are very important in hospitals, and keeping patients and families informed about delays is often a problematic topic. I couldn't have asked for anything more than the prompt notification my husband and I received about my surgeon being busy elsewhere, and his expected arrival time. I responded appropriately because that's what I do, and it certainly wasn't anyone's fault. But in my mind I was standing up on my stretcher, gown flapping in the breeze, swinging my IV bag overhead like a lariat, and saying "What do you mean he will be late?? I want to get this over with!!"

He arrived at 3:15pm with apologies and I was quickly transported to the OR. All went well and I'm relieved it is over. I am reminded, however, of the importance of providing quick and accurate updates to patients and families about what is going on. If I hadn't been told, and the minutes had continued to pass with no information, I would have been a very unsatisfied patient.