Another great collection of Nurse blog posts... Enjoy!
2.12.2011
Little Trauma Center in Big City - Background
Before I start writing about my challenges, you need to know a little something about where I work. LTC is a small Level I Trauma Center in the heart of one of the nicest neighborhoods in Big City. The hospital stands tall amidst the Huckstablesque brownstones, with newly built structures and some that are a piece of history.
Our surgery department is tiny compared to the 20-28 room ORs where I have worked. We have 12 rooms and on most days, at least 11 are running, with one open for any potential traumas that might come in. Approximately 60 people staff the department, but we definitely could use more to cover us in case of people calling in sick, taking a family leave of absence, getting injured on the job (workman's comp), or retiring. Speaking of retiring, in the next 3 years, we are anticipating the departure of at least 6 nurses.
Historically, this surgery department had weak leadership that did the bare minimum to keep this place running. Basically, the staff ran the show. They figured out their schedule - regular and call, plus made changes amongst themselves. No one was held accountable for subpar performance because management wasn't around.
As for budget ---- what budget??? Spending happened in silos with no one looking at the big picture. As a result, there is a surplus of supplies.
When it comes to training and education of nurses and scrub techs, there has been little to no structure. Practices vary from nurse to nurse, tech to tech. While in most cases, patients are well-care for, sometimes - I shudder to say - they are not.
The VP of Nursing, thanks to the prodding of the surgeons, eliminated the "old regime" and brought in new players. I am one of the New Sheriffs in Town. We come from large organizations that have processes that work in place. The processes that we wished we could change, we can now actually implement (slowly of course) in the OR at LTC.
The challenge that we accepted includes...
I have been there for approximately six months and already I can see things changing for the better. Many wish improvements could be delivered quickly, but alas, this is not possible with the kinds of change that needs to be introduced. Yes, it is frustrating for physicians and staff. They don't think that I too share that feeling. But I must press on.
And so I continue...
Our surgery department is tiny compared to the 20-28 room ORs where I have worked. We have 12 rooms and on most days, at least 11 are running, with one open for any potential traumas that might come in. Approximately 60 people staff the department, but we definitely could use more to cover us in case of people calling in sick, taking a family leave of absence, getting injured on the job (workman's comp), or retiring. Speaking of retiring, in the next 3 years, we are anticipating the departure of at least 6 nurses.
Historically, this surgery department had weak leadership that did the bare minimum to keep this place running. Basically, the staff ran the show. They figured out their schedule - regular and call, plus made changes amongst themselves. No one was held accountable for subpar performance because management wasn't around.
As for budget ---- what budget??? Spending happened in silos with no one looking at the big picture. As a result, there is a surplus of supplies.
When it comes to training and education of nurses and scrub techs, there has been little to no structure. Practices vary from nurse to nurse, tech to tech. While in most cases, patients are well-care for, sometimes - I shudder to say - they are not.
The VP of Nursing, thanks to the prodding of the surgeons, eliminated the "old regime" and brought in new players. I am one of the New Sheriffs in Town. We come from large organizations that have processes that work in place. The processes that we wished we could change, we can now actually implement (slowly of course) in the OR at LTC.
The challenge that we accepted includes...
- Improving practice of RNs, Surgical Techs, Ancillary Staff (orderlies, housekeepers, etc.)
- Implementing processes making the department more efficient
- Cleaning house --- upgrading instrumentation and equipment, actually CLEANING (after years of neglect), getting rid of excess inventory and streamlining supplies
- Increasing patient satisfaction, physician satisfaction, and associate satisfaction through leadership visibility and support
I have been there for approximately six months and already I can see things changing for the better. Many wish improvements could be delivered quickly, but alas, this is not possible with the kinds of change that needs to be introduced. Yes, it is frustrating for physicians and staff. They don't think that I too share that feeling. But I must press on.
And so I continue...
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