Accountability and Assistance for Personal Limitations

Guidelines:

• Physical
  • Use tools, use help
• Auditory
  • Pause music
  • Ask to repeat
    • Several times if needed
    • Repeat in different words
  • Quiet the room if needed
• Scope of practice
• Ethical
  • Facility dependent
  • State dependent
  • Staff availability dependent

Considerations:

• Know resources
• Plan ahead
• Size of room
• Identify need early
• Speak factually and truthfully
  • Own mistakes and move on

Nurse’s role:

• Arrange for assistance/tools
• Advocate the need to call
  • Anes is not superman
  • Surgeon not superman
• Accurate documentation
  • Factual

Pitfalls:

• Failure to identify mistake
• excuse/non-factual reporting
• Underestimate task
• “Best guess”

Examples:

• Gensurg asks for new load on stapler during gastric bypass. White load placed on stapler and passed back. Surgeon clarifies “is this the load I want?”(clarify, whatload? “This is a white load”, factual, clear)
• Missing raytec after closing, count correct at start of closing.“I know it isn’t in this wound” (retrace steps, do not leave room unless ICU, find raytek or xray)

Linchpins (Key Points):

• No second chances usually, get the information clearly and factually report events