Interdisciplinary Team Member Functions

Guidelines:

• TOTS
  • Anesthesia king before turnover
  • Usually unspoken, facility specific
• Anesthesia techs
• Consulting surgeons
• Boardrunner/floorwalker
• Primary RN stay in room as much as possible
  • Secondary arrivals make better runners
• “Neck up” = anes
• Communicating is key
  • Closed loop

Considerations:

• Know attending
  • Capabilities of residents
  • Supervising staff anes
• Speak up!
  • “Deer in headlights”
• Direct, factual
• Treat patient not monitor

Nurse’s role:

• Know what gear is in use and who is manipulating
• Ears open
• Avoid blame
• RN typically coordinates movement
  • Bed manager
  • PACU
  • ICU
    • Don’t surprise!

Pitfalls:

• Inexperience and quiet
• Superiority fight
• Consent fight
• Out of scope
  • Students, residents
• Outlet fight

Examples:

• Lap chole, anes begins working behind the curtain, drawers slamming, surgeon unaware (call attention, halt surgeon if possible, communicate)
• Local/Mac case, difficult airway/mask, surgeon demands “justtube ‘em and lets go” (anes in control, consent with patient and future plan important.)

Linchpins (Key Points):

• Communication resolves unpredictability which improves patient outcome