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Digital Issues

Archive >  December, 2013 XIV, No. 12

Cutting Remarks: Take Those Rules and Shove Them

Here are 5 operating room regulations that just don't make sense.

John Kelly, IV, MD

rules

I was raised to respect authority and obey the rules of the land, but the rules and regulations of the OR have become burdensome. Yes, I know surgeons today get sued BID, but let's get real.

1. Surgical consent. I love when a case gets delayed because the consent wasn't filled out properly. 'L' or 'R' can never stand for left or right, respectively. Heaven forbid, someone may misinterpret 'L' for lucky or last. Of course, the "lucky" shoulder is really lucky to have the surgery at this fine facility! Even more irksome is when I get called for an "incomplete" consent. Yes, I tend to make my consents rather terse, but last time I checked rotator cuff repair meant exactly that. Nowadays I get dinged for not adding possible spur excision. Ouch. Last I checked, that was a routine part of the procedure!

2. Pregnancy test. The serum HCG is indeed important. Anesthesia risks to a fetus are truly of great potential consequence. However, the enforcement of this test can sometimes teeter on craziness. Recently, I was attempting to perform a minor procedure on a woman advanced in years. No general, just sedation. I was not allowed to proceed without the HCG results. Truth was, the woman's last menstrual period was March 1997. I won't state her age, but her Social Security Number was 7. Her driver's license was in Latin. Gimme a break!

3. The time out. Unless the entire team utters all the key words of the time out, we all can get dinged by the compliance police. When I recite my part, I have to read the chart verbatim and enunciate like Shakespeare — the omission of 1 word can send the powers that be into a tailspin. Yes, this is truly an important step, but for those of us who suffer from ADHD, the mere pause to slowly deliver this soliloquy can be extremely painful.

 
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