No anesthesia tech - what do you do?

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kidthor

kidthor

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Lately at some of our sites there are now no anesthesia techs and we do the anesthesia room turnover ourselves. Are other people on the forum are having a similar experience? What do you all do in this situation?
 
happens frequently here sometimes. our tech leaves at 130 so we do turn overs after. and on call. and sometimes during the day if they dont stop by to turn over.
 
If you're salaried, it doesn't really matter. If not, it's definitely worth following up on.
 
kidthor said:
Lately at some of our sites there are now no anesthesia techs and we do the anesthesia room turnover ourselves. Are other people on the forum are having a similar experience? What do you all do in this situation?
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im just curious what exactly they take care of when doing turn over..

i think this varies a lot place to place and your place might be doing more than other places and you may not even realize it

our crnas stock everything, set up everything, anesthesia techs can help find and set up some more rarely used items but otherwise dont get involved in any of the room turnover where i am.. there is a room cleaner who changes the garbage bag near my cart.. thats about it
 
anbuitachi said:
happens frequently here sometimes. our tech leaves at 130 so we do turn overs after. and on call. and sometimes during the day if they dont stop by to turn over.
Click to expand...

It was like this at my old job lol tech leaved at 130. He was useless when he was there anyway. Would frequently forget to stock things like suction, do a machine check, or the face mask of the breathing circuit. If we needed anything, the or nurse would grab it from the anesthesia supply room. I’m not sure how he didn’t get fired
 
Hoya11 said:
im just curious what exactly they take care of when doing turn over..

i think this varies a lot place to place and your place might be doing more than other places and you may not even realize it

our crnas stock everything, set up everything, anesthesia techs can help find and set up some more rarely used items but otherwise dont get involved in any of the room turnover where i am.. there is a room cleaner who changes the garbage bag near my cart.. thats about it
Click to expand...

one of our techs got fired but only bc she was dangerous to patients in addition to doing nothing much. saw her sitting around random places on her phone a lot.
 
I ask the crnas and AAs to stock the rooms during down time (we have lots of down time) otherwise throwing out dirty circuit and suction are part of room turnover. We just set up a new suction and new circuit in between cases. Honestly I’d rather do these things myself than be surprised by a blown suction canister or look like the clutz because every single connection on the circuit falls apart when I’m intubating. I also provide a list of a handful of basic items that are must have to start a case.. basically what I would need to start any general or sedation case. If the staff wants to flip rooms between cases and I don’t have time to check the room myself the staff take 30 seconds to run that list for me before we go back with the next case. Anything that can be retrieved after the patient is asleep I just ask the nurses to find for me.

Keep in mind this setup won’t work if the nurses hate you or have no idea where the anesthesia stuff is.
 
We have techs that change circuit in between cases. After hours we do cases ourselves and change circuit and wipe down the machine between cases.

Whoever does room turnover should take off old circuit and suction and put on a new one. They have to do a leak test too though, otherwise you’d have to return to the room to check the machine. If I was in your position, I would see if the room turnover people can do this, otherwise at the end of the last case after exutbated and stable, I would throw away the circuit, attach a new one and start the leak test so I didn’t have to return to the room. It will add an extra 3 mins before leaving the room.
 
Well, no one can ding anesthesia for late room starts then.
 
The other day had to figure out how to set up high flow myself because techs were useless and respiratory hit me with “we don’t do anything in the ORs”. Called multiple attendings and they all had noo thing to offer.


Somehow didn’t delay the case but quite literally spent 6 hours of the day time in between and during cases trying to figure it out so we could apneic ventilate for this PM ENT case.


We turn over our own stations majority of the time because the techs don’t come in time in between cases. Plus when they do half the time the circuit is half disconnected or the suction canister lid isn’t even on. And every AM our carts are not stocked so I’m running to supply rooms to get drugs and equipment.


Honestly if more attendings had days without residents I’m pretty sure things would change. Or maybe we have juuust enough techs to support the solo attendings
 
In the Army, we had no techs, so we turned everything over and restocked ourselves. Hearts were a pain, as we had to set up all the pumps, hot line, transducers, and pull all of our equipment (TEE, line kits, USD, drugs) ourselves that morning.

In my current practice, we don't have techs at our outlying hospitals, but the circulator will change the circuit and suction, and wipe the machine and cables down during turnover. Restocking at those hospitals is our responsibility, and several of my partners are lazy/ find it to be beneath them, so don't whoever comes after them needs to spend a couple of minutes in the morning ensuring they have what they need.
 
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Our techs do a fair job keeping our rooms stocked and at least 7-3 M-F do an OK job turning over our rooms. No such luck on evenings, nights and weekends - we do it all.

First thing in the morning, we have to put circuits and suction on. The hospital claims there is a Joint Commission requirement that those can't be left on the machine overnight. Hmmmmm. Not that big a deal since we don't let anyone else do our machine checks, so it only takes a minute to hook them up while doing the checks which takes about 7 minutes anyway. The irritating thing is we occasionally have nurses that will toss unused clean circuits and suction in the trash late in the afternoon because "it's against the rules" to leave them on the machine. Clearly they haven't heard the "don't touch anesthesia's **** - ever.
 
jwk said:
Our techs do a fair job keeping our rooms stocked and at least 7-3 M-F do an OK job turning over our rooms. No such luck on evenings, nights and weekends - we do it all.

First thing in the morning, we have to put circuits and suction on. The hospital claims there is a Joint Commission requirement that those can't be left on the machine overnight. Hmmmmm. Not that big a deal since we don't let anyone else do our machine checks, so it only takes a minute to hook them up while doing the checks which takes about 7 minutes anyway. The irritating thing is we occasionally have nurses that will toss unused clean circuits and suction in the trash late in the afternoon because "it's against the rules" to leave them on the machine. Clearly they haven't heard the "don't touch anesthesia's **** - ever.
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This is insane. I do feel like “joint commission” is cited all the time, who knows because employees never see the actual surveys.
 
I'm surprised by the variability in technician help presented here. I guess I have been extremely lucky in my positions. I have always had outstanding support from technicians. At my new practice (MD only, true PP), they turn over the machine, set up lines and blocks, and assist with ultrasound and block. They're in the room for nearly all intubations and help position the patient. I had a patient laryngospasm the other day and the technician recognized what I was doing and knew how to help (basically helping with mask seal and jaw thrust and got everyone in the room to pipe down).
 
cchoukal said:
I'm surprised by the variability in technician help presented here. I guess I have been extremely lucky in my positions. I have always had outstanding support from technicians. At my new practice (MD only, true PP), they turn over the machine, set up lines and blocks, and assist with ultrasound and block. They're in the room for nearly all intubations and help position the patient.
Click to expand...
This sounds amazing. Probably the techs are directly employed by the PP group? Very different than a hosptial employed tech.
 
dipriMAN said:
This sounds amazing. Probably the techs are directly employed by the PP group? Very different than a hosptial employed tech.
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That's what I would've thought, but no; employed by hospital. They even take call and come in in the middle of the night and weekends.

overtime must be sweet.
 
cchoukal said:
I'm surprised by the variability in technician help presented here. I guess I have been extremely lucky in my positions. I have always had outstanding support from technicians. At my new practice (MD only, true PP), they turn over the machine, set up lines and blocks, and assist with ultrasound and block. They're in the room for nearly all intubations and help position the patient. I had a patient laryngospasm the other day and the technician recognized what I was doing and knew how to help (basically helping with mask seal and jaw thrust and got everyone in the room to pipe down).
Click to expand...
this sounds incredible. nothing like having post-extubation spasm and looking up and circulator and surgical team are somehow both not in the room.
 
cchoukal said:
I'm surprised by the variability in technician help presented here. I guess I have been extremely lucky in my positions. I have always had outstanding support from technicians. At my new practice (MD only, true PP), they turn over the machine, set up lines and blocks, and assist with ultrasound and block. They're in the room for nearly all intubations and help position the patient. I had a patient laryngospasm the other day and the technician recognized what I was doing and knew how to help (basically helping with mask seal and jaw thrust and got everyone in the room to pipe down).
Click to expand...
The money was too much to keep the old timers from selling out MD only and switching to 1:4 direction/supervision even when that ratio wasn't needed......but I bet if your anesthesia tech situation was the minimum standard all over the country you'd have a lot more docs sitting the stool.

We essentially have two (not very good) techs for 20-some anesthetizing locations, so the CRNA or resident usually has to stock the room, grab extra equipment, set up all the lines and drips, and then turnover at the end. If it weren't for that situation, I would probably try to renegotiate my contract so I could do 50/50 direction and MD only instead of 100% direction. Maybe I'm looking at it the wrong way, but I absolutely see having to do the tech's job as well as a waste of my time and, frankly, beneath me given my education and talent.

As another poster said, you don't see the surgeon opening their trays and setting up their own instruments before operating.
 
psychbender said:
In the Army, we had no techs, so we turned everything over and restocked ourselves. Hearts were a pain, as we had to set up all the pumps, hot line, transducers, and pull all of our equipment (TEE, line kits, USD, drugs) ourselves that morning.

In my current practice, we don't have techs at our outlying hospitals, but the circulator will change the circuit and suction, and wipe the machine and cables down during turnover. Restocking at those hospitals is our responsibility, and several of my partners are lazy/ find it to be beneath them, so don't whoever comes after them needs to spend a couple of minutes in the morning ensuring they have what they need.
Click to expand...

I've been there. Would always keep a set of lines and syringes ready. That way you can set up in less than 30 minutes.
 
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