Indexing Title: NALUDINOs Medical Anecdotal Report [06-02]

MAR Title: When events prevent us from operating

Date of Medical Observation: March 8, 2006

Narration:

            We had four elective operations scheduled that day. We all knew that in order for us to finish all our operations, we had to stick to the time allotted for each. We could at least try.

            After the first two cases, the team was still on schedule. There were two more operations in line. As the third patient was being her anesthetics, the smell of something burning filled the air. At first I thought nothing of it. I even dismissed it as just my overactive imagination. Then the others confirmed my observation. Below the operating suites, a room was on fire. There was tension in the air, so much so that even the patients and their relatives were getting quite anxious, except our patient. She had been already given her pre-medications and was sleeping quite soundly. At that time the decision not to push through with the operation was quite easy. All patients were brought to the recovery room, as we rode out the emergency.

            After electricity was restored and everything seemed in order, the prevailing question then was whether or not we will still proceed with the operations. If we did, how sure are we that it won’t happen all over again? What would happen if we were in the middle of the operation and the fire broke out? What would be best for the patient? Some were suggesting that we postpone all operations. Others were suggesting that we should wait for the emergency to be declared over before proceeding. There was confusion. An executive decision had to be made.

            After the authorities declared that everything was safe, the decision to go ahead with the operations was made. We pushed through, and finished all cases.

Insights (Physical, Psychosocial, Ethical) (Discovery, Stimulus, Reinforcements):

            Patients who are about to undergo an operation are subjected to great stress. Making the decision to go under the knife is by itself stressful. Even more so is waiting for the procedure to actually happen,

            We must do everything in our power to reduce the stress the patient is going though. First by providing a comfortable environment, pre and post operatively and most of all, by making sure the scheduled operation pushes through. I’m sure nobody wants to go through the waiting game only to find out that he has to go though it all over again.

            Sometimes, unexpected and unpreventable events wound prevent us from doing the procedure. If this happens we must fully explain to the patient the events that led to the postponement, what can be done to prevent a cancellation from happening again and assuring him that we will proceed as soon as possible.