Do You Know All the Players on Your Team?

Premier Pulse     April 2021

Kanagy_HS_350x350By Scott Kanagy, DO, MBA, chief medical officer, Upper Valley Medical Center

You are quickly approached by a nurse asking you to come to a room where one of your patients is in respiratory distress. You enter the room and notice your patient needs to be emergently intubated. You take control of the situation; everyone knows their role and you move to the head of the bed and prepare to intubate the patient. The nursing staff has already attached the patient to the monitor and defibrillator pads are on the patient. The respiratory therapist is preoxygenating the patient with an AMBU bag awaiting you to intubate. Suction is set up and functioning normally. The nurse asks if you are ready for them to proceed with medications needed to start rapid sequence intubation. You say “yes” and the medications are given. The nurse hands you the laryngeal scope and an ETT tube and you successfully intubate the patient. The patient’s heart rate returns to the 90s and oxygen saturation improves to 97 percent. Everyone takes a deep breath and you tell the nursing staff to move the patient to the ICU. As you head to the ICU to write further orders, you stop before you leave the room to thank everyone for all they did to help you treat this patient.

Now let’s look back one week prior. A critically ill patient from the nursing home with Clostridium difficile is dying in the same room as the patient you just intubated. An EVS worker comes an hour later after the patient passes to thoroughly clean the room to ensure your patient, you, or others do not contract or carry Clostridium difficile to others. Three days before, the nurse noted the overhead lights in the room were not working correctly and were dim. Plant operations had been called to the room and had found a short in a wire and fixed it, so the lights worked properly and offered good lighting, which allowed you to intubate the patient on the first attempt. The day prior, the pharmacy department had checked the PIXUS and made sure all the correct medications needed to emergently intubate a patient were present and not expired. The morning of these events, sourcing had checked the code cart and supplies in the room making sure all the correct sizes of EET tubes and yankauers for suction were available.

I always knew prior to getting into hospital operations that it took an entire team. However, I did not thank all the behind-the-scenes individuals who allowed me to do my job as often as I should have. Today, I make it a point to know who these individuals are and thank them every chance I get. They walk among us every day in the halls quietly doing their job so you can provide the best care to your patients. I would ask everyone reading this article to take the time to recognize these team members and thank them for what they do every day, so you are able to care for patients. They make us all Premier Proud.

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