Download Phoebe NORTH Orientation Packet

Phoebe NORTH Orientation Packet
First Things First
 You will need a MicroProx Tag which will allow you to enter the
facility and multiple areas within the hospital. It is a sticker which
you can attach to the back of your employee badge. Either
Melissa or Gloria can direct you to the Maintenance departmentyou will need to call beforehand to see if someone is available to
assign one to you that day. The office is located on the 1st Floor
near the Morgue.
 You will need to have a personal Pin Code to get into the locked
Controlled Substance drawer of the Anesthesia carts. This code
and your badge need to be programmed into the new cart system
in order for you to have access. Ask Mary for your assigned code
or call the Help Desk at 312-6333 for access issues.
 You may need to get an Accudose ID at Phoebe North to access
the Accudose machine. These are set by Pharmacy. It will prompt
you to choose a password the first time you use the Accudose
machine. These machines are similar to the Omnicell at Phoebe
Main. You can get most medications from this machine located in
the PreOp and PACU area of the OR instead of going downstairs to
Pharmacy.
Tour of Facility
*Please initial when each area has been visited/identified/oriented to*
___ Surgicare/ “Outpatient Services”
___ Endoscopy (In-room “mini” cart & larger supply/drug cart, Code
Cart)
___ PreOp (Accudose machine, Supplies, Blanket Warmer, Regional
Block Cart, Code Cart)
___ PACU (Accudose machine, Bins for Completed Paperwork, Code
Cart, Pediatric Code Cart, Reintubation/Airway Cart)
___ Radiology (Location & Anesthesia Machine)
___ OR rooms (Anesthesia machine, 2 Carts, Phone list, fire
extinguisher)
___ OR Front Desk (Electronic Schedule, Intercom System, Next Day
Schedule, Weekly Schedule Notebook)
___ Anesthesia Supply Room (*please orient with an Anesthesia Tech)
___ Old Doctor’s Dictation Room (Location of Serious/Rapid Response
Cart- similar to drips found in the Heart Room at Main) (items include:
(Albumin, Hespan, emergency drugs to make drips, central line kit, I.O.
kit, etc.)
___ Anesthesia Office (where anesthesiologists screen charts, computer
for anesthetists)
___ Pharmacy (Procedures, Paperwork)
Tour of Facility (cont.)
___ Nurses Lounge
___ Doctor’s Lounge (*Anesthesia Communication Board, Posted
Schedule)
___ Offices of Tammy (OR Director) & Deese (in charge of ordering
Supplies)
___ Cafeteria (Location & Hours)
___ Locker Rooms
___ ICU (on “Stand-by” for the majority of the time/patients needing
ICU care will be stabilized & transferred to Main)
Items that need to be Located & Checked-off
__ Code Cart (red) in Pre-Op
__ Code Cart (red) in PACU as well as Pediatric Code Cart in PACU
__ Code Cart (red) in Endo
__ Glidescope in Anesthesia Work Room
__ Fluid Warmers/Level 1 Infuser outside of OR 5 in open storage area
__ Spinal Cart (black) in OR Supply Room
__ Regional Block Cart (black) in PreOp
__ Malignant Hyperthermia Cart (black) outside OR 1
__ Rapid Response/Emergency Cart (black) in Old Doc’s Dictation Room
__ Pediatric Cart (sea green) between OR 1 and OR 3
__ Difficult Airway Cart (yellow) outside OR 2
__ Reintubation/Airway Cart (blue) in PACU
__ Fire Extinguishers (between OR 8 and OR 9/outside OR 4)
__ Emergency Gas Shut-Off Valves (multiple throughout OR hallways)
__ Anesthesia Communication Board/Posted Schedule in Doctor’s
Lounge
__ A-line set-up in Yellow Bin in Anesthesia Work Room
__ Central Line Kits in Anesthesia Work Room/Old Doc’s Dictation
Room (both open with MicroProx Tag)
Items that need to be Located & Checked-off (cont.)
__ Bougies/Stethoscopes/Ambu’s- should all be on the Anesthesia
Machine
__ Pacemaker/ICD Magnets- one should be on every Anesthesia cart;
typically on the underside of the top shelf of the Anesthesia cart
__ “Extra Supplies” Cart in hallway outside OR 5 (extra blades, LMAs,
pillows, etc.)
__ Time-Clocks (outside Emergency Center, Outside Locker Rooms, near
Employee Parking Lot, across from Pharmacy)
Pharmacy Hours
Mon-Fri 6:30am-9pm
Sat-Sun 8am-6pm
Pharmacy Procedures
 Pick up Narcotic Bag daily or use the Accudose machine to
withdraw medications
 Phenylephrine syringes will be assigned (2) per Narcotic Bag. You
may ask for more if needed. PHENYLEPHRINE SYRINGES ARE NOT
LOCATED IN YOUR CART’S DRUG DRAWER.
 If you need to make a Phenylephrine drip, there are 10 mg vials in
the Anesthesia WORK ROOM that the Anesthesia Tech can get for
you to prepare your own drip or call Pharmacy to make the drip
for you. RNs can get 200mL or 250mL NS bags from the Accudose
or elsewhere in the OR.
 OFIRIMEV 1Gram is located in the Accudose machine or Pharmacy
 Routinely supplied in daily Narcotic Bag: Propofol, Versed,
Fentanyl, Dilaudid, Phenylephrine. ***Any other controlled
substances (ex: Morphine, Phenergan) need to be requested
daily.
Pharmacy Procedures (cont.)
IMPORTANT:
 ***If you or a nurse DISPENSE a medication from the Accudose
machine, the patient is charged. ***Please DO NOT doublecharge the patient by marking the same medication on the
Pharmacy Drug Billing sheet.
o Accudose= PT ALREADY CHARGED
o Pharmacy Drug Billing Sheet= ALL OTHER MEDS USED
 ***If you or a nurse pull a medication from the Accudose and
YOU NEED TO RETURN IT (unused)= FILL OUT AN ORANGE SHEET
IN ORDER TO CREDIT THE PATIENT BACK. Pharmacy needs these
ORANGE Sheets ASAP.
o ORANGE Sheets are located on the side of the Accudose
machine
 If you check out a Narcotic Bag, YOU ARE RESPOSIBLE for those
items. Another Anesthetist CANNOT turn in your Narcotic Bag.
You are to sign back in your bag at the end of your shift.
 There is an EMERGENCY ONCALL Box in the case that Pharmacy is
closed. It is located in the locked metallic closet in the PreOp area
near the patient bathroom. You need to swipe your MicroProx
Tag on the side of the closet for it to unlock.
o YELLOW zip-tie on the box means it is not used.
o If you use the ONCALL BOX= Please date/initial & reseal the
box with a BLUE zip-tie, and notify Pharmacy ASAP.
Pharmacy Procedures (cont.)
 We are NOT to use multi-dose drug vials on more than one
patient per Pharmacy. Please discard these vials at the end of the
day. Some common multi-dose vials at North are: Labetalol,
Atropine, Decadron, Lidocaine
 Please DISPOSE of EMPTY vaporizer bottles. This is opposite of the
practice at Phoebe Main.
 There is a New Pharmacy Drug Billing Sheet. Please write in any
medications that are not listed. **Please charge by the amp or
syringe (according to the unit listed) **For multi-dose vials, write
in the milligrams used.
ENDOSCOPY
 Code Cart Outside the Room
 Procedure Nurse will bring patient to the Room. You are to drop
off patient in the same room for recovery after giving report to a
Recovery Nurse.
 Top Copy/”Original” Anesthesia Record will stay in the Patient’s
Chart. Pharmacy copy and Anesthesia Billing copy of the record
will go back to appropriate bins in PACU along with the Pharmacy
Billing Sheet.
 An Anesthesia Tech will restock the larger supply & drug cart in
Endo. This cart stays directly outside of the room. It is the
Anesthetist’s responsibility to restock the smaller “in-room” cart.
Other Info
 Post-it notes are located on every Anesthesia cart. They can be
used to make notes for the Anesthesia Tech of supplies that need
to be restocked in between cases.
 Electronic board in front of the OR desk is the most up-to-date
schedule with Add-ons listed there first in ORANGE.
 Some LMAs are reusable- please put these in the red blade bin on
side of your cart where the dirty blades also belong.
 Please circle your name & write the time you went to lunch or
who you are feeding on the board next to the daily schedule.
 Drugs or supplies that are on Back-order are updated on the
Anesthesia Communication Board by the Anesthesia Tech.
 Suction on the Anesthesia Machine is NOT to be shared during the
Procedure for any reason.
 Anesthetists need to VERBALIZE that the Anesthesia Checklist has
been completed prior to the start of the case.
 A Time-Out will be done in PreOp, repeated when the patient rolls
into the OR, and a final time-out prior to incision.
 Check if any of your drugs need to be restocked PRIOR to the start
of your case. Especially if it is an Emergency drug & especially if
the Anesthesia Tech has gone home for the day.
 Document the name of the person intubating your patient,
whether it is a student or an anesthesiologist. If the person
intubating is not documented- it is assumed to be YOU.
 Please separate your chart appropriately in the bins near the
automated door in PACU once your anesthesiologist has signed
the record. Otherwise, the PACU nurse will separate the
anesthesia record.
 There is a fire extinguisher located in EVERY OR as well as
between OR 8 & 9 and outside OR 4
 Most anesthesia machines at North have an automated machine
check-out. If you are unfamiliar with this, ask one of the
anesthetists or the Anesthesia Tech to run you through it. The
trickiest part is locating where to block off the connector during
the leak check in order for it to “PASS”.
 Please check your laryngoscope blade & check the light in the
handle before the start of every case. **Sometimes the blades do
not fit in the handle. **Sometimes the light is dim and the
batteries need to be replaced. Know where to find new batteries
within the Anesthesia Workroom.
The Help-Desk at 312-6333 can assist you in any access
or computer issues you are having.
Operating Rooms
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Currently some ORs are not being used: 1, 4, 7
General rooms: 3 & 5
Ortho rooms: 8 & 9
Cysto room: 6
Eye room: 2
Phone Lists
A list of frequently used extensions can be found in the
anesthesia office.
Room 1
Room 2
Room 3
Room 4
Room 5
Room 6
Room 7
Room 8
Room 9
42781
42782
42778
42776
42777
42775
42772
42779
42780
Phoebe North Cafeteria Hours
Breakfast 7am-9am
Lunch 11am-1:45pm
No Dinner
 **It is suggested you bring your own lunch as eating opportunities
may vary depending on cases and number of available
anesthetists to feed. Furthermore, anesthetists may not become
free until after the cafeteria has closed.
 On a busy day and lack of lunch relief, you are not guaranteed a
30 minute lunch break at North.
 Please circle your name & what time you went to lunch on the
dry-erase Anesthesia Communication Board found in the Doctor’s
Lounge.
 If you leave before 11am, PLEASE check with Main to see if you
are needed to help with lunches.
 If you come to Main as lunch relief, you will be sent home after all
lunches are given. You will NOT be used to run another room or
added to the yellow sticky note list of available anesthetists.
However, this is not the case if you are pulled first thing in the
morning.
 If you are pulled to Main first thing in the morning (light day, case
cancellations, call-outs, etc.), you will be added to the appropriate
spot on the yellow sticky note list for the day. The appropriate
spot where a North person fits in, depends on the CURRENT
MATRIX.
 The North case schedule for the next day is reported by noon to
Mary, so you will typically be notified by the afternoon if you will
be pulled to Main the next day.
 If you are done at North for the day, PLEASE make sure your
coworkers at North have all had a break. You are to ask your
anesthesiologist for permission to leave & you are to notify the
front desk- either Melissa or Gloria, that you are leaving the
hospital.
 Cases should be added on by 3pm and completed by 5pm. If you
leave for the day- you may be called back for an add-on case or to
relieve a locum or a specific shift. Leaving the hospital at North
DOES NOT qualify as “Call-Back” time. This is because you are the
AVAILABLE anesthetist and we do not take call at North. See the
explanations below for corresponding “available” times.
WHO goes WHERE when we are running HOW many
Rooms?
We currently run 3 rooms at Phoebe North.
The positions are Early, Late, 5pm shift.
**Please see current Matrix as to where the PN people fit into the Main
daily schedule of anesthetists**
 If we run ONE room:
o The 5pm person is at North.
o The late person goes to Main & is “available” to relieve the 5pm
person if the late person is sent home before then.
o The early person goes to Main (see the current matrix).
 If we run TWO rooms:
o The 5pm person is at North.
o The late person is at North & is “available” to relieve the 5pm person
if the late person is sent home before then.
o The early person goes to Main (see current matrix).
 If we run THREE rooms:
o The 5pm person is at North.
o The late person is at North & is “available” to relieve the 5pm person
if the late person is sent home before then.
o The early person goes to North & is “available” until 3pm for add-on
cases.