Cancelled Cases

Armed guards were all over-couldn't get too close.

The week is flying by already and it seems that things are starting to wind down.  Today was relatively light around the town following the election.  The ballots are being brought to the National Elections Center which is right across the street from me and there are so many armed military guards right outside.  I wanted to go around and take pictures, but I didn't want any drama so I mostly stared around.  Sounds like there weren't too many issues at the polls and things moved along relatively well.  Some of the people were telling me that some polls closed even with people still in line who didn't get to cast their vote which caused some commotion.  Overall though it seemed uneventful.

Today at the hospital everyone is doing well on rounds.  Many of the patients are still in the hospital and usually will stay there a couple of weeks until their incisions are all healed because the risk of infection when they leave is pretty high.  It's interesting here that most patients aren't eager to get out of the hospital because many of them have better food and a place to sleep more so than they do at home.  I can only imagine how that would go over back in the States!

Overall it was another frustrating day in the OR.  The first patient was up and ready to go before 8am and I was a hopeful that we could start actually on time today, but then reality hit again-the staff came in late and it wasn't until after 9am that the patient was in the room.  It wasn't until the patient was on the table that the anesthesiologist asks the patient the last time that he had eaten...the patient had a bowl of soup this morning!  Case cancelled....
The frustrations, albeit expected, are beginning to mount and I'm making note of everything so I know what to address at the end of the week during my debriefing with the HEARTT team.  The second case had been canceled a few times and was next up, but we had to wait until General Surgery finished 2 of their cases before we could proceed with mine.  They can only do one case at a time under general anesthesia so its another source for delay with only one anesthesia machine working.  I had the driver take me back to the hotel where I did some work on the computer.  When they called me back saying that they were ready for my next case I went back to hospital to find that our patient had been canceled!  The anesthesiologist cancelled the case once the patient was on the table and his blood pressure had become erratic.  2 cases cancelled today on the table.

I went back to the hotel for the second time a bit disgruntled at another frustrating day.  I spent the rest of the day working on a presentation that I'm planning to give to the team I'm recruiting already for the next trip.  It's a bit unpredictable how efficient I can be working alone especially when relying on so many other folks of varying work ethic.  I'm planning to bring my own team next time and have the more chronic complex cases set up for me when we return.  We'll be able to do the acute emergent cases more efficiently as well.

Looking forward to the next couple of days as I'm sure there's still good work and planning to be done.  Not going to let the frustrations hamstring the primary focus.