On hearing this comment, what is the most appropriate action to take?
You are the instrument nurse for a laparoscopic hemicolectomy and are organising equipment for the procedure.
What will be an ideal response?
Answer:
Alert the circulating nurse to make sure that a laparotomy tray, additional suction and sponges are available in case the surgeon decides to open the patient: this demonstrates good situational awareness. If the surgeon needs to open the patient, the additional equipment can be opened quickly, with less chance that the patient's condition will be compromised by any delay in obtaining equipment.
The procedure does proceed to an open hemicolectomy. As the surgeon commences closing the patient, you undertake your first closing count with the circulating nurse and discover that a sponge is missing. You bring this to the attention of the surgeon and request she search the surgical site. The surgeon tells you quite abruptly that you have made a mistake and there is no sponge left inside the patient. You tell the surgeon that you have recounted to be certain and the sponge is missing. The surgeon is getting more irate with you and refuses to search the site.
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