1. Describe the type of service you provide in your anaesthetic/recovery room.
Spire Gatwick Park is a private hospital in Horley. We offer a wide variety of surgeries including orthopaedics, spinal, plastics, max fax, dental, gynaecology, urology, colorectal, vascular, ENT, bariatrics and corneoplastics, and we also have an anaesthetist who regularly does joint injections for pain. We also recover all the endoscopy patients who have sedation. The hospital is looking to develop a cardiac pacing service that will also have an impact on recovery. We recover inpatients and day cases. We do not operate on paediatrics in this hospital currently. We recover the High Dependency Unit (HDU) patients and stabilise them prior to transfer to HDU.
2. How is your unit set up?
The unit originally consisted of 6 bays. We are now reduced to 4; 2 are being used for theatre storage. We are hoping to get one back when the new storage project is completed. We have 3 theatres and an endoscopy room. Recovery sits in front of the theatre 2 anaesthetic room; theatres 1 and 3 are in close proximity. Each bay is set up with the same equipment. One monitor is capable of invasive monitoring. New monitoring is currently being sourced.
3. Introduce us to your team.
There are 3 contracted members of staff, 2 whole time equivalent and 1 part-time nurse in recovery. We have a team leader and 2 staff nurses. We have general porters who help bring patients to and from the theatre and recovery. Staffing levels on each shift depend on the number of theatres and patients expected. There can be 1–3 members of staff on duty in recovery at any one time. We very much rely on our anaesthetic practitioners to assist in recovery when we are short of staff. Our private hospital's entire medical staff is made up of consultants and we have an onsite Registered Medical Officer who looks after the medical needs in the absence of the consultants.
4. What are the daily clinical or managerial challenges you cope with in your unit?
The most challenging parts of my day incorporate staffing and ensuring that there are adequate staff on duty. This can be highly challenging as our lists change regularly with the addition of patients and the re-ordering of the list schedule. Staffing in the private sector seems to be more variable and challenging compared to when I worked in the NHS. The workload is unpredictable by nature.
Discharging patients back to the ward or day care can prove challenging on busy days, leading to a bottleneck in recovery, which is less than satisfactory as this will impact on the theatre lists, and therefore our finish time.
5. What part of your working day do you find the most rewarding?
The most rewarding part of my working day is recovering patients, and teaching and helping staff improve their knowledge and skills. Teaching tends to be on an ad hoc basis at the moment and as time allows. Recovery is a happy place to work where the mood is light and the staff are friendly.
6. How do you orientate learners to your unit and what provision do you have for ongoing education?
Learners are allocated to a member of staff. We start by showing them the most important places – the tea and coffee facilities and the changing rooms. We then start with resuscitation equipment, fire exits and basic orientation to recovery, the theatre suite in general and the wider hospital area. They then go through recovering patients with us and we teach skills appropriate to their educational needs and in line with their objectives. We meet regularly with them to discuss progress. As and when appropriate, we get the learners into the anaesthetic room and into the theatre to appreciate the patient pathway. New staff are supernumerary to the area for at least 4 weeks. We are in the process of updating the induction information package and pathway.
7. What was the last audit/research your unit took part in, and what were the outcomes?
We are starting to audit delayed discharges and will be developing a post-operative pain audit as well.
