I don’t know about you, but I hate that we are already being bombarded with holiday stuff.  I just put my bathing suit away, realize that I am not in love with my winter wardrobe (I blame my wardrobe woes on too many years in scrubs every day), and just turned the air conditioner off, and smelled that burn-the-dust-off-the-heater smell.  I do love the changing leaves, and I’ve had the fireplace on a couple of times (we southerners do not cope with cold well), and I am beginning to think about Thanksgiving meal planning and promising myself I won’t stress myself out with procrastination this season.

With the holiday season comes surgical challenges. Every year its about the same:  everyone decides that elective surgery is now a good plan.  They’ve met their deductibles in full, there’s a little money left in their HSA, and they can add a couple of days to their vacation time  to recover.

Meanwhile, your staff has family coming in, they want to plan a trip away and need some time off, and everyone’s schedules are growing.  To make your holidays less stressful, I’ve decided to open up my school of hard knocks knapsack, and pull out my old and tattered notes, and share what I learned that may help.

Add on cases:  If you don’t have a clear formula for how cases are added, now is the time.  Having a cut off date and time for adding cases will allow for better staff planning and less last minute preparation.  If you do have a clear policy, now is the time to kindly remind everyone of it as the schedule is getting busier.  Setting clear expectations of when cases can be added will decrease staffing challenges, as well as reduce staff time in having to prepare for last minute surgeries.  Getting physician and anesthesia buy-in is key.  Remind everyone that the goal is  a uniform plan for how the schedule is managed, so that increased workloads can be better managed.

Late days:  As the schedule grows, so do late days.  The easiest way to have staff morale suffer is to work everyone late all the time.  If your center doesn’t have it, assign late days, and allow staff to switch days to meet their personal needs.  Keep snacks around so folks can grab a quick nibble between cases.  If everyone must work late, buy them dinner.  If your budget allows, propose a late differential  to soften the blow and get your staff some more holiday dollars.

Plan Ahead:  Plan your staffing through the end of the year, identify needs, and get them covered now.  The later you get into the holiday season, the harder those needs are to fill.

Communicate:  Talk to your staff, your leadership team, your schedulers and your physicians.  Remind everyone that the goal is the same:  coordinated safe patient care.  Take the time to discuss your plans to manage the time effectively, and get buy-in from everyone before the time comes.  Being proactive may help prevent a tug of war when censuses are up and staffing and patience is thin.

Have a back-up plan:  If you don’t have an agreement with a staffing agency, look into one.   You won’t be obligated financially unless you use the service.  Check with colleagues to see who they recommend.  Make sure their staff has the right experience.  If you do use contract labor and have a good vendor, touch base with your contact person to see how equipped they are to back you up.

Supplies:  Make sure that you have the supplies you need to get you through.  Don’t forget medications and fluids on allocation, and anything on direct ship that may need to be increased.  If you use implants or need trays brought in, be as proactive as possible and make arrangements early.   Have your Materials Manager review your stock, and plan now for the schedule ahead.

And my last bit of advice:

Your time.  Plan the weeks ahead through the end of the year for yourself.  Break out your tasks into manageable pieces over the weeks ahead.  Schedule some early days or a day or two off to fit in some errands and shopping, so you don’t feel the crunch as much.  Then, take a deep breath, smile, and put it all in perspective.  You’ve got this!

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