There is sometimes a conflict of interest between business profits and clinical safety

In one Australian private day clinic, patients were being pushed through theatre, late into the afternoon.

Minor surgical procedures were being done, broken fingers fixed, colonoscopies, grommets placed in children’s ears. The patients were a mix of adults and children.

The surgeon was also an owner of the clinic.

The anaesthetist had complained several times about the large number of patients being put through surgery, especially late into the day. The surgeon had dismissed the concerns. After the last case left theatre, usually around five o’clock the surgeon, the anaesthetist and the majority of nurses left the building. Only one nurse was left in the clinic after hours, and a handful of patients.

Some patients recovered quickly from theatre. Some were slow to wake up. Some vomited severely after the anaesthetic. Others had no nausea at all.

All patients were different.

In between juggling recovering patients the nurse had to make phone calls to relatives, organise discharge paperwork and find patients their clothes and bags. She also had to monitor patients still recovering from an anaesthetic. If they needed extra drugs she had to ring the surgeon and get a phone order.

It was unsafe, and the nurse complained to the surgeon numerous times.

“You’re an experienced nurse” he replied, “you can handle it”.

The nurse explained that some of the patients were children, and if something went wrong like a blocked airway, all she could do was call an ambulance and wait for them to turn up. The surgeon refused to hire more staff.

Eventually the nurse left the clinic to work in a public theatre, where nurse to patient ratios were standardised.

© Wikihospitals 2014.