dure in which patients will be in the prone position, we ask them to
demonstrate how they'll hold their arms during surgery. Patients must
be comfortable extending both of their arms into right angles. If there's
any pain or discomfort that could potentially lead to problems during
the surgery, we learn about it during this demonstration phase and
note it for our team.
Transfer station
Positioning problems are like an avalanche. If you start off on the
wrong foot, you're often forced to move the patient over and over in
an attempt to get it right. And nothing puts you behind the 8-ball like a
poor transfer from stretcher to table, either by overshooting or under-
shooting the distance between the two. To avoid problems here, you
need to have a solid awareness of the patient's width in relation to
flipping them over. If your patient's width is 12 inches, they're only
going to flip 12 inches during the transfer. If the span between patient
and table is greater than this, you're going to need to slide the patient
closer to the edge of the stretcher to achieve a smooth transfer. With
smaller patients, you'll often need to slide them right up to the very
edge of the stretcher before the flip to ensure everything lines up nice-
ly.
Method trumps mayhem
Before we changed things up, our positioning method was like an
orchestra where each musical section played a different song. The
anesthesia team would be adjusting the patient's head while the nurs-
ing team fiddled with the hip pads and the doctor worried about
something else entirely. Yes, everybody was doing their part, but they
weren't doing it together. Result: A whole lot of unnecessary readjust-
ments and, in too many cases, skin tears.
7 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 9
