By Christopher Walters
We work in an environment where the result of not doing our job can lead to patients being injured; a doctor or facility facing a lawsuit; or a facility losing its accreditation and insurance coverage.
I have been a biomed for over 2 decades. I started at 15, helping to work on Puritan Bennet 7200s at a hospital in Brooklyn. Thirty-two years later, which included college, I’ve seen a lot working at five hospitals, two manufacturers and five third-party or ISOs. I’ve seen quite a bit from multiple perspectives and MedWrench remains a valuable tool for me and my team.
Some of the issues I’ve seen are technicians skipping device testing; overlooking accessories and consumables that are damaged, failing or expired; lack of test equipment; wrong test equipment being used; and no or poor, documentation.
I’ve watched coworkers follow every step of a service manual’s periodic maintenance instructions. I’ve watched coworkers stare at a device, turn it on/off, slap a sticker on it and call it a day. I’ve witnessed everything in between those two extremes. Sometimes the skipping of steps or tests was because of a lack of test equipment, lack of training or just lack of integrity.
Another aspect to properly inspecting devices is to uncover problems with the device or it’s accessories before the device might fail while in use. A service technician, doing their job, prevents downtime and generates extra revenue for their employer. He or she uncovers expired pads, expired or failing batteries and damaged accessories such as lead wires. If a device fails to work during a case, the case can now take longer and that increases the possibility of harm to the patient. A user must locate a replacement device or stop/cancel the case. This costs money and puts an undue hardship on the patient. They now have to take more time off work to come back for the surgery, exam, etc. Now imagine if instead of an operating room or exam room, this failure happens in the emergency room. Such an event could be catastrophic. Would you want your wife/husband, son/daughter, mother/father, etc. to be fighting for their life in that scenario? I’ve been there and I absolutely do not want to have that result.
Some of those companies and biomed shops haven’t had the specific test equipment or accessories and we’ve either made our own (test rigs from expired pads, ESU REM cables, etc.). When specific test equipment wasn’t available, the device became electrical safety only. I’ve also witnessed techs using the wrong test equipment (like an O2 analyzer on a neopuff – a respiratory pressure device for newborns). Bringing this up to the tech, led to my getting canned but the backstabbing and office politics are a story for another time.
So, what do each of you do when you don’t have the proper test equipment, accessories, training, etc.?
I’ve learned many things in my time, not just in this career but a few other career fields I’ve worked in. Of those, I was taught to fully document what I do and to test as far as I can, and to seek out advice, or assistance when needed. These days I find myself as the one giving out the assistance and knowledge.
Without proper documentation, any work you’ve done counts for nothing. Now, a work order should tell a clear, easy-to-follow story. Something a user, inspector or lawyer can easily read and understand. We need to take every job seriously and documentation is major aspect of that. Proper documentation allows a customer to give inspectors what they need, to maintain accreditation and insurance. It also defends us in court in case of a malpractice or negligence suit. I’ve heard from many companies and medical centers about their issues with technicians not documenting properly, or at all. I’ve also looked over other people’s work orders. If I have to go on a service call, I want as much information as possible as I can get. The information means that I show up prepared. After all the 6 Ps (Proper Preparation Prevents Piss Poor Performance) applies every day. It also means I can spend less time on a call and not necessarily have to worry about having to return.
I was also taught to treat every device as if a family member could be using it one day. As a single parent to a special-needs child, I’ve experienced my son needing several different medical devices. Some that I have not tested and some that I have. We have many devices in our home and because of my career, I’m able to understand and adjust them as necessary. This has become particularly useful when in a PICU. I’m able to have equipment added to or removed from my child’s care, and train/instruct staff on its use. I’ve checked for current PM labels, visual inspection of devices, etc. And this has made a difference in his care and current quality of life. This I could talk about all day, every day.
These are lessons I’ve carried throughout my career.
