In the world of anesthesia, issues can arise FAST and without warning. Just as this holds true inside the operating room, chaos can also ensue outside the OR. One example is in personnel and staffing. In my years as an anesthesiologist, team members have suddenly died, have been found unresponsive in the call room, have gotten kicked out of the hospital for behavior issues and myriad other things. These happened without warning and without the requisite notice. Without a backup plan, our anesthesia department would have been sunk. If you are in a large city with many providers, these types of crises can be easier to recover from. However, if you are in a smaller or rural area with fewer anesthesia providers, personnel issues can be catastrophic.
To be best prepared for sudden staffing shortages, I have learned over the years to do what I like to call, “building the bench.” What is, “building the bench,” you ask?
It means having a “bench” of backup anesthesia providers who are credentialed and ready to work at a moment’s notice. It is a similar concept to your favorite sporting team having depth in case first-string players get injured. The bench serves two functions: the first is for PRN coverage when needed and the second is to have a pool of providers from which to hire. These anesthesia providers know us and we know them. Having a “bench” is a great trial run for both parties and if hired, the credentialing process is eliminated. As you are likely aware, credentialing can be a significant roadblock and take many months to complete, so having your “benched” providers already finished with this arduous process is a major perk. Also, you have the ability to recruit your “benched” providers without using an agency, thus saving on recruiter fees whether for locums or for permanent hires.
This past year, COVID-19 revealed another bonus use for our bench. We had a new startup hospital and used some of our current full-time anesthesia team members to work at the new startup. Some were extra because of slowdowns in our case volume. We then backfilled with our “bench” providers when we needed help at the current sites. This resulted in making startup staffing easier and we were able to send our strongest providers to the startup—a SWAT team, if you will, for the startup. Without the bench, we would have been rolling the dice with unknown providers at our startup hospitals.
I like to keep in contact with the providers on my bench and work them whenever I can. The business of anesthesia relies strongly on relationships in order to be successful and this commitment to fostering mutually beneficial relationships applies to the building the “bench.” The providers on your “bench” should be kept in the loop on the current affairs of your group and facility and be made to feel as though they are valuable team members.
How do you find people for your bench? Ask! Ask your current anesthesia department team members if they have friends in the industry who would like to come work. Ask your colleagues from other facilities. Advertise. Develop relationships. Before COVID-19, conferences were a great way to meet colleagues, and there are still opportunities to do so through virtual events. Professional staffing agencies can be used as well. The key is to have providers on your “bench” credentialed and ready to go.
Having a “bench” is similar to having the backup oxygen tank on your anesthesia machine. As anesthesia providers, we know how to be prepared in case of an emergency. We are always anticipating what could happen next and thinking through our next move. A catastrophic staffing event can be easily and seamlessly avoided by building a “bench.”