A: If necessary, we are called and said "needs to be replaced, it fills up."
Q: Unless, the surgeon asks you to.
A: I think it's rare, that a surgeon will ask a guy to be in the room. If it's at a certain point, say at the very beginning of the surgery, you have to do some kind of position or some kind of accessory to do, but All in all, a guy doesn't need to stay inside the room.
Q: For changing the patient's postures.
A: It's at some point. So I say, if it's in a certain situation, which we have to say in the middle of the operation, then he's waiting in the middle of the operation. Just a few minutes ago, before he had to go to bed, he was called. But If it's right next to the beginning, then it stays, if not, then there's no need. Usually don't stay.
- Moreover, the description of the role presented by the respondent for the purpose of estimating the time includes quite a few actions in respect of which the respondent herself notes that they are not carried out regularly but only as needed (such as bringing equipment before the operation), and as we will see below, sometimes sanitaries and auxiliary workers assist each other in various activities or nurses and technicians perform the tasks of the nursery, and therefore the estimate of the times presented by the respondent is inaccurate.
- In fact, it is doubtful whether it is possible to estimate the time periods necessary for each type of analysis, in view of the wide range of actions and the intervals between the actions as described by the witnesses and by the documents presented by the respondent. We got the impression that the snitter's work is done intermittently and not necessarily sequentially throughout the surgery, while waiting for instructions both before, during, and at the end of the operation. Therefore, the respondent's argument that the value of the sanitizer's work for each surgery should be measured on the basis of the entire duration of the operation is incorrect. Later in the cross-examination, Mr. Canberra confirmed that, as a rule, the senator does not leave the operating room before the operation begins,[28] and when asked to estimate the period of time from the beginning of the patient's transportation to the operating room until the operation begins, he replied as follows: "... 10 minutes, 15 minutes maximum, if it's a regular surgery. There are more complicated surgeries, for example, blood vessels and hearts, so the guy stays until you start, and it's a matter of let's say half an hour. At least half an hour. Because the instrumentation technician is the one who actually helps all the time."[29] From the witness's statements, we learned that as a rule, the work of the satirist before the operation takes 10-15 minutes. Kanbura also noted that if the operation is delayed, the nurse does not necessarily wait in the room, but the nurse in charge may refer him to perform tasks in other operating rooms.[30] In other words, the respondent's claim that the sniper was required to wait with the patient until the operation began, is incorrect.
- We will also note the words of the witness later on, when he was asked about his knowledge of how the budget for the analysis of the budget is distributed: "... Guy, what does he actually do in the operating room? All he does is let the patient in and out... Two minutes, five minutes..."It [31] should not be ignored that the witness confirmed, as stated earlier in his testimony, that a sniper is responsible for additional tasks inside the operating room, but it is also difficult to ignore these things that were said in connection with the comparison between the work of the sanitar and the work of auxiliary forces, when according to the witness there is no material difference between the contribution of the two roles to the operating room. We found Mr. Kanbura's testimony fluent, eloquent, without evasions or contradictions, and therefore we gave great credence to his words. It should be noted that Mr. Kanbura's testimony also showed that the sniper's work is not necessarily performed in one operating room at any given time, but that it is possible that he will be assigned to several operating rooms at the same time.[32] This fact undermines the attempt to estimate the amount of time required for each operation, and at the very least, shows that it is practically difficult to quantify the time periods necessary for the sanitizer to perform the full range of actions necessary to transport the patient.
The Distinction Between a Regular Shift and a Regular Shift
- Since, during the regular shift, janitors and auxiliary workers earn the same salary, the respondent devoted a significant part of her arguments to show that there is a material difference between the work of the janitor in the extra shift and the regular shift, which further increases its value in comparison to the value of auxiliary work. According to her, during a regular shift, the nurse is not required to assist in the anesthesia procedures, while on the Katzat shift, anesthesia technicians are not present, and therefore the nurse is required to perform the operations in their place. But Mr. Kanbura's testimony paints a different picture: The witness explained that in the past, sanitizers were required to help with anesthesia even during the regular shift: "We were in the beginning, during my time, we also helped with anesthesia. This includes intubation, insertion of a tube into the patient, preparation of an anesthesia cart, anesthesia machine. After that the anesthesia technician came and we just moved aside, we said "OK, there are no certificates, but our experience is not important and we have no problem, we will continue to do what we do." All sorts of"[33] In other words, prior to the entry of anesthesia technicians (also known as 'instrumentation technicians') into the hospital's work, the nurses would perform the assistance in anesthesia operations on an ongoing basis even during regular shifts, and after the anesthesia technician entered regular work, these tasks were not fulfilled by the sanitaries. This implies that during the period relevant to this claim, sanitizers are not engaged in the regular shift in assisting with anesthesia operations. Later, when it was claimed before him that there was no anesthesia technician present at all during the surgery, the witness replied that "during my time there was an anesthesia technician who stayed for a few hours...",[34] and even when asked to confirm that there were no anesthesia technicians present in the surgery, he replied, "They are at the beginning of the operation, at the beginning of the anesthesia, and in a certain part they also come out...".[35] In other words, it emerges from these statements that anesthesia technicians are also present in the operation of the KAT. Indeed, the witness later confirmed that a sanitary practitioner should assist the anesthesiologist when an anesthesia technician is not on duty, when "it is illegal, but it is true,"[36] but implied that this is not a routine matter, but only when the anesthesia technician is not present. The Respondent did not present data indicating the frequency of the absence of anesthesia technicians from the Specialized Shifts. Beyond that, Mr. Feckler confirmed in his testimony that the position of technologist requires an apprenticeship of three years and an internship of six months,[37] so we found it difficult to accept the claim that a sanitary technician without any training performs the same job as an anesthesia technician on the KAT shift, including the operation of anesthesia devices(!), unless Mr. Peckler's testimony should be understood as referring to basic and minimal assistance to the anesthesiologist and under the strict guidance of the professional bodies. Thus, the difference presented by the Respondent between a regular shift and an allowance shift is significantly reduced.
- In fact, it emerged from Mr. Kanbura's testimony that there is not necessarily a defined division between tasks that support the surgery, or that there is no strict adherence to such a division, when he explained, for example, that actions relating to the connection of oxygen cylinders are under the responsibility of an instrumentation technician, but that sanitators will also perform these operations at times, and a task known as 'opening an operating field' is supposed to be performed by a nurse, but in practice an instrumentation technician sometimes performs the operation because there is cooperation between the staff members.[38] Moreover, even when the witness was asked whether the snitter was engaged in removing heavy equipment after the end of the operation, such as cameras, he replied that it was the job of an instrumentation technician, and if he was not there, "then the person who does it is a nurse and also a guy",[39] meaning that the sniper does not necessarily replace the anesthesia/instrumentation technician on the KAT's shift. This testimony is inconsistent with the description of the role of the snitter presented by the respondent.
- Beyond that, we did not find any explanation as to why anesthesia technicians/instrumentation technicians are not assigned to the CAT surgeries, when it was explained by the respondent's witnesses that the same staff members who perform the surgeries on the regular shifts also perform the CAT surgery. Moreover, the evidence shows that in parallel to the KAT's shift, there is a regular evening shift (i.e., in the afternoon) to perform routine surgeries in other operating rooms. Aren't anesthesia technicians/instrumentation embedded in those surgeries? Can't they also work in the Kaftat surgery if they are assigned to the evening shift anyway? These questions are not answered in the evidence presented by the respondent, but Mr. Feckler confirmed that "there is always a call technician who is present during these hours".[40]
- Marchenko's testimony also revealed that technicians sometimes work on the Transportation Maintenance Shift: "Technicians do not work on the Maintenance Shift, but in some cases, technicians do... I hear that sometimes anesthesiologists ask to come to a hole, that's how it's an anesthesia technician, but if an anesthesia technician isn't there, then it's a guy."[41] In other words, the work of the sanitary worker on the Katzat shift does not include in principle assistance to anesthesiologists, and this is done only if technicians are not available. On the basis of these words, we are not convinced that there are no anesthesia technicians in the surgery on an ongoing basis, or that sanitizers necessarily perform additional tasks beyond those performed by them in the morning. From Mr. Kanbura's testimony, we got the impression that the work of the Special Operations Unit is essentially similar to the work required in the morning shift, and Mr. Feckler also confirmed that with the exception of the operation of anesthesia equipment, "[the sanitar] does the same job" as in the morning shift.[42]
- Beyond the Respondent's claim that as a rule, sanitary workers perform more tasks during the Reserve Duty shift, a claim that we do not accept at this stage, the Respondent also claims that the auxiliary workers perform fewer tasks in the Reserve Duty shift compared to the regular shift, since they do not engage in any tasks other than cleaning the operating rooms. However, Ms. Marchenko's testimony revealed a different picture:
A: I need to check that there is equipment required. It's usually the same employee, who works the morning shift and stays for the security guards, so my job in the morning shift is to check that there is nothing missing for the special needs as well, to order equipment, to make sure I received equipment, to dismantle the equipment...