Dear Surgeon

Oh yeah been there many times. 40 yrs exp. But you have to do whats best for your patient. The Doc may be an ass but the patient counts on us.

When you are given no notice that the case will be done laparoscopic and the patient is already in the OR this is not doing the best by the patient. Anaesthetist was told several hours earlier yet assumed surgeon had told us.

I'm not talking about a chole or appendix here. I can throw a basket of extras together in very little time. This was a gastric bypass and the preferences are two pages long.

I filed a complaint against the surgical team and recommended that Not only did they not acknowledge how this caused a great deal of stress but they didn't show us any support. A simple thankyou goes a long with me. To top it off surgeon comes mincing into the theatre while I'm tearing around getting supplies and started to tell me how he wanted some suture that is hard to get,some port that we don't have. I told him we don't have it, he started to whinge about how he uses it in private and I told him that he needs to give my team more notice, not 5 minutes after the patient comes in.

This sounds like an adverse patient event that should be reported immediately to the appropriate administrator or patient safety committee. Gee, I hope it doesn't create too much additional headache and paperwork for the surgeon...

Definitely report this. As soon as you get Risk Management involved, an investigation can be conducted. The last thing the hospital wants is a lawsuit!!! Always CYA (cover your ass) with documentation...

There was no adverse event because I was able to get relief so I could run out and get a set up.

The fact is it caused a lot of unnecessary stress. We have 'disrespectful behaviour' forms and I've written this up as a clear case of failing to communicate with staff re: change of procedure, causing significantly high levels of stress amongst nursing staff. The patient was not harmed because we were able to deal with the issue-at expense of morale. This isn't the first time this particular surgeon has done this, he came in one time after the patient was anaesthetised, we were all set up and he said 'this is supposed to be laparoscopic'. The operating list and consent said open. I am going to use this report as a means to deal with this because it is getting beyond a joke.

Anyway thanks for letting me vent. Yesterday was quite literally the worst day I've had this year. We had a lap adrenelectomy before this case that had to go open in a hurry, both me and the other nurse I was with were left short staffed because another OR was hogging the relief staff and this just made things worse.