I just can't believe this one!

[Scrubby]

Heres the scenario:

30 year old patients has hernia repair. Is a very tall and large man, quite scary looking not surprising given that he is a prisoner.

Anyway procedure goes well, then it's time for waking up.

He was quite combative and there were three nurses myself included trying to keep him from falling of the OR table. He's kicking, punching and trying to jump off the bed. This started happening before we could bring his bed into the room. If this happens on a bed we put pillows next to side rails and just let them kick out all they want. But on an OR table they can quite easily fall off and it's hard getting them up off the floor.

I'm on one side (patient is facing me) trying to hold his legs without being kicked in the face. The other two nurses are on the other side as he is almost slipping off. They didn't want to push him onto me as I'm holding his legs on and trying to avoid being kicked.

The anaesthetists is maintaining the airway. I got an intern to protect the arm on my side as he was waving it around everywhere.

So where are the surgeons during all this ruckus?

Why sitting at the desk, one was on the phone the other was doing paperwork.

As soon as it started happening I yelled out 'we need assistance'. I have a very loud voice you'd have to be pretty hard of hearing not to hear me bellow.

No response from them whatsoever. And they weren't facing the other direction either :angryfire

I yelled out again 'we need a hand here'.

And again.

No response. Other nurses were yelling out for help too at this point. The only people free to press the emergency alarm were the surgeons who didn't move to help us, let alone ring the alarm (they probably don't know how to press the button anyway).

At this point I'm fearing an injury to myself as his legs were kicking towards me and I'm almost ready to step aside and just let the patient fall on the floor. May sound bad but I'm not being a hero and risking a permanent injury.

I just lost it at this point.

"GET OFF YOUR LAZY orificeS AND GET HERE NOW!!!!!!!!!!!!"

Pardon my french but it worked (one gave me an odd look like what's wrong with you?) but I'm just feeling so disgusted with the lack of teamwork and care they demonstrated towards patient and staff. I don't know whether it's because they believe they are above simple things like making sure the patient is safe after surgery or if it's just them being oblivious. I don't know. But what annoys me is that I had no chance at all today to talk to them about this.

My back, shoulders and neck is aching from holding his legs down. I'm filling out a workplace injury form and I'm going to making a report to someone about this.

And I did not apologise for my language and have no intentions of it. To have to yell out for help 4 times and be ignored while we have a patient who is about to fall off the table, staff who are struggling not to be injured is just unbelievable. If they try discipling me for yelling at them I will explain that I asked nicely to begin with, even said please but their lack of respect and the situation at the time left me no choice but to resort to shock tactics.

Anyway that's what happened today.

Any similar stories? Do your doctors just sit there and do nothing as well?

[Ruby Vee, BSN]

maybe it's because i'm older now, but i haven't had these kinds of problems in years. i think i would have yelled "hey joe, we need some help over here right now." calling them by name indicates that yes, you *do* mean them. but one would think that with all their education, they would have noticed your need for help and just jumped in there.

years ago, i had a 400 pound patient on a balloon pump being evaluated by anesthesia for cardiac surgery. the anesthesiologist demanded "sit him up so i can listen to his lungs." no please, thank you or any sort of "softening." nor did he call me by name.

i replied that i couldn't sit him up due to the large iab in his femoral artery, "but i'll be happy to help you roll him on his side so you can listen."

he threw a complete fit, calling into question my education, licensure, professionalism, ethics and intelligence and ended with "you wouldn't ask dr. smith (medical director of our icu) to help you turn a patient so why would you ask me?"

it just so happened that dr. smith was right outside the room and had heard most of the tirade. i've never been so happy to see him as when he slipped into the room behind dr. donkey, the anesthesiologist and said "i'm right here, ruby. what do you need help with?" and he helped me turn the patient so the anesthesiologist could listen. i never again had a similar problem with any physician when i worked in that hospital. seems that dr. smith had a "come to jesus meeting" with the medical staff and let them know it wouldn't be tolerated.

now, i expect i remind the younger physicians of their mothers and the older ones who know me wouldn't dream of messing with me. but i would not hesitate to ask anyone with a name tag to help me if it was a safety issue, and clearly it was. next time, yell their first names when you ask them to help.

[prmenrs, RN]

I do think they need to hear their name--otherwise, they just don't pay att'n. Even "HEY, DOC!!" would probably work.

Yes, it would be lovely if they were more cognizant of their surroundings, but ya gotta work w/what ya got.

[morte, LPN, LVN]

the OP is in OZ, i wonder if that makes a difference with the guard thing?

[skipaway]

I'm sorry this happened to you all. As a CRNA, I'd have re-sedated the man, moved him to the larger bed and then allowed him to wake up again. Might have saved you some sore muscles.

[PICNICRN, BSN, RN]

maybe it's because i'm older now, but i haven't had these kinds of problems in years. i think i would have yelled "hey joe, we need some help over here right now." calling them by name indicates that yes, you *do* mean them. but one would think that with all their education, they would have noticed your need for help and just jumped in there.

years ago, i had a 400 pound patient on a balloon pump being evaluated by anesthesia for cardiac surgery. the anesthesiologist demanded "sit him up so i can listen to his lungs." no please, thank you or any sort of "softening." nor did he call me by name.

i replied that i couldn't sit him up due to the large iab in his femoral artery, "but i'll be happy to help you roll him on his side so you can listen."

he threw a complete fit, calling into question my education, licensure, professionalism, ethics and intelligence and ended with "you wouldn't ask dr. smith (medical director of our icu) to help you turn a patient so why would you ask me?"

it just so happened that dr. smith was right outside the room and had heard most of the tirade. i've never been so happy to see him as when he slipped into the room behind dr. donkey, the anesthesiologist and said "i'm right here, ruby. what do you need help with?" and he helped me turn the patient so the anesthesiologist could listen. i never again had a similar problem with any physician when i worked in that hospital. seems that dr. smith had a "come to jesus meeting" with the medical staff and let them know it wouldn't be tolerated.

now, i expect i remind the younger physicians of their mothers and the older ones who know me wouldn't dream of messing with me. but i would not hesitate to ask anyone with a name tag to help me if it was a safety issue, and clearly it was. next time, yell their first names when you ask them to help.

the unit where i work the residents are informed on their very first day that the nurses are not their slaves. all of the docs are expected to gather their own supplies for a procedure and set up and clean up after themselves- surgeons, intensivists, neurosurg, residents, fellows, whatever! our medical director feels strongly that the bedside rn needs to be at the bedside for that pt to maintain the airway, give meds, silence alarms or whatever it is we might be doing as the doc prepairs for the procedure. one time a new cv fellow came to my pt's bedside to place a chest tube- obviously i was busy with the pt as they needed an emergent chest tube. this surgeon just stood there and said " i'll need a size 14 ct, some betadine, a 10 blade, bla bla bla" and looked at me and the rt who are bagging the kid and pushing fluid.oh yes... let me stop what i'm doing and go gather your supplies for you while you do what?? so the intensivist stepped in and said " dr. sonso, let me show you where you can find all of your supplies."

some doctors just think they are superior to everyone else! you know that these two docs knew exactly that you were talking to them but did nothing! what jerks i think ruby was right- call them by name that way there is no question!!

hope you are feeling better, btw turning in an incident report with your injuries was a good idea!

[RN1982]

The residents are told almost the same thing. They are told that they are "guests" and this is the nurses' hospital.

[Scrubby]

The hospital policy on prison guards is that they escort the patient into the OR, they wait until they are general anaesthesia then they go the recovery unit and wait for the patient there.

I actually believe that it IS the surgeons responsibility as much as it's anyone elses to ensure that the patient is safe before, during and after the procedure because we are all part of the operating room team. This means helping with transfers and if a patient gets combative, helping them. Most surgeons I've worked with are actually pretty good at helping us out. This view is also held by the head surgeon of general theatres and I've seen him make the younger guys help the nurses out.

I did speak with the two surgeons today. I told them that they were not focusing on out patient and that I felt left alone in a dangerous situation without their help. They apologies and I told them in future to keep an eye on what is going on around them. The sad thing is that I have a good working relationship with these guys normally.

Next time I'll try and remember to call people by name....

[Scrubby]

years ago, i had a 400 pound patient on a balloon pump being evaluated by anesthesia for cardiac surgery. the anesthesiologist demanded "sit him up so i can listen to his lungs." no please, thank you or any sort of "softening." nor did he call me by name.

i replied that i couldn't sit him up due to the large iab in his femoral artery, "but i'll be happy to help you roll him on his side so you can listen."

he threw a complete fit, calling into question my education, licensure, professionalism, ethics and intelligence and ended with "you wouldn't ask dr. smith (medical director of our icu) to help you turn a patient so why would you ask me?"

it just so happened that dr. smith was right outside the room and had heard most of the tirade. i've never been so happy to see him as when he slipped into the room behind dr. donkey, the anesthesiologist and said "i'm right here, ruby. what do you need help with?" and he helped me turn the patient so the anesthesiologist could listen. i never again had a similar problem with any physician when i worked in that hospital. seems that dr. smith had a "come to jesus meeting" with the medical staff and let them know it wouldn't be tolerated.

ha ha love that story, i can just imagine the look on dr donkeys face!

[lolalolacherrycola]

You go girl! What else were you suppose to do, just stand there and hold his legs until you either tired out or he fell?? You did the right thing... although I may not have called them lazy orifices.. LOL :)

"if the shoe fits"...which in this case it certainly did!

[RNKel, ASN, RN]

The only thing I can think of (playing devil's advocate) is that hearing "we need some assistance" wouldn't bring a great amount of urgency... if they heard shouts of "WE NEED SOME HELP HERE NOW!!", that might get someone moving. Just my opinion.

[rnmi2004]

I'd assume the surgeons sat there because they were cowards, not because they're lazy. Hopefully they're ashamed enough that if something like that happens again they'll get in there & help.

[lolalolacherrycola]

I'd assume the surgeons sat there because they were cowards, not because they're lazy. Hopefully they're ashamed enough that if something like that happens again they'll get in there & help.

I don't think surgeons are in to doing any actual manual labor like restraining someone...but yes, cowards as well!