goats'r'us

Patients always look at me askance when the anaesthetist puts in their IV and then asks me for a toilet seat. I used to try to explain, now i just show them this and they laugh.

it's more important to know what things do than what they're called. focus on that :)

Ha ha, i remembered another one.. Peekers. our theatre doors have little windows in them, and i get so so cross when i'm in the middle of a stressful emergency case and i look up at the door to see three or four faces peeking through. not trying to be nosy about the case, just checking up on me. on more than one occasion i've had to pull dagger eyes and wave in an unmistakable 'eff off' manner, and once, when that didn't work i had to call them into the room to ask 'is there a problem? no? then GO AWAY, I'M TRYING TO CONCENTRATE ON CLIPPING A FRIGGING ANEURYSM!' i used to work with a lovely german lady who, if someone tried to take something off her trolley, would slap their hand and say 'this is not tesco'. i'm often tempted to shoo people away with a brisk, german accented 'this is not cinema'

i have a lot of little peeves, most of them so petty that i feel silly about bringing them up, but they make me so cross! *med students/junior doctors who, while scrubbed, try to take instruments from me to pass to the surgeon. i know they're trying to help and feel involved, but i'm keeping track of what goes up and comes back, and also am handing the instrument properly, so that the surgeon doesn't have to look at it or turn it around to use it. *people who undo the back of my gown as soon as i push my trolley away from the table at the end of the case. i know you'e trying to help, but I'd like to keep it on to protect my clothes and my skin while i'm tidying my trays and throwing out gross stuff, but now its falling off my shoulders in a most annoying way and i'm tripping over the hem. *people who come and start throwing thing out off my trolley at the end of the case. i know you're trying to help, but i've got mess everywhere, still have sharps on the table, and am trying to put my trays back together and do a final check with myself that everything's back where it belongs. *med students/junior doctors/assistant surgeons/scout nurses who repeat everything the consultant asks for. i know he wants a forcep, i heard him ask for it too, which is why I’m holding it right now, and don’t you worry, just as soon as he puts his hand out, I’ll give it to him. *scout nurses who pick and choose what they think I’ll need out of the pile of stuff I’ve put out to be opened at the start of a case. I’m trying to make it easy for them, I’ve asked the surgeon what they want, and have selected the stuff I’d like to have opened and put it all in one place, ready for my scout to just go ‘bam, bam, bam’, but no, they’d rather pick and choose what they think I’ll want, so that at the start of the case I’m still standing there looking disorganised asking for things. *scout nurses who think that the most important thing to open at the start of a crash caesarean is the surgeon’s gloves so that they don’t have to go through the trauma of putting on their gown, when turning 90degrees to their left to take their gloves from the scout. Sure, its nice to have everything ready for the surgeon, but I’m sure they’d prefer I had the caesarean tray and a blade. *surgeons who ask for something they want in 5 minutes time. We have a surgeon who does this all the time. He’ll say ‘prepare the 3/0 vicryl’, then a minute later will put out his hand. So you give him the 3/0 vicryl, and he looks at you like you’re an idiot because what he wants is a scissor, then a haemostat, then a tie, then a suture scissor, THEN a 3/0 vicryl. *people who tell people what I want without asking me. ‘oh no, goats doesn’t like doing craniotomies’ (news to me. actually I really enjoy them. Even the scary ones). ‘no, goats won’t want to work with that surgeon, he’s rude and mean’ (he’s rude and mean to YOU because you don’t know what you’re doing and you insist on calling him ‘sir’. He’s perfectly civil to me and I’d much rather work with him that one of his whingey colleagues, who refuse to acknowledge my presence because I refuse to pander to their whining). this one goes for real life too. *people who confuse me wanting to do things the right/safe/legal way with being a control freak. *people who try to perform a surgical count without referring to the count sheet. I know you trust your memory, but I don’t trust it! I know I’ve been guilty of it once or twice in speedy little cases, but at the end of a four hour laparotomy where multiple staff have opened extra items for me, I just think it’d be a nice idea for you to peek at the count sheet as we go. I try to explain that it’s best practice – I’m just being stubborn. I try to refer to the ACORN standards – I’m just being difficult. I try to explain that I’ve done a case before where the scout counted everything without referring to the count sheet, then went back to the bench and wrote all the numbers in as correct according to the count sheet, only for me to find another hypodermic on my trolley that we hadn’t counted in our second count.. but don’t worry, despite not counting it, my scout had written it in as present J *people who don’t use professional language/legible penmanship/correct spelling on paperwork. I should not have to tell an experienced colleague not to scribble things out, nor should I have to explain that in the event that a laparoscopic bowel resection goes open, the procedure should be stated as ‘laparoscopic bowel resection converted to open procedure’. And for Pete’s sake, its ‘Lower uterine segment caesarean section, live female infant delivered @.....’ not ‘LUCS, baby girl born @....’ the diathermy plate is not on the patient’s bottom, and that labial abrasion you noticed when you put the catheter in is not a ‘reddened lady parts’. *people who take extra-long breaks when we’re running a really fast-paced list. Sure, there are times when I won’t mind if you take an extra couple of minutes, have one more biscuit, tell one last bit of gossip, but when you know you’ve left me running my tail off with a narky surgeon, I mind. *people who flat-out refuse to work in a specialty. I do a bit of everything, and I really don’t see why you cant too. Wow.. what a debrief! There’s probably more too!

fournier's gangrene debridement. I will never forget those two sad, uncovered testicles.

i've heard this one too, and there are a few surgeons who go with it, but most use saline. i got similar crazy looks when i started at a new hospital and found that they use saline in neurosurgery. i was taught at my previous hospital that ringers solution is the closest thing to CSF so should always be used in neuro, but my new hospital didn't even stock it!

i can tell you exactly why this happened. time is money. my hospital has a policy that before the patient can be brought up from the waiting bay to the anaesthetic room, the surgical site must be marked and initialled by the surgeon, and the consent must be signed. If this has not been done, the anaesthetic nurse cannot bring the patient up, therefore the anaesthetic reg cannot begin doing anaestheticy things like putting in lines while the consultant finishes up the previous case, which increases changeover time. so, technically, if there is a signed (albeit incorrect) consent, the nurse can bring the patient up to start non-sedatey anaesthetic stuff, rather than waiting for the surgeon to finish the case and make their way down to correct the situation. it's not like they're going to medicate the patient or anything, right? and the patient can talk still talk to the surgeon in the anaesthetic room, so where's the harm? so wrong!! policies are in place for a reason, and basically this nurse is bending the rules to save a bit of time wastage and reduce hassle for herself. one of the reasons why my hospital has this policy is that it's been decided that when the patient's already got changed, waited in the waiting bay, been checked through to the anaesthetic room and essentially had their anaesthetic started, their consent is no longer being given freely and without pressure. bottom line. the nurse should 1) not be consenting you in the first place, that's the doctor's responsibility, 2) the nurse should not have allowed you to progress through to the anaesthetic room with an incorrect consent (and she knows it), and 3) stand up for yourself - you shouldn't have signed the incorrect consent form (and you know it!).

i got busted the other day turning around so that my body was aligned the same way as the patient's so that i could work out which side the diathermy plate was on and which arm was on an arm board.

it's funny, i work in theatres and i see a lot of stuff that most people would think is really gross, spanning a wide range from your run-of-the-mill 'where does all the poo come from?', though ridiculous random injuries, and finishing in bad smells, but there are two things today that have truly turned my stomach: footage of this round's AFL injuries which included a spectacular hyperextension of a knee and an absolutely vile ankle dislocation, and my brother-in-law (a jewelerry-store manager) talking about the dead skin he finds in the links of watch bands.

hello all! I've been reading these threads for years, and for the most part have managed to translate your american qualifications, medications and abbreviations into australianisms well enough to understand what it is that you're saying. However, it had just occurred to me that there is one thing that you all talk about that is beyond me.. The pyxis machine. but it's ok, in my head i've worked out what it looks like and how it works: it looks like the lovechild of a dalek and C3PO, with lots of shiny chrome and blue lights and has a little drawer that pops out with whatever medication you may require at the touch of a button. am i close?

update, since i've just returned to look at this thread.. she's now closing in on 2kg, weaning off CPAP really well and in an open cot! mum and dad get to see her whole face!!

ok, i googled it. that's new! how exciting for you!

i'm confused. UTAS is University of Tasmania - how is it that they have a Sydney campus?

now, to the OP (and other interviewers), you touched on something dear to my heart, and my face. my nose stud. before having it done, i checked my work's uniform policy, and made sure to use a discreet little stud. nobody mentioned it once it was done, and i have had no indication from anybody in management that it is a problem. say you were interviewing for another job, how would you feel about me just asking in the interview if it is a problem? or would you just see it and think 'strike 1'?

i'm no expert on interview technique (i interview terribly due to nerves, and am always surprised when i get a job!) but i'm guessing what the OP means isn't so much 'be sure to wear make-up' as 'take a bit of pride in your appearance'. i don't really wear make-up, i can't wear it at work because i work in theatres and it just rubs off on my mask and then i look half-done and silly, and so generally forget to wear it in real life, but there is no way i would turn up to an interview looking like i haven't glanced in a mirror on my way past it!