Specialties Operating Room
Published Sep 8, 2010
canesdukegirl, BSN, RN
1 Article; 2,543 Posts
Dear Surgeon,
When responding to your not-so-tactfully (with added color) asked question of why are your cases backed up every single day that you do surgery, let me respond in a tactful manner to your question:
1. When I ask you specifically what you want for the next case, please don't bark, "It's on my pref card!" Your pref card has not been updated since 1995 and I have absolutely no control over correcting your card since I don't have access to the program to change it.
2. I can't seem to find my crystal ball today, so I didn't foresee that the attending that was scheduled ahead of you went waaaayyy over his scheduled time. Please leave this frustration at the door, and don't take it out on the staff who are trying to help.
3. Please do not say that you "only" need a minor basket and a drape. You will undoubtedly ask for everything but the kitchen sink, and when it is unsterile or unavailable because the surgeon who is using the needed item actually posted his case correctly, you go into a rage and rip off your gown while spouting about how "ridiculous" everything is.
4. The nurses and the techs are cleaning the room without the help of the ORAs, who are either on break, at lunch, smoking, or cleaning another room. We are trying our best to do their job as well as ours. Oh, and we aren't getting paid extra to do someone else's job. Wanna talk to their supervisor? Here's the number.
5. It seems, sir, as if your pager is going off non-stop. I am unable to return the billions of pages you insist that I return because I am delivering patient care. I still have to chart on this case even though you only took 6 minutes to do your I&D. The antiquated computer charting that is offered to us nurses requires at least 15 minutes to complete because we have to chart the SAME thing in 5 different places, or we will not know how to answer the attorney in court when we get sued because of a technicality. We love our license! Do you?
6. We can't control the emergency cases that have to bump your room. Please don't come into the OR expecting us to be in the same tizzy that you are in because you can't make lecture on time. We are here for the patient.
7. Oh and yeah....we are short staffed and cannot open another room for you. Quit your yelling, because we don't have control over that.
8. If you say one more time that you have done this same procedure the same time for 10 years, I will totally work overtime to pull my charts to prove to you that you don't, in fact, do the same procedure the same way every time. And you have only been here for 2 years.
Thanks, Mr. Awesome Surgeon for listening to me. I hope that you will take my answers to the Nursing Director so that she can see what is really going on and hire more nurses to help out. Maybe she will actually saunter back to the ORs to see what is actually taking place.
Rose_Queen, BSN, MSN, RN
6 Articles; 11,854 Posts
Dear surgeon,
When you are calling to book an add-on case, please have all of the information I need. The lady in room XXX is no help, because that's a semi-private room. Also, if there is a side involved, "it's either the left or the right" is not the answer I want to hear when discussing a fracture.
No, I can't give you an exact time for your non-urgent add-on. Surgeons X,Y, and Z are all running behind schedule. I can't make them work any faster.
No, I cannot open another room for you. Sorry, but I am not capable of pulling an anesthesia provider and a surgical team out of my backside just to appease you because it's your fault your case wasn't scheduled correctly and took two hours longer than it was supposed to.
You probably wouldn't be this far behind if you stopped insisting on coming to the phone EVERY SINGLE TIME I'm returning a page from your beeper that is going off incessantly. Each phone call takes at least 5 minutes that you are pausing surgery.
Boy, isn't venting fun? Now if only we could really say these things and have something positive come out of it!
wartthree
8 Posts
Yes, I know it will only take YOU 20 minutes to do the procedure, but we do have standards and those take us XXX minutes so we are ready to provide good, safe surgery for your patient.
Susan317
58 Posts
Ask them to leave their beepers at the front desk and have the secretary return their pages.
While this is a good suggestion for a small OR, the one I am working in has 31 rooms, and at least 2 docs to a room. They are all running at the same time. So that means (when I am in charge and I am at the front desk) that I would have at least 62 beepers at the desk. The last time I worked with a surgeon whose beeper kept going off, I offered to put it in the autoclave.
The last time I worked with a surgeon whose beeper kept going off, I offered to put it in the autoclave.
Hey, if it's sterile, he can deal with it himself, provided it survived! Now off to invent the autoclavable pager, and while I'm at it, cell phone.
bnhanna9
16 Posts
All I have to say to that is.... HAHAHAHAHAHA
...and THANK YOU!! :yeah:
boopette
14 Posts
do not huff and puff when I am trying to adhere to the policy of the hospital. You know that before you patient is allowed to come to the OR their consent must be signed, dated, and initialied by YOU, yes YOU the surgeon. Not to mention that they must also be marked with YOUR initials if laterality is involved. It's a safety concern for the nurse, yourself, and ultimately the patient. If you just listened and complied with the policy then you wouldn't have to complain about delays on starting your case.
Scrubby
1,313 Posts
This one happened yesterday.
Dear Surgeon
When you asked to do your add on case I responded with 'if there is time because Dr X starts his list in here at 1230. When you take an hour and a half to do one inguinal hernia repair and there is two on your list, then you simply don't have time to put another case in because....well let's face it, you're not a very quick surgeon. When I say no, you cannot put this case in here because it will meant that Dr X will start his list late, and you start being disruptive, argue with me then unscrub and run to mummy (The TL) throw a tantrum to get your own way this is not being a team player. I have been the CN of this speciality for several years now and am capable of working out what can be done and what can't, in fact I have very good time management skills, perhaps you need to work on yours.
Predictably, Dr X started his case late and he was very angry about it. His last patient was cancelled because we ran out of time and none of us could stay late, including Dr X. Together we have written a complaint about you and your disruptive behaviour which will go to the head of surgery. I cannot wait to see the look on your face when you are disciplined about your lack of teamwork, your causing an elective surgery patient to be cancelled and I cannot wait to tell you how it is going to be from now on.
From now on you will show respect the rest of the team and not work against us. You will moderate your voice while you are in my theatre and if it goes up one octave I will tell you to shut it. You will not throw a tantrum and you will negotiate add on cases with the rest of the OR team and not covertly bully the coordinator to override the decision of the team. And you will certainly not try and stop me and the other nurse in my clinic discussing whether an add on is going to impact on Dr X's list because you are not in charge of my OR, I am.
Sister Fox
85 Posts
Oh this gave me such a belly laugh! Seems the US and the UK aren't so different after all, even if what we call the OR does sound like something from Broadway!
I can only reply with a story of my own but it won't be as succinct as you guys!
I was theatre manager, on call with 2 other members of staff. We had a strict protocol during on calls, only one patient in the department at a a time. We'd get around this by sending for the next patient while the first one was in recovery (we had to do recovery too!). Often as not, the first one would be awake enough to send back as the second one arrived and everyone would be happy (including me).
This Sunday evening, we had an appendix on the table. Been going for about 30 mins when ortho registrar came to book a case. 12 yr old girl, dislocated a hip when she fell out of tree that afternoon. He wants to do a closed reduction.
Now this chap, Sam, is Iranian (say no more!). I've always got along with Sam extremely well but this weekend he was standing in for his absent senior and a little, well, proud of himself that he was SENIOR reg that weekend.
So I tell him the appendix will probably be finished about 6.30pm, give or take, and all being well he can follow on. Well all was not well as the lassie having her appendix removed decided she wasn't going to wake up very quickly from her anaesthetic. 6.20pm and up comes Sam and starts pacing up and down the corridor, demanding to know where his patient is - you know the routine. I try to explain but he throws a tantrum and decides that he will do this case in the ER. I then made the big mistake of saying to him "Don't be daft - suppose you need to open her up?" whereupon he goes incandescent and storms out shouting that he's the surgeon and I'm not to tell him how to operate, etc., etc.
By this time the other patient is awake and going back to the ward but he won't climb down and leaves anyway. We all go home.
About 9pm, a very subdued Sam is on the phone. Can we please come back as, when he tried to reduce the dislocated hip, the corner of the acetabulum hooked into the epiphyseal plate and flicked the epiphysis off the femur like the top off a beer bottle! Poor girl.
We got back in, me expecting to find the consultant (senior surgeon) there too but no boss man. When I ask Sam he says he's perfectly capable of doing this himself!
Well, as luck (and an awful lot of prayer from me) would have it, just as we were draping, there was a call from the ward. Father had just remembered that his employment private health cover also applies to his children and was it too late for him to go private? Boss man comes in and tears strips off Sam for even trying to do the closed reduction on his own, much less the open one!
Patient is saved a botched surgery and all is well. But I learned never to call a non-English surgeon "daft" even when they were!
Libitina
144 Posts
This one happened yesterday.Dear SurgeonWhen you asked to do your add on case I responded with 'if there is time because Dr X starts his list in here at 1230. When you take an hour and a half to do one inguinal hernia repair and there is two on your list, then you simply don't have time to put another case in because....well let's face it, you're not a very quick surgeon. When I say no, you cannot put this case in here because it will meant that Dr X will start his list late, and you start being disruptive, argue with me then unscrub and run to mummy (The TL) throw a tantrum to get your own way this is not being a team player. I have been the CN of this speciality for several years now and am capable of working out what can be done and what can't, in fact I have very good time management skills, perhaps you need to work on yours.Predictably, Dr X started his case late and he was very angry about it. His last patient was cancelled because we ran out of time and none of us could stay late, including Dr X. Together we have written a complaint about you and your disruptive behaviour which will go to the head of surgery. I cannot wait to see the look on your face when you are disciplined about your lack of teamwork, your causing an elective surgery patient to be cancelled and I cannot wait to tell you how it is going to be from now on. From now on you will show respect the rest of the team and not work against us. You will moderate your voice while you are in my theatre and if it goes up one octave I will tell you to shut it. You will not throw a tantrum and you will negotiate add on cases with the rest of the OR team and not covertly bully the coordinator to override the decision of the team. And you will certainly not try and stop me and the other nurse in my clinic discussing whether an add on is going to impact on Dr X's list because you are not in charge of my OR, I am.