"Why are my cases backed up?!?!"

Editorial Team / Admin · Sep 8, 2010

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 · Sep 22, 2010

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 · Oct 3, 2010

Ask them to leave their beepers at the front desk and have the secretary return their pages.

canesdukegirl, BSN, RN · Oct 4, 2010

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.

Editorial Team / Admin · Oct 4, 2010

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 · Oct 4, 2010

All I have to say to that is.... HAHAHAHAHAHA

...and THANK YOU!! :yeah: :yeah: :yeah:

boopette · Nov 11, 2010

Dear Surgeon,

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 · Nov 12, 2010

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 · Nov 15, 2010

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 · Nov 17, 2010

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.

Happens all the time with a particular one of our surgeons. He blames the turn around time when in fact it's because his lists are over subscribed and he is sloooooooowwwwww..... :uhoh3: