Venting session / Jackass surgeon

[London88]

We were doing an off pump CABG yesterday. My attending ologist and I work very well together, so no c/o where he is concerned. Here I am in this room with a SRNA tirating drips back and forth. My ologist is in and out of the room routine business. I survive the hairy moments such as when they occluded the RCA and went into a mobitz II in the low 40's from a NSR 80's and a dip in B/P from a systolic of 120's to to 80's.I gently tell the surgeon whats going on, in other words hurry up and release the RCA. As this was going on my attending was not in the room, but he was aware of what was going on. We finally get done. The pt does fine even though i now have carpal tunnel from so much titrating of drips. The surgeon says to my ologist at the end of the case it always make such a difference when a good anesthesiologist is doing the case because we have a good anesthetic and good outcomes. It was as if I was totally invisible even though one mistake on my part could have caused us to go on bypass in a heartbeat. My ologist looked at me when the surgeon made the comment and he knew what was going through my mind as he himself had already complimented me and the SRNA on doing a nice job. God forbid the surgeon complimented the whole anesthesia team! I guess it is beneath him to compliment a nurse.

[MaleAPRN]

It's almost as if most (if not all) heart surgeons have this innate understanding NOT to see the CRNA behind the drapes and to completely ignore him/her when the case is going well. But, if one little thing goes wrong...expect the surgeon to reem your behind for the REST of the case, just to torture you for their enjoyment. I totally sympathize with you. I'm seen this in my training hospital too. I just don't understand it.

[suzanne4, RN]

Give yourself a pat on the back............you deserve it............

I have worked on a heart team for years, and unfortunately see things like this every once in awhile. Pay no attention to the surgeon in this case, and if you do another case with him, pay no attention to him, but only to your patient and what he is doing to to the patient, and surprise he will realize that you do exist up there.

Has worked every time...........

[Pete495]

Sorry to hear about your predicament. I can sympathize with you because the surgeons won't even allow CRNA's in the heart rooms where I work, and am doing my clinical right now. we will have to be farmed out for hearts. This is a continuation of a negative conitative attitude toward CRNA's, and a lack of knowledge regarding not only the history of anesthesia care, but also lack of knowledge over educational requirements, and the misbelief that having an MD behind your name makes you a competent and superior practitioner. Granted, not all crna's should be doing hearts, but not all MD's should be either. Respect should be earned for good outcomes, but surgeons are too arrogant to figure that out.

[Gabie Baby]

You might want to invite him to have coffee with you at some point and try to gently educate him, AFTER sounding him out to see if he REALLY has the attitude you think he does. It could be your imagination. Don't jump to conclusions. Verify before you crucify.

Or you could just say to him at the time he makes remarks like that, "What about me?", and say it with a smile. At least he will notice you. Which might be good. Or bad.

[yoga crna]

I really, really hate to do this, but...get used to jackass surgeons. No amount of discussion or education is going to make a difference. it comes with the territory when you are a nurse anesthetist. Surgeons are egotisical, self-centered and arrogant. Of couse, there are exceptions. They expect respect, but won't give it. Get used to it. That being said, they can't do surgery without anesthesia and it doesn't hurt to point that out to them occasionally.

I have found, through the years, that the best surgeons, the ones most respected by their collegues are the easiest to work with. Of couse, it helps to feed their ego occasionally.

Learn how to deal with it in and out of the operating room.

That's why I do yoga.

[MmacFN]

Ugh.

Yoga hit the nail on the head. I have known many surgeons over the years and while I have become friends with some, 90% are asses plain and simple. I also find that the surgeons typically are male and typically treat the female RNs and CRNAs worse than they treat men with the exact same training. Its very odd.

[London88]

That is why I work out 4-5 times a week and when I see this surgeon next week it will be back to business as usual. I do my case, I then go home! MmacFN hit it right on the nail. I am female, and a CRNA.

Gabie just what do you think I should verify that he knows CRNAs are behind the drapes. CRNAs do all the hearts where I work so me being behind the drape is not a new scenario. The truth is I mentioned the issue here for the sake of discussion. Do I really give a s---t? No. Is it important enough to verify or crucify? No. Do I bear a grudge over the issue? No.

[MmacFN]

I can only apologise for my gender

That is why I work out 4-5 times a week and when I see this surgeon next week it will be back to business as usual. I do my case, I then go home! MmacFN hit it right on the nail. I am female, and a CRNA.

[WVUturtle514]

CRNAs do all the hearts where I work so me being behind the drape is not a new scenario.

London, would you mind telling me where you work (you can PM me if you want)? There are several people in my program who are dying to soley do hearts, but these opportunities are few and far between in our area (Washington, DC). Any info would be great!!! Thanks in advance!

Tracie

[jwk]

That being said, they can't do surgery without anesthesia and it doesn't hurt to point that out to them occasionally.

And when you've given 50 of roc in the last 20 minutes and the surgeon still complains that the patient isn't relaxed, just smile and remind them that anesthesia makes surgery possible, not easy.