Worst Surgeries to deal with?

mikethern · Oct 25, 2007

Anything with a tuberculosis, hepatitis-C, or HIV patient because there's always a tiny chance of catching it.

Also, the worst cases to circulate are cases that last only 5 minutes or so. You have to work very quickly, and by the time you have a chance to being your charting, the case has already finished.

Patients from the ICU can be challenging too. They are in bad shape and have a lot of lines. You really need to know what you are doing.

I guess the VERY worst cases are cases in which the surgeons are arrogant bastards. I'd rather do a very tough case with a nice surgeon than an easy case with a bastard.

Marie_LPN, RN, LPN, RN · Oct 25, 2007

The worst surgeries i think are the ones to repair the physical damages done to a child who's been raped or sodomized.

Annony RN · Oct 26, 2007

Oh Marie! Fortunately for us we don't do those surgeries where I work in the OR but I do get those kids in the peds hospital I work in.

In our OR the worst are the ruptured AAAs. They're a LOT of work and they all end the same anyway.

And I definitely agree with Mike about short cases. A 15 minute cataract or debridement requires the same amount of paperwork as a 1+ hour bowel. Actually the cataract is more writing in mt OR b/c of all the meds to fill in. And some of those cases are so short that the pt is sedated so lightly that I'll have to hold them to keep their arm down while I write. Ugh... and some short cases like lipoma excisions are done under local so I'm monitoring them, too.

brewerpaul · Oct 27, 2007

Short cases eg cystoscopes are a PITA 'cause they're done almost before they get started, but you still have all that paperwork (well, computer work), same as a big case.

I also don't like cases where the surgeon wants EVERY piece of equipment, EVERY supply, EVERY suture etc in the known world in the room, even for relatively routine cases. Sure, it's good to be prepared, but sometimes they go overboard and the room looks and feels like a junkyard. You're constantly tripping over things. Plus, all that stuff has to be put away after the case.

Naturally, abusive Docs make ANY case unpleasant. Fortunately, our OR has few of those.

DNRme · Oct 28, 2007

Without a doubt, after >20 years in the OR, pedi organ procurements are the worst. :scrying:

newname · Oct 28, 2007

I HATE cataract case!!! :angryfire easy case but too fast, lots of set up, charting, and end in 10 minutes. Both scrub nurse and circulating nurse can't stop for any second. They really should do it in day surgery.

GadgetRN71, ASN, RN · Oct 29, 2007

D and C's or any GYN case...Not interested in the hoo hoo surgeries! Also not interested in C-sections. I like kids and babies but childbirth freaks me out-it's so MESSY! LOL, I would be perfectly fine with being knocked out if I ever have kids. Of course, when I worked evenings at one facility, I was the only woman..guess who got stuck with the cooter cases? Yup, yours truly.

maeyken · Nov 27, 2007

I've never been in on one, but I think that organ procurement cases would be difficult emotionally.

The case that terrifies me the most is an emergency AAA, but mostly because the surgeon is a big witch. Even little stuff with her is awful. Of course with our other vascular surgeon, the same cases are a breeze!

Necrotic bowel cases are some of the worst smelling cases.

Eyeballs and teeth both make me a little queasy if I pay too much attention to them. If I have to scrub for those I try to ignore most of what is going on as best I can (while still paying enough attention to not appear totally clueless!)

Scrubby · Nov 27, 2007

I have never seen a donor case but i can imagine that it would be pretty tough to deal with.

For me the surgery i hate the most are varicose veins. I loathe scrubbing for them because they are extremely boring and can be lengthy when they are a redo.

I agree with mikethern that a lot of it depends on the surgeon your working with.

Jarnaes · Nov 27, 2007

Like other people have mentioned, it's all about the team in the room. If the mix is bad, even a short easy case is too much.

TallBlondie · Dec 3, 2007

I actually love doing amputations. I think it is sad when they are done but I find them to be quite interesting. Cataracts can be a hassle though, unless you treat it like a game, we are lucky in our OR the eye gtts are put in while the patient is in holding and it is the holding nurses job to document and put these in. Anterior-Posteriors are probably my worst because of the turning and and it seems like there are never enough "unsterile" people around to help you flip the patients. Also, patients who come in for anything who are >500 lbs are horrible regardless of what you are doing. Especially if you are having to cram one of those gigantic beds in through the OR suite, I don't care if its a simple lap chole my back can only handle so much! That and patients who come down from the ICU already intubated and hooked up to a million monitors, sometimes I think it would be easier to just do these surgeries up on the unit!