This was my favorite skit on the old “Muppet Show”.
Usually the “patient” would sit up and make some wisecrack to the OR team.
Can’t say much for their technique, though!
No one is wearing a mask and Miss Piggy’s hair would easily all into the surgical field.
Oh well, no one is perfect.
We all expect our surgeons to be perfect.
Perfect in technique, perfect in personality, perfect in demeanor.
Eternally patient, never exhausted, always in a good mood.
Hate to break this to ya, folks but surgeons are human!
It’s no secret that surgeons have a reputation for being egotistical, overbearing and intolerant.
We’ve all heard the horror stories of instrument tossed across the OR in anger.
I once saw a surgeon throw a chest tube full of contaminated blood across a trauma room in an ER.
And let us not forget the infamous Dr. Prissy Pants who intimated that no one in my ER was working because the patient did not have his consent signed by the time the Dr. walked in to see him!
We nurses have a million of them.
But how many of us have ever looked at the situation from the side of the surgeon?
Instead of dreading the idea of having to work with one, what can a nurse do pro actively to make the preoperative experience a smooth one for themselves, the patient and the surgeon?
Having dealt with surgeons as a nurse, a patient and a family member, I have a few ideas born out of my experiences. Your mileage may vary.
- If you work with inpatients, for pete’s sake make sure the patient is NPO! Nothing will make a surgeon blow up faster than finding out the patient can’t go to OR because they have eaten! I know of one incident that caused a six hour delay in the removal of what turned out to be a gangrenous gall bladder.
- Make it a priority to have the patient ready for surgery. Paperwork can come later. The surgeon is not operating on the chart.
- Having said that, the more paperwork you have done, the more efficient the process. Have alert patients fill out their own anesthesia questionnaire if they can.
- After hours, follow up and make sure the supervisor has called in the OR team and make sure you know the ETA. Hell hath no fury like a surgeon who walks in ready to take the patient to OR only to discover the team wasn’t called in.
- If pre-op antibiotics/medications are ordered get them in – they are ordered for a reason.
- Every nurse knows the surgeon must speak to the patient about the risks/benefits of surgery before the consent is signed. Every surgeon knows it too, but that doesn’t stop them from telling you to have the consent done before they get there. Fill it out so it is ready to go after the surgeon is done explaining.
- Post-op: when you call a surgeon, be concise. Tell them what you want. Is more pain medication needed? Are you seeing signs of infection at the incision site? Is the patient now febrile? Don’t beat around the bush with a long-winded story.
Those are just a few of the ideas that come to mind when working with pre-op patients and their surgeons that contribute to a smooth peri-operative experience for everyone involved.
It helps to remember that surgeons are just like us. They get tired with long hours, they have no control over their workload if they are on-call. Yes, they get paid well and yes, they chose their specialty and yes, being called in is part of the deal they signed up for but that doesn’t mean it is easy. Even though you work a night shift and are chipper at 0400 (raising hand here) the surgeon who is coming in early to fit your appy in before his full day in the OR might not be so upbeat.
There is always room for understanding and for cutting each other a little slack.
That is why I can count the number of think-they-are-God surgeons on less than one hand.
Mutual respect goes a long way.
(Epilogue: to all surgeons reading, please understand that nothing undermines the care of your patient worse than an arrogant, insulting attitude. If you are lucky, the nurse will call you on it. Worst case scenario, the nurse is afraid/unwilling to interact with you and that is never in the best interest of your patients.)