Tuesday, June 19, 2007

Scrubbing with the enemy...

I was scrub nurse last night on a C-section and the doctors were not in a great mood. The first surgery started out as a crash turned non-emergent. As I understood it we were not in a hurry. In an emergency, we do not have to opportunity to perform what is known as a pre-operative count. In the pre-operative count we establish sort of a baseline inventory of equipment that we are starting with to perform surgery. Since the first surgery was not an emergency a count should have been performed, but the doctor grabbed instruments off of the field before they could be counted and started the surgery as if we were ancillary staff instead of licensed professionals who assist in making sure that the surgery is being performed safely. As a result, an x-ray had to be performed. Not a bad thing, but would not have been necessitated had the doctor given us an extra three minutes to finish the count. The x-ray came back unremarkable. Everything turned out fine.

The thing that probably pisses me off the most was that the circulating nurse tried to make it seem like it was all my fault. He decided counsel me on "how to be a better scrub nurse" in the middle of surgery in front of all of the surgeons. I told him right away that I am not accepting the blame for the count not being done. I think that instead of assigning blame or using that as an opportunity to "teach me" how to better scrub, we should have been defending each other because we BOTH made the MD aware of the fact that the count hadn't been done. How many times must I tell people that reprimanding me in the middle of surgery is unprofessional and plain old rude. After surgery, pull me aside and tell me what you want me to know. I am approachable.

The second C-section was with a doctor that wanted me to anticipate her needs and differentiate by tone of voice when she is talking to me and when she is talking to the resident. I couldn't do anything right for this doctor. I didn't fold the sponge properly or hand off the suture scissors quick enough and she in the middle of surgery decided to give me immediate feedback regarding my performance. I responded by saying that I was a new nurse with limited scrubbing opportunities and with practice, I will become better at anticipating her needs but in the meantime I need her to be patient and clear about her desires during surgery and I left it at that. She walked out of surgery with a major attitude. Most of my peers would have been bawling their eyes out but I think that these "experienced medical personnel" need to realize that at one point in time they were new and that medical school or nursing school is ineffective at teaching a person everything they need to know about being a doctor or nurse.

DiVa, Experience is the best teacher...

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