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Tuesday, May 24, 2011
OR Tyrants and Aggression
"Why don't you like your job, mommy?"
"Because mommy likes to know when her day starts and when her day ends. In the OR, you never know."
This was an actual conversation I had over breakfast yesterday. I had a 'late start', first case to begin at almost eleven a.m.
There was a phone call. I was in my pajamas. "When can you come in?" I gave my best estimate-sixty to ninety minutes. (From pajama, to breakfast, to lunches packed, to kid to school, through traffic--the worst time of day for it--to work). "That's not going to help me."
Okay then, start another room.
Then my boss calls. Apparently, even though you check TWICE to make sure of the start time, 'you are responsible' for any coverage before that is added on. Another doc was called in.. I got there ten minutes after him. But I had to sit in shame for two hours until I started my case. Unpaid.
That is the nature of the OR. Remember how I said it is like a server navigating a busy kitchen? This is Hell's Kitchen, the OR. And unless you are trained on it from early on, you are not going to make it, not going to fit in. From the scrub tech, to OR nurse, to surgeons and anesthesia...it is rife with conflict.
And why, exactly was not one but TWO anesthesiologists' mornings radically disrupted?
A cardiac surgeon had a VATS (video-assisted thoracic surgery) scheduled at 3:45 p.m. and wanted to move it up. No emergency. No saving a life. He just didn't want to wait until his scheduled time for add-on. All add-ons are to be scheduled on a first-come, first-serve basis in the OR to be done at the end of the day following scheduled ones. Any bumping (cutting in line) is a direct surgeon-to-surgeon agreement.
This was bullshit. The charge OR nurse wanted to look good. And the surgeon saw the gap in the schedule, and went for it. Ego. Pure, unadulterated ego.
I kid you not. Patients DIE from this. The poor woman, in the rush, there was trouble putting in the double-lumen tube. Safety last. Ego first.