Communication: Part 2


Communication

I work weekends, so I never know what service or procedure I’m going into. I love that, there’s no anxiety about working with unpleasant people or fear about being good enough. That happened during residency, a lot of people were shifted around, and often times I was placed in more difficult cases to protect less-skilled nurses. I took as a badge of honor and moved on. As soon as I could get on weekends, I transitioned.

It was a femoral nail, which I’ve done a few times more than when I started weekends and didn’t even know what the Hana table was. I gathered my supplies, more than happy to know what I needed to position to decrease my patient’s time under anesthesia (I had just learned how terrible the effects of anesthesia were on temperature, circulation, and pain management, much less the increase in cost per minute in the OR - $62!).

I got the patient in the room and called the surgeons in. The residents came, helped me move the patient over, and started working on getting the legs in the boots. The music was on, my scrub tech was opening supplies from the vendors, and I wasn’t worried about a thing.

Then the faculty surgeon came in and asked why we weren’t on an OSI table. I get the awkward laugh, the one where you know you’ve done wrong and you don’t know the first thing to do to fix it. And this is an awesome surgeon, a sweetheart who wouldn’t hurt a fly unless he was extremely tired and that fly was standing between him and a bed.

I looked down, looked up, choked, and asked if we needed to move. There’s really no reason to argue or even say you’re sorry, although I do apologize later. But in this instance, the only thing I can do is make it right, whatever it takes. So he shook his head like he always does, and just sighed, saying it would be harder to do the entire case, but moving was going to be too much work.

And then I watched them suffer to keep the femur in alignment while they were reaming and I knew it was only because I hadn’t called to make sure they wanted the Hana table, I just assumed that a femur fracture was a femur fracture. 

And while I hate the agony of waiting for a surgeon to call back, and while surgeons may complain about getting pages, open, clear, consistent communication is the best way to advocate for yourself, your patient, and your operating room. You own the room, and it is your responsibility to make sure that everyone, including yourself, has what they need to perform their best operation in that moment.

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