Behind Closed Doors


Unanswered Questions of the OR

Don't get me wrong: After all this time, I still like OR nursing. Nothing in me wants to be a lawyer or study for an MBA. But when I get to thinking about my chosen profession, I'm always left pondering a few unanswerable questions.

Why do we call in sick using a choked-up, hoarse voice when it's diarrhea?
You know you've done this.

Is double-gloving enough?
There's only one thing between you and everything you have to touch during a case, and it's probably about 95% reliable, mostly. The other 5% of your surgical gloves will rip while you're trying to don them in a hurry — not that you're ever not in a hurry — except when there's already a hole in one of the fingers. It's the surgeons who usually find these holes, while they're in the belly, cauterizing. The resulting roar is deafening.

We put a lot of trust into an ultra-thin, latex-free, powder-free barrier, but when it comes to economy-size boxes of exam gloves, that trust may be misplaced. If you really want to practice safe circulating, you'd best don surgical gloves instead. Your supply manager will have a fit, of course, and the CFO will stroke once your preference reaches his spreadsheets, but at least you'll have that 95% reliability on your side.

Shouldn't a hospital have good hospitality?
I've often wondered where surgical facilities hide the good sheets and blankets, the ones you might actually make up the guest bed at home with. Not every patient is coming in here for ophthalmic surgery, so surely some of them have noticed the frayed holes, the frayed holes patched with tape or (worst of all) the frayed holes patched with tape that's taken a spin through the laundry to collect hair and lint. If healthcare reform's lawmakers had ever been patients, I think they would've demanded intact, unstained linens first thing.

Are the engineers who design stretchers kidding?
Do they conspire with the architects who plan medical facilities over the width of doorways? I'll bet they have a good laugh imagining nurses trying to get them in and out of rooms. And let's not forget hospital beds. Who decided that the button to activate the battery should go underneath the bed? You practically have to stand on your head to see it, then work your finger into its hiding place to press it. If the bed frame were to fall — and freakier things have happened with equipment — you'd be lucky if it just fractured your finger.

Why do surgeons behave the way they do?
Maybe we use that hoarse voice to emphasize that we're sick, not just ducking a case we've been scheduled to work with a spectacularly annoying surgeon. The one who always tries to rubber-band-snap his discarded gloves into the trash can. Nine out of 10 times he misses, leaving them on the floor for me to pick up. Or the one who could be in the middle of a 5-way organ transplant when he interrupts my charting to ask if I'll go over to the satellite radio and find out who sings this song. His choice of music has gotten a country song called "Snake Farm" permanently stuck in my head.

I know it's difficult to read faces in surgery, what with the masks, but here are some hints for the physicians I work with. If I find something you do or say amusing, I'll laugh out loud. But if I raise an eyebrow (when I can: with Botox, this isn't always possible), that's a good sign I think you're out of line. You can also gauge my level of stress by how fast I'm chewing my gum. If my jaw's really churning, I may be working on a bite block instead. If I'm humming "Snake Farm," I've probably bitten through 2 of them already.

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