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Behind Closed Doors: How to Build a Bad Day
You don't have to try hard to have a rough shift.
Paula Watkins
Publish Date: May 13, 2015   |  Tags:   Opinion
stormy skies

How many times have you worked a shift only to find everything in order and on time? Boring, right? Aren't frantic and frustrating shifts much more entertaining? Well, guess what? You don't have to settle for good days when perfectly bad ones are easily made. Here's what you'll need:

  • Some ill-fitting scrubs. A bad day starts off on the right foot when the scrubs dispenser refuses to read my badge. I call the OR desk to tell them I can't get my scrubs. "Does this mean I can go home?" I ask. They're not amused. In the locker room, the charge nurse brings a pair of size XL. I wear medium. "Medium is back-ordered," she says. "Tie a double-knot and roll them up."
  • A bit of friction. I look at the schedule board, which points me in the direction of my least favorite surgeon and a particularly grueling procedure, already in progress. Lucky for me, the case is about ready to close and the new hire who started it offers to circulate if I'll chart. Unfortunately, I'm still on the hook for getting the patient out of the harness, disconnecting the cables and pulleys, reattaching the footboard to the table, removing all the cloth tape (a.k.a. "OR duct tape") that's been holding everything together and getting the patient supine.
  • A special request. One hour down, 7½ to go, and I'm paged to call the desk. (Like going to the principal's office, it's rarely for good news.) They ask me to head to OR 4. The case is all set up and open, they say, you just need to get the patient. Now, the phrase "set up" has a few different meanings. I peek into OR 4 on my way to the patient. The room is open, that's for sure. There's no headlight there. The Bovie is against the wall with the cords still wound tightly around the handle. No fluid waste collector — it's at the docking station. There aren't even bags in the trash containers.
  • An impatient co-worker. The desk said the surgeon wants to start right now — of course he does, he 'always does — but as always, he's nowhere to be found. There is a CRNA hollering at me, however: "Go get the patient, I'm ready to go." Good luck beginning the case with nothing set up, Mr. Fire-Under-the-Butt. I wonder if he'd mind running for the supplies when the surgeon gets here, or maybe doing some of my circulating and charting while I'm out pulling the case.
  • A scavenger hunt. I start hitting storage rooms for missing equipment and asking for help along the way. I succeed in finding maybe half of what I need, but I don't have any of the medications listed on the preference sheet. Most of the supplies I'm pulling are not where they should be. I'm imagining the staff on other shifts whiling away the hours throwing supplies into random bins on random shelves for fun. I return to the OR with my arms full and am greeted at the door by a CRNA who's raring to go and a patient on a stretcher. "While I was waiting, I thought I'd go ahead and bring him here," the CRNA says, "so you could do whatever it is you do with patients."
  • More cloth tape. We roll the patient into the room, transfer him to the table and connect the monitors. Now, where is that blasted safety belt? I grab the 3-inch cloth tape and do a duct-tape job around the patient and table. I'll find the Velcro straps in just a second.
  • Assorted bumps and bruises. Watch your head! Too late. Are your fingers clear? Unfortunately, no. Don't trip on that cord. I won't, I saw it from the floor where I landed. The equipment we use to treat patients sure does a number on us providers.
  • Multitasking. Before this case is over, I will have done 3 cultures with orders, 3 specimens and 4 meds out of the med select. I will have charted almost the entire case and run for all the items that no one pulled. At the same time, I've made a list of all the co-workers I want to hog-tie and hoist up. No time for that now, though: The desk is paging me about a case in OR 5. Keeping busy makes time fly. I could work an hour past end-of-shift without even knowing it.