Tuesday, October 20, 2009

My pet peeve

When my surgeon finally walked into preop holding this morning for the first case, thirty minutes late, the first thing he said to me was how he wanted his anesthetic performed. That automatically raised my ire and soured my mood for the rest of the case. When he started injecting local anesthesia into the nose for the septoplasty case, rivulets of blood started streaming down the patient's face. He then turned to me, asked me what anesthetic I was using, and asked me to use a different one since I was causing his patient to bleed excessively. Then I thought this guy doesn't know what the f*** he's doing. I've seen hundreds of nasal injections for septoplasty and not once has another surgeon blamed it on the anesthesia.

That is just one thing I can't stand to hear and immediately lowers my attitude toward the surgeon. I don't understand why surgeons don't get it that they are not anesthesiologists. I am not their CRNA, there to be directed by an MD on how to do my job. Do I ever tell the surgeon where to make the incision? Or what sutures to use? Or which rod to insert? They would just as soon kick me out of the room for demanding that they follow my instructions.

I try to stay professional by acknowledging their "request" and will try to fulfill it if it is not detrimental to the patient. But some surgeons will repeatedly look over the drapes to check on the vital signs or ask if the patient is "completely paralyzed." Some have even asked what muscle relaxant I was using, as if they knew the difference. Then it just gets annoying and I blow them off with a dismissive "uh huh." But I'm passive in that way. I know some anesthesiologists who wouldn't blink an eye at talking back directly, setting up a confrontational atmosphere in the OR. We even have anesthesiologists in our group who are known to have such anger issues that nobody dares mess with them. Bravo I say. If I only had the guts myself. But in the end, the case finishes soon enough and the surgeon never knows my true feelings about his professional conduct. And we each go our separate ways.

1 comment:

  1. Sounds like my residency experience right now. Some of the best are asking for "zero twitches" and blaming their poor surgical exposure on me when they've inflated a tourniquet before the paralytic can be given. Since I'm a resident I'm passive, but I believe that once out I'll likely be a lion - I can't stand it and really have to hold my tongue.