Wednesday, July 23, 2008

Nurses versus Surgeons

Seven a.m. in the surgical hallway of Fort Anonymous U.S. Army Hospital on a dark December morning. Nurses in clean surgical scrub attire hurry between Central Supply and operating rooms with bundles of instruments and sterile drapes. Others wheel patients on stretchers, each to an assigned operating room. Anesthetists check their gas machines and syringes as the surgical teams gather at the scrub sinks, cleaning hands and forearms the required five minutes with antiseptic soap.

“I can’t find my scrubs!” a surgeon complains to the chief operating room nurse as she walks by, her eyes checking her nurse lieutenants as they go about their assigned tasks.

The chief nurse stops to look at the surgeon, then at the nearly empty rack where surgical scrub suits for the operating rooms are stored. “Why do you suppose that is?” she asks him.

“It’s not my job to know why that is,” he fumes. “My job is to be in the Operating Room fifteen minutes from now, ready to operate. Where are my scrubs!”

“Well, let’s think a minute,” she says. “How many scrub suits are hidden behind your desk in your office? How many stayed on the floor in the intern’s lounge when you changed back into street clothes last week? If you don’t put them in the laundry hamper, Major, they don’t get picked up. I can’t give you what I don’t have.”

“I don’t care about that,” the major snaps, “what we need in this OR is one of those scrub-dispensing machines!” He stamps off down to the laundry department to harass the workers who unload the laundry delivery truck each day. But they really couldn’t do anything about scrub suits the truck hasn’t picked up, and therefore can't deliver again.

“Dispensing machines don’t solve the problem,” the chief nurse remarks to her assistant. “The hospital in San Antonio had them when I worked there as an instructor. You have a card to insert, you punch in your size, and out comes a scrub suit. But the surgeons can’t be bothered to dump them back into the machine’s bin at the end of the day and get their card credited. If they don’t return them two days in a row, the machine voids their card and they come screaming to the nurses again.”

She turns her attention to another surgeon who is demanding a certain surgical instrument NOW. ”Dr. B is using it in Room 3,” she said. “We can have it resterillized in about 20 minutes.”

“My patient is on the table now. I need it now."

“It’s already in use. You didn’t think of that when you changed your scheduled time for this case, did you,” she says patiently.

“Look, I’m a surgeon. Surgeons operate. Nurses get instruments ready. If that one’s in use, get me another one from the supply house.”

“The supply house that sells that instrument is in Omaha,” she says sweetly. “I can ask them to send it urgent express, and we can have it for you on Wednesday. Otherwise we have to wait till Dr. B’s case is finished in a few minutes and we resterillize the one we’ve got.”

“I’m going to bring this up in staff meeting.” He strides angrily off down the hall.

“Do that,” she calls after him. “I’ll give you the serial number and cost figures. It’s expensive.”

Five hundred people attend the all-hospital Christmas dinner a few days later. Part of the entertainment after the meal is Christmas carols. Each group of tables is assigned one verse of “Twelve Days of Christmas.” The operating room crew’s tables are assigned to sing “seven swans a-swimming” with each successive verse.

“Colonel, Ma’am?” A nurse lieutenant leans across the table. “Seven swans a-swimming sounds kind of dull,” she says. “How about ‘Seven surgeons screaming’?”

“No,” says another nurse, “They don’t actually scream. What else could we say?”

The chief OR nurse lets them work it out. They finally agree on “Seven surgeons whining.” The chief nods. This isn’t her idea, but it expresses the thought.

“The Colonel says it’s okay,” is whispered from nurse to nurse down the row of tables.When the sixth verse of the song finishes, their verse is next.

“On the seventh day of Christmas my true-love gave to me-" The surgical nurses rise as one and sing out, “seven surgeons whining–"

There's a pause in the large hall. “I don’t think those are the right words,” the song leader says from the head table. “Let’s try again. On the seventh day of Christmas my true-love gave to me–"

The surgical techs rise again, “Seven surgeons whining-"

In the following silence, two or three voices from the surgeons’ tables are heard, “Hey, now, what is this?”

“See?” a nurse exclaims triumphantly, “there you go again!”

Later, as the party breaks up and people are saying their goodbyes, the chief surgeon and the hospital commander come over to the chief surgical nurse. “Colonel, what are you doing to those nurses?”

“Wasn’t my idea,” she says. “But, ya know, sometimes they need a little morale-building. See y’all Monday morning!”