It snowballs now. For months I’ve worked with people who weren’t certain of my skills or my knowledge base. I’ve dealt with people questioning my judgement. I’ve gone toe to toe with people over patient care, over paperwork. I even questioned if I was going to fit in with this tightly knit, esoteric bunch of professionals. Maybe I needed to go look for another job. I knew I was a crotchety old broad too, but this was getting ridiculous.
Then, it all began to fall into place. I worked with surgeons who complimented the job I did. I stayed late, even though I was tired so that we could finish a case without delaying another. I anticipated needs, grabbed the right supplies without consulting the preference cards. My rooms ran smooth as silk, even when there were complications or blips. One procedure wasn’t booked correctly; part of the procedure wasn’t booked. We needed more instruments and I only had access to the implant rep via phone. I ran for instruments, called central supply. I shoved another table in the room and draped it out. My tech hadn’t asked. It’s not a huge gesture, but it’s considerate. He thanked me profusely later.
Yesterday, a patient returned for obstructed bowel. I knew it would mean another evening of leaving late, but I offered to assist. The surgeon looked at me, and then asked for another nurse, R. However, R had to “run” the desk, so I was the only one available. I didn’t let it bother me; just another surgeon to prove myself to. I helped the circulator prepare the room and position the patient on the bed before I scrubbed in. The tech was an experienced tech, but it was soon apparent that she wasn’t completely comfortable doing an open abdominal case.
For me, an open abdominal case is as familiar and easy as drawing breath. Soon we’ve incised through skin, fat, muscle and fascia and I’m gently retracting bowel. The adhesions are numerous and bind the loops of gut together. We’ll need to join two sections that are damaged from the adhesions. The surgeon asks for the “stapler”, but doesn’t specify the one he wants. The circulator holds up the wrong one and the the tech gestures for her to open it. Before I can stop myself (to let the surgeon correct the error) I alert the circulator that she’s opening the wrong stapler; then I tell her the correct one. The surgeon looks at me, “That’s correct. You knew what stapler I needed. Good job.” When he asks for suture to oversew the anastenosis, the circulator scans the preference card, the tech calls out the wrong suture. Again, I speak up, “We need 3-0 silk pop-offs on SH (this code tells the size of the suture, the size and type of needle, and that they are controlled release).” The surgeon looks up, “That’s exactly what I need. You know what you are doing. Why do they hide you from me?” The tech stares, shocked. When the case is finished she’ll complain that she doesn’t know that specialty as well as she does neuro. She’s not comfortable that I may be better versed with some surgeries than she is.
I see that often here. When someone doesn’t know a specialty, there are many excuses. The egos are huge. The “pissing contests” are epic. I’m not like that. I’m comfortable in my skin, and it makes me different. J comes to help me prepare for my last case of the day today, “I’m having a party by the pool at my complex. Only inviting the cool people so there’s no drama. Just drinks and cooking on the grill”. She runs through the guest list. It’s sausage heavy, but I agree to go. I tease that I need to lose a few pounds to look good in my bikini. She was disappointed with her birthday party. I didn’t attend but she confessed that she shouldn’t have invited certain people. “DD acted like she was on drugs,” J shudders, “She was slurring her words, taking offense at nothing, acting weird.” DD is on muscle relaxants and pain pills for a failed neck fusion. I feel bad for her, but she’s not helping her case.
Today, DD announces that she’ll have repeat surgery on her neck sometime next week. She tells us her wishes, that no one be allowed in her room, who can close her incision. She tells us that she hopes she won’t need a catheter. I shrug, “If you do, you do. It’s nothing really”. Then she goes on about how she doesn’t want anyone else in the room, staring at her body. J looks at me alarmed, “But, you’ll be covered with sterile drapes. No one will see anything. You know everyone will be busy in their own rooms anyway. People will come wish you well in holding, but no one will bother you once you’re wheeled to the room.” I look back at her, concerned, while DD continues to tell us her wishes, which are slightly bizarre considering that she works in surgery and knows the routine. J’s right, DD doesn’t sound sober or rational. Personally, I think she’ll end up getting let go. She’s not “getting it”. I don’t tell J that I find DD’s concern over having a urinary catheter or that people will come and look at her naked body to be quite overblown. After all, we’re working on her neck. We’d hardly be ripping the gown from her body to look at her. Inserting a catheter is something we all do every day. It’s a mindless task, no more intrusive than starting an intravenous line. It disturbs me that she worries that we will “look”. That’s the sort of thing that unstable people who don’t work in surgery worry about, that somehow we admire and find something sexual about their nakedness while we are doing our jobs. I wonder if DD does that, “looks” at our patients. I know she looks at J and I. She’ll compliment both of us on any variety of body parts or attributes.
Sometimes it’s not very comfortable to listen to. I realize that she’s bisexual, but it wouldn’t be comfortable listening to that from a male colleague either. She has a locker right next to ours. I notice she frequently takes a bathroom break about the time I clock in to work. She’ll sit in the locker room and talk to me while I change my clothes. I don’t say anything to J about that, because I don’t want to make waves.
J ignores it all too. We don’t want to upset DD, and we don’t want to contribute to the rumor mill.
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