Tuesday, 6 November 2007

Cocky young doctor

Sometimes you meet people and they just get your back up.

Operating theatres are staffed by the anaesthetists, surgeons and ODAs (operating department assistants). The job of the ODA is to make sure the theatre runs smoothly. To check the right patient has some for the right procedure, to keep the theatre tidy and to pass things to (assist) the anaesthetists and surgeons.

I was working in a new operating theatre today and, when I entered the anaesthetic room, after seeing my patients on the ward, I introduced myself to the Susan, the ODA and Marcus, her student.

Sarah, the first patient, comes in and Susan and Marcus complete their checks and then I set about the business of actually giving Sarah the anaesthetic. I start putting the drip in back of the patient’s hand and Susan says,

“Why are you putting it there? Why don’t you put it in her wrist? It’s better in the wrist.”

This annoys me. I may be young but I’ve probably sited close to a thousand drips so far in my career and I KNOW how to do it. I feel that she is trying to tell me how to do my job. I let it pass and the drip goes in to the patient’s hand first time.

Susan and Marcus had got the intubation stuff ready and I did my mental check so that I knew where everything was before I started. Oxygen? Yes. Suction? Yes Laryngoscope? Yes. Bougie? I couldn’t see it.

“Do we have a bougie?” I ask.
“It’s over here” Susan replies, pulling one out from behind the anaesthetic machine, “I’ve been in anaesthetics a lot longer than you, you know” she adds.

I wonder if she’s deliberately trying to wind me up. I know she’s been “in anaesthetics” a lot longer than me. She’s about 50 years old and was probably doing the job the day I was born, but I also know that I’m the anaesthetist and she’s my assistant. I have to look after this patient. I’m about to give her medications that will first send her into a coma and then paralyse her so she can’t move or even breathe for herself. I have a duty to make sure I can keep her alive and unharmed, so I NEED to know EXACTLY all the equipment I may potentially need is because I have only a few seconds to intubate my patient before she starts to suffer ill effects. When I spoke to Sarah on the ward, I made a promise to her that I’d look after her and the best way to look after her is to anticipate things that could go wrong and to nip them in the bud.

Once again I let Susan’s comment slide and I inject the anaesthetic drugs into Sarah’s vein. Marcus passes me the laryngoscope and I slide the blade into Sarah’s mouth.

“Don’t damage her teeth will you?” Susan pipes up

I can’t see what I’m looking for and I slide the blade further into Sarah’s throat.

“Watch out for her teeth!”

The blade is not near her teeth, so I ignore Susan and concentrate as the epiglottis pops into view.

I lift the blade to visualise the vocal cords.

“Careful with her teeth!”

The blade is still nowhere near Sarah’s teeth and Susan is really annoying me because I’m concentrating all I can and she is distracting me at a crucial moment.

“I’m nowhere near her teeth! You are NOT helping” I snap.

I push the endotracheal tube into Sarah’s trachea then connect the ventilator. We can now start the operation safely. I look up and Susan is giving me a look that could kill.
No doubt I’m now a “cocky young doctor” who “thinks he knows everything” and “doesn’t respect experienced staff members.”


1 comment:

Jo said...

Back seat anaesthetists!

Sounds to me like you wouldn't have been able to win that one...