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I'm an operating room nurse at a level 1 trauma center in a large city. I work primarily in orthopedics, so we deal with trauma cases, but it's mostly scheduled surgeries like knee or hip replacements. Surgeries start around 7 a.m., so I start by prepping the patient and then I have about a half hour to get them fully ready for the surgery. One of the first things I have the patient do is fill out a consent form. It amazes me how many people don't read the consent form at all. In reality, you're not going to come in for a breast biopsy and have your foot taken off. But it's important to know what you're signing up for. It's rarely a problem, but occasionally a surgeon will, for example, want to remove more tissue than originally planned. It's worth knowing that's a possibility.
In the surgery room, typically there's the surgeon, an anesthesiologist, an anesthesiologist's assistant, a scrub tech — a technician trained to help the surgeon with surgical tools, a scrub nurse, and a circulator — and also a nurse who acts as more of an overseer, making sure everyone has what they need and that everything is sterile.
Before we start surgery, hospital policy mandates that we do a "check in," in which we take a minute or two to restate the patient's name, condition, and go over the details of the surgery, to make sure we don't get something wrong. Recently I was in an operating room where the surgeon refused to do the check in because he said it was a waste of time. We weren't comfortable with skipping it, so the circulator went to get a hospital administrator, who came in and told the surgeon he really had to do the check in. The surgeon started going off again about how this was a waste of time, and then he decided to put us all the spot. He pointed his finger at each of us and asked if we agreed that it was a waste of time. I think he was a little shocked when none of us agreed with him. Nurses are supposed to be patient advocates, so that's what we were being in this case.
Also, once I had a surgeon throw a suture needle at me because I set it up for a righty, and it turned out he was a lefty. There was another who ripped a phone off the wall when it wouldn't stop ringing.
During the surgery, the surgeon is always the one who directs the conversation. Occasionally you'll get a particularly chatty scrub tech and the surgeon will resent not being the one leading the discussion. There are some surgeons who are humble and great, but some are really out of touch. People say surgeons are kind of socially inept because they're always in the books, and I get that. But they'll complain that they have to pay $12,000 to fix something on their boat. They don't think about the fact that the rest of the room makes a fraction of their salary.
Before I was in an operating room, I thought people would lay off hot button issues while performing surgery. Not the case! Surgeons love to talk politics in the operating room. It was all they'd talk about during the election. I'd say 90% are Republicans, mostly because of health care. They don't like Obamacare because they likely won't be paid as much. A lot of surgeons are really money-driven and they aren't ashamed to admit it. I'm very liberal, so I stay quiet when it comes to politics. I really don't want to get into a heated debate while a patient is cut open on the operating table.
People always want to know if hospital TV shows are accurate. None of them are, but Grey's Anatomy actually does a pretty good job showing what an operating room can look like. However, no one would ever talk about their sex life in front of everyone in an operating room like that. Also, they never wear goggles while in surgery, which is crazy. Blood can spray into your face at any time. You have to wear goggles. The other thing is that nurses have a much bigger role than gets depicted in those shows. When I watch with my friends, and you see a doctor doing something, I'm often like, "The nurse would be doing that!" But they're like, "Be quiet! We just want to watch the show."
As told to Hillary Reinsberg.