I love the idea of the neck tourniquet. Although I am also a big fan of the electric cattle prod. I think it is clinically indicated in some situations. Do you think NANDA could write up a nursing diagnosis for that?

That is in L&D, yes? I find that docs who have to manage patients for non-surgical reasons tend to be a bit more…personable, as a rule. (Ortho, ob-gyn, urology, etc) Other docs, who tend to be more…assembly line oriented, shall we say (neuro, general, cardiovascular) tend to be more prima donna. I have wanted to call for the neck tourniquet to be brought to my room more than once. There are, of course, exceptions to this.

If you have to go head to head all the time, maybe you work in the wrong place. Last time I had to go all the way up the chain is when we the nursing staff disagreed with one of my favorite Doctors. He is MFM and I think he has written a bunch of papers and folks geneflect when they pass him in the halls. I really really get a long great with the guy. Which does help in a disareement. We did end up doing things his way. But first we called the Nurse Manager at home and our clinical educator to make sure it was a reasonable order for the patient since we were unaccomstomed to his intervention. Also the research he showed me on the topic did not convince me and I told him so which made him yell at me just a bit. This is uncharactoristic of this guy.

I agree with choose your battles. I have lost sponges and we kept the surgery going. Why? Cause it is usually in a few tell tale places. Not in the abdomen. When a Doc sticks a sponge in the abdomen, I put a kelly on my gown to keep track of it. So not usually a big deal but if you are new to scrubbing I can see where that would flip someone out.

I have raised my voice at Docs who throw their needle drivers on my mayo. Why? Because the needle driver has a needle on it. The needle can pop off and it will take f-ing forever to find it. And I hate X-rays. We usually take like 4 or 5. She comes she takes a picture. Brings it to radiology. She comes back takes another picture. This is a f-ing 3 hour tour without Gilligan. I find when my Docs are wrong, like throwing their needle driver on the mayo and I yell at them, they apologize. Why? Cause they know I know they are wrong. We all know they are wrong. And they don’t have 3 hours to spend in the OR taking x-rays either.

I later worked for a medical device company, and a surgeon threw something bloody behind him, where I was standing. I waited, and after the case, told him that I’d appreciate it in the future, if he didn’t throw things. I did it quietly away from everyone. He started yelling at me that “it wasn’t my place to tell him that.” I told him that if it compromises my safety, it does. The sales rep that supervised me was mortified that I had spoken up, but my district manager had my back. Lucky for me, the circulating nurse had already gone to the OR director and reported the throwing incident. He was sheepish when they did call him on the carpet for it. Not that he ever apologized to *me*.

I love it when the sponge count is wrong, and we inform the surgeon over and over again. We are told, “It’s not in there. I guarantee it’s not in there.” The xray happens and…wow! The sponge IS in there. Not only does the surgeon have to hang out and wait for the xray…he then has to REOPEN THE PATIENT, take the damn sponge out, and reclose. He’s a lot nicer about it, though…