Operating Room Nurse Quotes

After three hours, I come back to the waiting room. It is a cosmetic surgery office, so a little like a hotel lobby, underheated and expensively decorated, with candy in little dishes, emerald-green plush chairs, and upscale fashion magazines artfully displayed against the wall. A young woman comes in, frantic to get a pimple "zapped" before she sees her family over the holidays. An older woman comes in with her daughter for a follow-up visit to a face-lift. She is wearing a scarf and dark glasses. The nurse examines her bruises right out in the waiting room. And you are in the operating room having your body and your gender legally altered. I feel like laughing, but I know it makes me sound like a lunatic.

Surgical Talk As we look at the insides of humans, We find the inside of ourselves And each other. What lies beneath us? What do we believe About the world and our place in it? We cut down layer upon layer And dissect the inner life.

The orchestra musician’s plight caught the interest of Harvard researcher Richard Hackman, who was studying the job satisfaction of workers employed in a variety of industries. Orchestral musicians were near the bottom, scoring lower in job satisfaction and overall happiness than airline flight attendants, mental health treatment teams, beer salesmen, government economic analysts, and even federal prison guards. Only operating room nurses and semiconductor fabrication teams scored lower than these musicians.

In airplane crashes and chemical industry accidents, in the infrequent but serious nuclear plant accidents, in the NASA Challenger and Columbia disasters, and in the British Petroleum gulf spill, a common finding is that lower-ranking employees had information that would have prevented or lessened the consequences of the accident, but either it was not passed up to higher levels, or it was ignored, or it was overridden. When I talk to senior managers, they always assure me that they are open, that they want to hear from their subordinates, and that they take the information seriously. However, when I talk to the subordinates in those same organizations, they tell me either they do not feel safe bringing bad news to their bosses or they’ve tried but never got any response or even acknowledgment, so they concluded that their input wasn’t welcome and gave up. Shockingly often, they settled for risky alternatives rather than upset their bosses with potentially bad news. When I look at what goes on in hospitals, in operating rooms, and in the health care system generally, I find the same problems of communication exist and that patients frequently pay the price. Nurses and technicians do not feel safe bringing negative information to doctors or correcting a doctor who is about to make a mistake. Doctors will argue that if the others were “professionals” they would speak up, but in many a hospital the nurses will tell you that doctors feel free to yell at nurses in a punishing way, which creates a climate where nurses will certainly not speak up. Doctors engage patients in one-way conversations in which they ask only enough questions to make a diagnosis and sometimes make misdiagnoses because they don’t ask enough questions before they begin to tell patients what they should do.

In the early 1970s, racial and gender discrimination was still prevalent. The easy camaraderie prevailing in the operating room evaporated at the completion of surgical procedures. There was an unspoken pecking order of seating arrangements at lunch among my fellow physicians. At the top were the white male 'primary producers' in prestigious surgical specialties. They were followed by the internists. Next came the general practitioners. Last on the list were the hospital-based physicians: the radiologists, pathologists and anaesthesiologists - especially non-white, female ones like me. Apart from colour, we were shunned because we did not bring in patients ourselves but, like vultures, lived off the patients generated by other doctors. We were also resented because being hospital-based and not having to rent office space or hire nursing staff, we had low overheads. Since a physician's number of admissions to the hospital and referral pattern determined the degree of attention and regard accorded by colleagues, it was safe for our peers to ignore us and target those in position to send over income-producing referrals. This attitude was mirrored from the board of directors all the way down to the orderlies.

Finally it was time to go into the operating room, and the nurse came to wheel her away from me. My heart tightened. To ease her fears, the pediatric nurses gathered around her and created a “bubble parade,” blowing little soap bubbles as they went into the operating room. To create this fairy-tale experience, they used a wand. Specifically, a bubble wand. All the worry and fear melted from my daughter’s face as she was captivated by the magical moment. As a parent, I felt a great deal of gratitude for this small but meaningful touch. As a marketer, I was awed. I’d just witnessed my daughter’s customer experience switch from anxiety to anticipation in less than ten seconds.

Code Blue! We’re losing him!” The EMTs hustled the gurney containing Erik Dawson’s broken body into the operating room where the surgical team waited. The nursing staff literally ripped his clothes off as they worked to stabilize him. “What do we have here?” the lead surgeon asked. His assistant didn’t bother to look up as she answered, “Auto accident. An eighteen- wheeler smashed his car into a guardrail.” The lead surgeon whistled through his teeth. “It’s a miracle he’s still breathing. Let’s keep him that way.” As the surgical team moved into action with skill born of practice, Erik drifted on the fringes of consciousness. Erik’s thoughts raced. What? Where? Anesthesia put him under, but as the doctors began their work and his parents prayed fervently in the waiting room, Erik spasmed and stopped breathing. Family Matters, from Home Again

Another common practice, the reps told us, was to take fancy meals to the entire doctor’s office (one of the perks of being a nurse or receptionist, I suppose). One doctor’s office even required alternating days of steak and lobster for lunch if the reps wanted access to the doctors. Even more shocking, we found out that physicians sometimes called the reps into the examination room (as an “expert”) to directly inform patients about the way certain drugs work. Hearing stories from the reps who sold medical devices was even more disturbing. We learned that it’s common practice for device reps to peddle their medical devices in the operating room in real time and while a surgery is under way. Janet and I were surprised at how well the pharmaceutical reps understood classic psychological persuasion strategies and how they employed them in a sophisticated and intuitive manner.

Sylphid was beginning to play professionally, and she was subbing as second harpist in the orchestra at Radio City Music Hall. She was called pretty regularly, once or twice a week, and she’d also got a job playing at a fancy restaurant in the East Sixties on Friday night. Ira would drive her from the Village up to the restaurant with her harp and then go and pick her and the harp up when she finished. He had the station wagon, and he’d pull up in front of the house and go inside and have to carry it down the stairs. The harp is in its felt cover, and Ira puts one hand on the column and one hand in the sound hole at the back and he lifts it up, lays the harp on a mattress they keep in the station wagon, and drives Sylphid and the harp uptown to the restaurant. At the restaurant he takes the harp out of the car and, big radio star that he is, he carries it inside. At ten-thirty, when the restaurant is finished serving dinner and Sylphid’s ready to come back to the Village, he goes around to pick her up and the whole operation is repeated. Every Friday. He hated the physical imposition that it was—those things weigh about eighty pounds—but he did it. I remember that in the hospital, when he had cracked up, he said to me, ‘She married me to carry her daughter’s harp! That’s why the woman married me! To haul that fucking harp!’ “On those Friday night trips, Ira found he could talk to Sylphid in ways he couldn’t when Eve was around. He’d ask her about being a movie star’s child. He’d say to her, ‘When you were a little girl, when did it dawn on you that something was up, that this wasn’t the way everyone grew up?’ She told him it was when the tour buses went up and down their street in Beverly Hills. She said she never saw her parents’ movies until she was a teenager. Her parents were trying to keep her normal and so they downplayed those movies around the house. Even the rich kid’s life in Beverly Hills with the other movie stars’ kids seemed normal enough until the tour buses stopped in front of her house and she could hear the tour guide saying, ‘This is Carlton Pennington’s house, where he lives with his wife, Eve Frame.’ “She told him about the production that birthday parties were for the movie stars’ kids—clowns, magicians, ponies, puppet shows, and every child attended by a nanny in a white nurse’s uniform. At the dining table, behind every child would be a nanny. The Penningtons had their own screening room and they ran movies. Kids would come over. Fifteen, twenty kids.

Robertson was in the operating room and no word on his condition was coming out. A bloody-handed nurse, who’d taken him in, stood washing her hands, and when Lucas asked, she said, “I’ve seen worse who lived. But then, I’ve seen better who died.” No help there.

I’m Jay Powers, the circulating nurse”; “I’m Zhi Xiong, the anesthesiologist”—that sort of thing. It felt kind of hokey to me, and I wondered how much difference this step could really make. But it turned out to have been carefully devised. There have been psychology studies in various fields backing up what should have been self-evident—people who don’t know one another’s names don’t work together nearly as well as those who do. And Brian Sexton, the Johns Hopkins psychologist, had done studies showing the same in operating rooms. In one, he and his research team buttonholed surgical staff members outside their operating rooms and asked them two questions: how would they rate the level of communications during the operation they had just finished and what were the names of the other staff members on the team? The researchers learned that about half the time the staff did not know one another’s names. When they did, however, the communications ratings jumped significantly. The investigators at Johns Hopkins and elsewhere had also observed that when nurses were given a chance to say their names and mention concerns at the beginning of a case, they were more likely to note problems and offer solutions. The researchers called it an “activation phenomenon.” Giving people a chance to say something at the start seemed to activate their sense of participation and responsibility and their willingness to speak up. These were limited studies and hardly definitive. But the initial results were enticing. Nothing had ever been shown to improve the ability of surgeons to broadly reduce harm to patients aside from experience and specialized training. Yet here, in three separate cities, teams had tried out these unusual checklists, and each had found a positive effect. At Johns Hopkins, researchers specifically measured their checklist’s effect on teamwork. Eleven surgeons had agreed to try it in their cases—seven general surgeons, two plastic surgeons, and two neurosurgeons. After three months, the number of team members in their operations reporting that they “functioned as a well-coordinated team” leapt from 68 percent to 92 percent. At the Kaiser hospitals in Southern California, researchers had tested their checklist for six months in thirty-five hundred operations. During that time, they found that their staff’s average rating of the teamwork climate improved from “good” to “outstanding.” Employee satisfaction rose 19 percent. The rate of OR nurse turnover—the proportion leaving their jobs each year—dropped from 23 percent to 7 percent. And the checklist appeared to have caught numerous near errors. In

As I was wheeled into the operating room one of the nurses said, “Hey, it’s Hillary Clinton!” and I answered by barfing all over her. Full circle.

Before long, something unexpected happened to test my newfound faith. Mom had to go in for a simple, twenty-minute surgery. I went with Dad to the hospital, and we waited while she was in the operating room. Forty-five minutes went by, and no one came out to tell us anything. Then a nurse came out, and one look at her face told me the news was not good. “Look, there’s a problem,” she said. “We haven’t been able to wake her up. She’s gone into a coma. We have a machine breathing for her, and we think she’s going to be okay, but she needs to wake up.” Dad looked at me, his face white and his eyes big and scared. We had no idea what was going on, but we knew it was bad. Really bad. He grabbed my shoulder and said through tears, “We’re fixin’ to pray for your mom right now.” I’d never heard him pray as fervently. He was frantic and telling God about how much we needed Mom in our family. We knew her life was at stake, and we both were scared she would never wake up. The rest of the family came to the hospital, and we gathered, praying our hearts out. We finally got in to see her, and the sight of Mom on a respirator, her chest rising and falling with the help of the machine, freaked us all out. Eventually, we found out what had happened. There had been a mistake, and Mom had been given too much anesthetic, sending her into a serious coma. Two days later, after many tears and huddles with family and desperate prayers, Mom came out of it, woke up, and started breathing on her own. I knew deep in my heart that she could have died, but God had chosen to answer our prayers, and that really built my faith. I was such a new Christian that I’m not sure how I would have reacted if something would have happened to my mom. I also felt like it drew me closer to my dad, as we had been the first ones to hear the news and to pray for her together. I saw a side of him I didn’t see very often, how much he loved and needed my mom and how much he trusted God to help him in a very bad situation. No matter whose fault it was, we were just relieved Mom made it out alive. She recovered from the experience, and with her cooking during those months, my appetite came back, and I gained fifty pounds. I even got a little chunky, so I started working out so I could look and feel better. Those three months of house arrest were probably the best days of my life. My thinking had changed, my heart’s desires were back on track, and I had hope for the future.

Teamwork may just be hard in certain lines of work. Under conditions of extreme complexity, we inevitably rely on a division of tasks and expertise—in the operating room, for example, there is the surgeon, the surgical assistant, the scrub nurse, the circulating nurse, the anesthesiologist, and so on. They can each be technical masters at what they do. That’s what we train them to be, and that alone can take years. But the evidence suggests we need them to see their job not just as performing their isolated set of tasks well but also as helping the group get the best possible results. This requires finding a way to ensure that the group lets nothing fall between the cracks and also adapts as a team to whatever problems might arise.

Despite all this bad news, there is real-world evidence that groups do confront bullies as a group—and it works! A shining example is the “Code Pink” technique used by surgical nurses. These highly skilled professionals are often berated and belittled by pompous surgeons, both men and women. In some hospitals, whenever a bullying surgeon steps over the line into mistreatment, “Code Pink” is called by the targeted nurse. Immediately, supportive nurses form a circle around the physician. Together, they declare their unwillingness to assist that person with current and future patients, if an apology is not given with a promise to behave in a civil manner. The interdependent nature of surgery makes the surgeon powerless without the help of the team in the operating room. All work stops and the physician is accountable for her or his bullying. It is the physician who is responsible for the patient’s life. “Code Pink” is the group displaying its power to the bully, demanding cooperation instead of controlling games.

I had full knowledge of the fact that my body had just stopped living. I could hear lots of commotion in the operating room (even though I was completely sedated and with no heartbeat). The nurses that were assisting were quite frantic.

In 1984, a psychologist named Roger Ulrich studied patients recuperating from gallbladder surgery at a Pennsylvania hospital. Some patients were assigned to a room overlooking a small strand of deciduous trees. Others were assigned to rooms that overlooked a brick wall. Urlich describes the results: “Patients with the natural window view had shorter post-operative hospital stays, had fewer negative comments in nurses’ notes . . . and tended to have lower scores for minor post-surgical complications such as persistent headache or nausea requiring medication. Moreover, the wall-view patients required many more injections of potent painkillers.

moment.’ She smiled. ‘How old are you, Ned?’ ‘Nineteen.’ ‘You risked your life for me.’ She stood on tiptoe and kissed him on the lips briefly but tenderly. ‘Thank you,’ she said. Then she left the room. * MOST PEOPLE BATHED twice a year, in spring and autumn, but princesses were fastidious, and Elizabeth bathed more often. It was a major operation, with maidservants carrying big two-handled laundry tubs of hot water from the kitchen fire to her bedchamber, hurrying up the stairs before the water cooled. She took a bath the day after Swithin’s visit, as if to wash away her disgust. She had said no more about Swithin, after kissing Ned, but Ned thought he had won her trust. Ned knew he had made an enemy of a powerful earl, but he hoped it would not last: Swithin was quick-tempered and vengeful but, Ned thought, he had a short attention span. With luck he would nurse his grudge against Ned only until a better one came along. Sir William Cecil had arrived shortly after Swithin left, and next morning he got down to work with Ned. Cecil’s office was in the same wing as Elizabeth’s private suite. He sent Ned to Tom Parry’s office to fetch a ledger of expenditure for another house Elizabeth owned. Coming back with the heavy book in his hand, Ned walked along Elizabeth’s corridor, where the floorboards were puddled with water spilled by the maids. As he passed her suite, he saw that the door was open, and – stupidly – he glanced in. Elizabeth had just got out of her bath. The tub itself was screened off, but she had stepped across the room to pick up a large white linen sheet with which to dry herself. There should have been a maid waiting beside the tub holding

In 1984, a psychologist named Roger Ulrich studied patients recuperating from gallbladder surgery at a Pennsylvania hospital. Some patients were assigned to a room overlooking a small strand of deciduous trees. Others were assigned to rooms that overlooked a brick wall. Urlich describes the results: “Patients with the natural window view had shorter post-operative hospital stays, had fewer negative comments in nurses’ notes . . . and tended to have lower scores for minor post-surgical complications such as persistent headache or nausea requiring medication. Moreover, the wall-view patients required many more injections of potent painkillers.” The implications of this obscure study are enormous. Proximity to nature doesn’t just give us a warm, fuzzy feeling. It affects our physiology in real, measurable ways. It’s not a giant leap to conclude that proximity to nature makes us happier. That’s why even the most no-nonsense office building includes a park or atrium (in the belief, no doubt, that a happy worker is a productive one).

What homeless people with wheelchairs were supposed to do when all that was available to them were inaccessible shelters was never discussed. Were they supposed to continue to live on the street? Most did; they could find neither housing nor homeless shelters they could get into in their wheelchairs. If they were really bad off, they'd go to the emergency room, and from there to a nursing home, where they were kept  -- the nursing home operator getting upwards of $100,000 a year in public money for keeping them there.

had to volunteer. Thought I couldn’t wait to get there. Arrived at Stotsenberg at nightfall. The hospital was bedlam—amputations, dressings, intravenouses, blood transfusions, shock, death … Worked all night, hopped over banisters and slid under the hospital during raids. It was remarkable to see the medical staff at work. One doctor, a flight surgeon, had a head injury, but during the night he got up and went to the operating room to help with the other patients.