The first place we get “You What?” moments for surgery are in the preoperative area where the nurses are getting final information and preparing the patient for the surgery itself
Some of the questions can elicit some interesting answers.
NPO-a difficult concept.
“Have you had anything to eat or drink this morning” (They are supposed to have nothing after midnight, maybe some clear liquids in the morning)
- “No,” said the patient-a 20 year old male. “No, but he smoked crystal meth on the way over here this morning.” His mother ratted him out. The surgery was canceled.
- “Yes, I drank Gatorade at 6,8, and 10 and in the waiting room before surgery.”
- “Yes, I woke myself up and ate grapes at 4 am because a nurse friend of mine said I could eat grapes.”
- “Yes, I had a burger and fries.” “You what? Why would you do that?” “Well they told me I couldn’t eat breakfast but I don’t eat hamburgers for breakfast.”
- “Yes, I ate a bagel.” “A bagel? Why would you eat a bagel?!” “The nurse in the office said I could have clear liquids. I asked, “ How do I know they are clear liquids?” She said, “Just put it up to the light and see if you can read through it.”
The nurse goes over their medicines. One patient gave the nurse a list she had typed up.. Nurse “That is a very nice organized list of your medicines.” The patient said “Yes, I’m very anal about that. Her husband said, “No you’re not. We’ve tried it twice and you didn’t like it either time.”
Or the time the patient forgot he had told both his wife and his girlfriend when and where he was having his surgery. They both showed up at the same time. They each introduced themselves. Oops. Very awkward!.
Then the CRNA and/or anesthesiologist comes in to discuss anesthesia with the patient. I one time asked the CRNA how they decided how much preoperative sedation for relaxation.
There were several answers.
1. He said, “I give Versed 0.5 mg per allergy!”
2. “Versed 1 mg per plastic surgery procedure.”
3. “Versed 1.5 times the normal amount if they have a lot of tattoos.”
Another patient was being quite nasty to all the people preparing her for her surgery. It got to the point where I had to speak to her about it. I said, “You can’t talk to these people that way. They are just doing their job.” Her response, “These people here are just the leftovers. If they were any good they would be at the hospital.” My response, “Well then, you are not having surgery here if you are going to act like this. And I am not doing surgery on you anywhere!”
What she didn’t realize is that the people there at the surgery center were the best or they wouldn’t make it there. They were certainly more experienced. New grads always start at the hospital and then get trained -just like residents. One time late in my career we counted up the years of experience the people in the operating room had. The 4 people in the room-surgeon, nurse CRNA, and scrub tech had over120 years of experience. It was quite reassuring to me to have them in there with me.
One of my favorite stories of all time in the OR is the older lady, a little overweight, who was struggling to transfer from the stretcher to the OR table. The CRNA said, “Just lift your hips up and over, Up and over. Up and over. She said “Honey my husband has been dead 10 years. I forgot all those moves” We all just cracked up uncontrollably.
So when I went out to talk to her family afterwards I didn’t mention it of course and her daughter said, “She didn’t say anything embarrassing as she was going to sleep, did she?”
I liked to go out to talk to the family in person after surgery and at least 20% of the time the families weren’t there, despite being told, “Don’t go anywhere so the Doctor can talk to you after the surgery.”
Usually they went to lunch or out in the parking lot smoking. But sometimes, with their child being the patient, they would leave to go shopping! We were free babysitters!
One time I couldn’t find my patient’s wife and I had just spoken to her when she was with him in the pre-op area.
I asked the nurses “Did his wife leave to go eat lunch?”
Her response, ”Not this time. When he was going to be taken back to surgery we asked him to give his wife his cell phone and he wouldn’t do it!”
After he went into the OR she told us, “I don’t want to talk to the doctor, or anybody, about him!” and she went out to the parking lot to sit in her car!”