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Nurses’ Effect in the Operating Theatre? What Effect?

Aaronsingh72x721_3Aaron Singh -- The waiting room was cold. I remember thinking to myself, why the heck are all hospital waiting rooms cold? If I ever become a hospital bigwig I’m going to make sure there are MORE than a few heaters installed in my hospital waiting rooms.

I sat on the edge of the bench looking straight ahead. It was only after a few minutes that I noticed that the rest of my family members there were looking at me with an odd expression on their faces. Then I remembered. Here I was, a bigtime medical student, studying at a top university. Knowledge coursed through my veins, and I was sitting in a hospital. I was supposed to be in my element. Master of my realm, all that jazz. They clearly expected me to be the picture of calm. The source of reassurance. Not this quaking, sweating, nervous wreck sitting on the bench unable to make eye contact with them.

On the other side of the wall, in an operating theatre, was my cousin brother. He was undergoing surgery in an operation which I was told was quite routine and from which "he probably won’t die," or so said the surgeon with a smile. Someone needs to tell surgeons that sarcasm isn’t exactly what family members want to hear right before you slice their loved ones open.

Pull yourself together, man! Time to play genius medic. And so I forced myself to stop worrying, plastered a silly grin on my face, and turned to my family members. I tried to think of something reassuring to say, mentally digging through all those Communication Skills classes I’d slept through, when she came.

A shimmering vision of beauty and kindness, holding a cup of steaming tea, with a kindly understanding expression on her face. She sat down with us on the bench, introduced herself as the head nurse on duty, and started talking, and before long she had the whole family calmed down and raptly paying attention, myself included.

On the other side of the wall, my cousin brother (being a plucky medical student himself) had elected not to have general anaesthesia so he could experience what it was like to undergo the operation. He later related to me how cold it felt, and how the surgeon was rather impersonal, humming away without so much as an "are you okay?" It was the OT nurses who kept him reassured and made sure he was comfortable. He told me they were really professional and concerned, and made up for the surgeon’s lack in communication skills several times over.

Some doctors have told me that nurses play a very small role in a patient’s stay in hospital. I beg to differ. Whilst it may be true that the doctor’s role is far bigger, it should be remembered that there are some things a doctor can’t do that nurses can. I hope I still remember this when I grow up and become some impersonal drone mindlessly chipping away in some ward somewhere.

January 9, 2007 | Permalink

Comments

It's kinda depressing to hear how down on nurses some docs are. Makes me think I'll last about a day being a nurse after not taking any M.D. smack ;-(
Then again, there are asshats everywhere...sigh.

Posted by: tomla | Jan 11, 2007 7:16:33 PM

Thank you for this wonderful post about the importance of a nurse's care during your hospital experience. All healthcare workers, from physicians to housekeeping staff, need to remember that we are not just caring for the patient. We are caring for their loved ones as well. Every encounter gives us a chance to convey caring, comfort and reassurance. As the saying goes, patients don't care how much you know until they know how much you care.

Posted by: April LPN | Jan 12, 2007 6:11:38 AM

How could a doctor say that a nurse plays a small role in patient care? The nurse is there with the patient more than any other healthcare provider!
Although it is nice to mention that nurses are there to comfort patients, what about the technical skills they have, as well as the knowledge they possess? Nurses are not there just to make people feel better; they're around to keep people alive. They are able to do this because believe it or not, nurses are quite intelligent and knowledgeable.

Posted by: Nicole | Jan 14, 2007 10:58:05 AM

One of the fascinating things about the past two clinical years for me has been feeling out the border between the role of doctor and nurse. Some of the differences are obvious, and others are not as clear. Good nursing is amazing, as I said a a while ago on my blog, but bad nursing can be so frustrating. Since nurses see more of the patient than the doc does, they are wonderful (and powerful) allies in patient care, when they are good.

Posted by: Nathan | Jan 15, 2007 8:00:13 AM

include a layout too

Posted by: sabna | Jan 21, 2007 11:32:09 PM

A wonderfully written article.

I completely agree with the author; when I was on a surgical rotation, the consultant surgeon did explain the operation to the patients, but in a very detached, clinical and emotionless manner. Don't get me wrong - he was a brilliant surgeon and performed operations flawlessly - but he was like a machine when it came to talking to patients beforehand.

It was often the nurse (or myself, the mere medstudent!) who took time and talked to the patients and/or their families, allaying their fears or going over some of the finer points, with simple gestures such as bringing them tea or water easing their nerves a bit.

I'm glad that the author has brought this to light - and all the more sincere, because he experienced it firsthand himself.

Posted by: Calavera | Jan 22, 2007 4:01:26 AM

Thank you for your kind words about our profession. I really enjoyed reading your story.

MJ

Posted by: motherjones-rn | Jan 22, 2007 12:52:47 PM

Q:Why are patients hospitalized?

A: Because they need 24 hour nursing care, not 24 hour doctor care. And I might add, very few doctors could even do what nurses do. Don't believe me, ask a Kaiser Doc who has been through a nursing strike. Lots of work to do AFTER pronouncing someone dead!!

Posted by: tom | Jan 22, 2007 3:07:40 PM

This was a great post. Nurses do have an incredibly interactive and vital role in patient care. So do doctors but I know that this post was more nurse-centric, as it were. I hate to hear of stories from nurses of problems between physicians and those within their profession. Very troubling.

Posted by: patientanonymous | Jan 22, 2007 3:11:40 PM

Physicians frequently forget that there is a health care TEAM, and while doctors direct the team, the nurses and other members (aides, therapists, even social workers) are vital members since they often carry out the doctor's orders and address social and other issues which may be of equal importance to the patient's continued health (like patient education, discharge planning, navigating insurance, etc.)

This is so because the team approach is not really emphasized in our training, although the more perceptive physicians will already know this by the time they finish residency. Many a nurse saved me during my medical school and internship days. In their honor, whenever I am rounding and am still mistaken for a nurse (in spite of the long white coat with my name Dr. So and So embroidered all over it, stethoscope, and confident demeanor), I merely smile sweetly and say "No, I'm not a nurse," and mutter like Seinfeld, "Not that there's anything wrong with that."
P.S. Thanks for the comment on my blog

Posted by: docwhisperer | Jan 23, 2007 8:22:17 PM

I totally agree

I'm in fourth year and have just started off at hospitals in a surgical team. In my two days at hospital i've managed to observe a number of surgeries. While the 'god like' surgeons are goin abt their business grunting/mumble u away, its the nurses that look at you and decide to come over to explain the procedure to you.

Nevertheless you do get the absolutely wonderful surgeon who understands your excitment in being in OR for the first time and explain as they go along and you also get that arrogant nurse who looks down at you as though the superiority complex has just boost her ego ten-fold.

It eventually comes down to the surgeons/nurses personalities....nevertheless nurses are absolute angels - much respect to them :)

Posted by: Anu | Jan 25, 2007 2:33:34 AM

Thank you. Words of appreciation about nurses are appreciated at all times. But from a med student, even more so. Build a rapport with the nursing staff who shares your patient with you and they will move mountains to take care of that patient and incidentally, make you look really good.

You can bring your patients to my hospital when you're done residency.
/jo

Posted by: JustCallMeJo | Feb 9, 2007 9:06:55 AM

Nurses do not practice as an extension, or as an arm (or as any other body part, for that matter) of physicians.

Where medicine aims to diagnose and treat disease/injury, professional nursing aims to assist patients in attining, regaining and maintaining health or in assisting them in a peaceful death.

Clinical nursing expertise involves frequent patient assessment which alerts to incremental and often subtle changes in status. Nurses coordinate and manage health providers and servcies, and they work with patients in their context of family, community and social roles. Nursing attempts to empower patients to be able to function as independently as possible. Nursing is the sole profession which intentionally transfers decision-making power to its patients by freely sharing care strategies, interventions and emphasizing patient/family teaching around self management of health problems.

Because the patient "turf" overlaps with physicians, physicians and nurses often clash needlessly. Where there is mutual professional respect, collaboration and recognition of both professions' aims and goals, there will be better collegiality, better communication and better patient outcomes.

Posted by: N=1 | Feb 26, 2007 2:43:50 PM

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