Coming into each facility as a traveler, the first week feels like walking into the hunger games. You are lined up against all the group of people you start with and scaled on your strengths and weaknesses. You are then released to the board, for testing. Each day put into a different room to be assessed. You are being assessed by not only the Surgeon, but also the staff who will report back to the managers and let them know exactly how smart or dumb you really are. If you will hack it in a challenging room, or if you are destined to cysto land for your assignment.
After a harrowing first week in each specialty, my assignment was determined to be primarily with the chief neurosurgeon that absolutely no staff want to work with, Dr X. Staff have left his room crying, refuse to go back claiming “they don’t do neuro anymore”, whatever excuse to stay out. So of course I would be assigned to his room. I love a good challenge though and take this in stride.
This particular surgeon has an assigned scrub tech that is a badass, that opens and sets up her mayo and back table(of instruments) in under 10 minutes flat. The kind of mastery she has of her movements is astonishing. No move is wasted; no pan is placed down to then be touched again. She has been working with this neurosurgeon for years and knows how to get through a case without ever being asked for an instrument. I sense her hesitancy when I first walk in, getting the typical “how long have you been traveling, nursing, in neuro questions?”. I answer them all honestly and truthfully, and I always fly with the concept that I will show them what I got quicker than tell them.
Making a playful environment is crucial to having a successful day, just with the shear pressures we are under to perform fast turnovers and make decisions daily, the moments that we find to jam out to a good song, or make jokes is what can keep our spirits up. I quickly realize that when Dr X’s assigned scrub goes home for the day, that is when I have the toughest moments. When Dr. X must open his mouth and ask for something from someone, you can sense his mood change, and frustrations building.
Everyday at 5pm I notice my day begins to struggle, the relief scrub, a guy named Dan shows up late to relieve the tech, because of course he hates being in the room, and Dr X immediately rolls his eyes at him. The passive aggressive remarks begin to be made, “the same instrument I use for every single laminectomy Dan”. I can see Dan’s anger rise in his eyes. Sometimes I even wonder if Dr. X is just making up things that he really doesn’t even need just to test Dan and make him feel stupid. I do the best that I can to learn instruments along with him so that I can help guide Dan and improve our evenings.
The moods always shift based on the way the case is going as well, if the surgeon makes any mistakes you can be sure that he will find a way to take it out on his least favorite person in the room.
This particular evening, we are fighting for our life to get the last case to the room. Dan is playing dumb, acting like he wasn’t assigned to the room, knowing he is the only neuro tech in the evenings. I am scrambling to get the room set up and open, and he comes dragging in, saying he hasn’t even had lunch yet. I just want to get the patient and get moving. He finally scrubs in, and off I go. Arriving at the room with pouty Dan, and getting the patient put to sleep and flipped, in comes Dr. X. eyes locking with Dan, doesn’t speak to him. Gowns and gloves him and ask’s for drapes, the PA is dragging around to get into the room. Dan doesn’t usually, drape, its typically the PA, so Dan hands him one, “wrong”, Dan hands him another “wrong”, Dan hands him another “try again”, I am just feeling mortified, finally the PA gets to the field and takes over. Dan asks me to call out for his lunch relief.
I call out to charge and let her know that Dan would like lunch, he is very upset and needs a break. Charge tells me there isn’t anyone else to get him, and I reiterate Dan’s frustration. About 10 minutes later a new travel tech walks in Megan. Megan scrubs in, and Dan is out of there. Megan introduces herself; Dr X just looks at her. He asks for a instrument, she scans the mayo she didn’t set up and struggles to find it, handing him one, “Nope” he yells, she continues, “Nope”, every instrument he denies. He yells at his PA to help her, which I’m sure he doesn’t have a clue either. When Dr. X looks at me and tells me “Call the charge, tell her to get Megan the fuck out of here, she doesn’t know what she is doing!”. I shake my head.
Calling charge and explaining that here we are again with another tech, and Dr X wants her out. Charge reports that Dan is the only other tech and he isn’t answering his phone, trying to get him back early from lunch. Dan takes his full lunch, 45 minutes, and with every tick of clock my heart is sitting in my throat. Waiting to see if Dr. X will go off again, scream, stomp, or turn his frustrations onto anyone else. The emotional roller coaster of this case was excruciating. Knowing that Megan is standing next to a surgeon that pretty much called her a dumb ass and must remain was awful for her I’m sure of that.
Dan returned from lunch; Megan ran for the hills. Dr X seemed to in that moment have some self-reflection of his behavior, because of how poorly he rated Megans performance, he gave Dan a “good job” at the end of the case. Creating these loops of almost abusive behavior, spending your efforts disqualifying someone’s skills, mistreating them, and then thanking them. Dan may spend time pondering if he will ever get Dr. X’s approval, he may not care, but the poor treatment and a after thought “good job”, is not the kind of behavior I would like to see in my rooms.
I spent an entire year in Dr X’s room, learning, studying, and realizing the type of behaviors he liked. Someone quiet, someone routine, someone who lets him lead the stories in the OR, someone who reads up on his patients’ history, and showed just the right amount of interest in the cases. Acclimating my personality to perform in the way he needed is much easier than the poor scrub techs who stand at the field and could be told at any moment to “Get the Fuck Out”.