Before I became a travel nurse I spent time in the recovery room learning all the skills it took to be a great PACU (post anesthesia care unit) nurse. This was my bridge into the surgery department, and I quite enjoyed my time there. I made many good friends and took a lot of weekend call to help cover the bills that were never ending at home. I made a friend named Annie who became one of my best friends to this day. We spent many weekends on call, taking turns taking patients, and helping each other through the weekend.
Each weekend learning the patterns and moods of the surgeons and how to properly address our concerns to each doctor without getting them too riled up. One particular doctor, Dr B., is always the difficult one to deal with. If it was a question as simple as “Can I put in a X-ray to confirm the N-G tube?” to deal with a barrage of snide comments about how ridiculous we were to ask him. It didn’t matter if the question was to help him from getting phone calls, or to help protect the patient, every question was met with the same nasty comments. I told Annie we should not talk to him anymore if we can help it, to protect our mood.
One weekend Dr. B performed a surgery, and I am reviewing the post op orders, which we always do to make sure we have completed what is necessary in PACU, as well as answer any questions the floor may have when we take them upstairs. I notice an order for ½ Normal Saline with 20K going at 150ml/hr. I know the patient is end stage renal disease, and being dialyzed three times a week. I sit for a moment, contemplating how I approach this to Dr. B. Obviously this patient doesn’t need this fluid, and will cause fluid overload. I could just ignore the order and not start it and pass the buck to the floor. Tough decisions, I decide to do the right thing and approach Dr B at the dictation desk.
I approach gently, excuse me Dr. B, I have a question about this order. He turns his chair around and gives me the look that is clearly like “why the hell are you bothering me”. I showed him the order for the fluid, and ask him to confirm that this is what he wanted as patient is on dialysis. He grabs my name badge dangling on my chest and turns it around to show the RN initials on my badge and clearly states “that’s what I wrote isn’t it?”. I was instantly furious, I said “yes, I just wanted to make sure you knew she was a dialysis patient.” He states well what do you think they give in surgery? I just take a deep breath and walk away.
I immediately went to Annie and unload on her about how ridiculous his behavior was, about how I was just trying to make sure he was aware of the patients history. Knowing the nurse upstairs will call him immediately as well or call Renal to get the order changed. Annie validated my frustration, and just reaffirms that he is just an asshole. Many of these situations continue to unfold as it seems that Dr. B is the only surgeon that takes weekend call for weeks upon end.
One particular weekend we get called in for a gastric perforation. We pick up the patient from the ER and walk the patient and family to the recovery room where we will prepare her for surgery. The family has not been able to speak to the surgeon yet, as when he spoke to the patient, the family hadn’t arrived. Looking through the papers we notice there is no consent for surgery, as well as no order for consent from the surgeon to tell us what it should say. I just dreaded that phone call, I try to convince Annie to call him, to no luck. She says he likes you better. Family begins to ask to speak to the surgeon as well before surgery. I paged Dr. B to PACU and wait his return call.
The phone rings and I notice it says, “surgery lounge”, I answer, tell Dr. B that family would like to talk to him before surgery, he asks to be put on speaker phone. I was so irked at that moment; you are literally 50 feet behind me and won’t come face to face with the family to comfort them before surgery. I place the phone on speaker, and family approaches nervously to the desk and asks all the questions on their mind regarding their family member. After family has asked all their questions, I tell Dr. B., I need one thing please, on speaker phone, I ask for orders for consent, he immediately gets nasty, “what do you think we are going to do, get your pen out sweetie and I will spell it for you expl”. I slam the phone down. I look at Annie and tell her I am going to get water.
In that moment I am humiliated, infuriated, and just so disgusted with his behavior. Who does he think he is to continue to treat me with such utter disrespect. I walked back to the surgery lounge to get water, forgetting he was calling from there. I enter the lounge and go for water, and make eye contact, and he starts saying “hey I just”, and I just snapped, in that moment, making eye contact with him and telling him “fuck you mother fucker, I have been working with you for two years and you treat me like utter shit!”. He looks stunned and quickly quips with “you need to take a Xanax sweetie”. I approach him and begin to unload all the garbage treatment stories of what he has put me through, grabbing his badge and showing him how he made me feel making sure I knew I was beneath him. I express to him how narrow minded he was to think that only his opinion mattered, and I came from a University where all teams collaborated to make sure the patients had the best care. Called him an arrogant asshole and began my walk back to PACU.
There sat Annie who knew by the look on my face something terrible had transpired. I picked up the recovery room phone and get connected to the house supervisor, in that moment I was determined to do something I had never done in my career, write him up. Even though I am sure I could get into trouble for cussing him out, at that moment I didn’t care. House supervisor answers and is guiding me on how to find the link to the reporting events page. When here comes Dr B, with his hands out, professing his apologies, about how his daughter is a nurse, and he has the utmost respect for our career. I let the house supervisor know he was apologizing and never mind. I listen to Dr B apologize and give all the reasons why he does value my opinion, and asks for another chance to work together. I accept his apology and off he went to perform his gastric ulcer repair.
That was a pivotal moment in my career. The moment I realized that people treat you how you allow them too. That I had allowed too many boundaries to be crossed before snapping. That I didn’t feel good acting un-lady like and cussing him out, that it shouldn’t have come to that. I begin to work on myself and figure out how I can express my feelings in the moment, and address the disrespect to ensure I never find myself cussing out a general surgeon on call again. I worked for many years in the OR after this incident, and Dr. B never made a snide comment again, became very nice and easy to work with. The one and hopefully only time I state so clearly “fuck you mother fucker” at work.