Out of nowhere, as I was walking into the hospital today, I was reminded of a surgeon that I knew back in CA.
I may have told this story before.
I was a newer OR nurse and I was assisting with a manipulation of a shoulder.
The surgeon did the manipulation and then barked for the medication.
‘What medication?’ I asked, innocently.
‘You know the medication, the epi, to inject this joint.’
I had been an OR nurse for about three months as I recall.
I dutifully went to the pyxis and pulled out an entire bottle of epinephrine.
I knew it was not correct.
But no one else corrected him.
Not the scrub tech.
Not the anesthesiologist.
It didn’t even phase the PACU nurses when I pulled out a ginormous bottle of epi.
Okay, no one was going to help me.
The surgeon was waiting, impatiently, for a syringe of medication and a needle.
I put the epi in my pocket and walked back to the room.
He put his hand out.
And I refused.
He looked at me as if I was less than nothing.
Me? Denying a surgeon.
He looked at the anesthesiologist who was maintaining the airway, probably hoping I’d get a move on.
He looked at the scrub who was leaning against the wall. They don’t have a role in manipulations.
I pulled out the brown 20 ml bottle of epinephrine and I showed it to him.
‘This is not the medication you think it is.’
‘Never mind,’ he growled, hand still out.
‘This is epinephrine. This is a medication that is given during codes to restart someone’s heart. I will not be giving you a 20 ml syringe of this. It would kill the patient.’
He blinked and looked at me and then at the bottle and then back to me.
‘What can I give then?’
I pulled the second bottle out of my pocket and showed it to him. ‘This is marcaine with epi 1:200,000. This is what you want.’
He made a gimmee motion with his fingers.
I drew it up, put a new needle on it, and handed it to him, telling him in a closed loop communication although he had just seen me draw it up, ‘This is marcaine 0.5% with epinephrine 1:200,000.’
No further mention was made of his nearly catastrophic medication error.
No further mention was made of how it was good that I stood up to him.
Nurses don’t do this kind of thing for recognition.
We do it to keep the patient safe.
And that was the first time I stood up and defied a surgeon.
It has not been the last.