I have made no secret of my worst case. Ectopics are a pain in the butt. The surgeons always try to save the tube, which I understand trying to save someone’s fertility, but it rarely works. In the hundreds of these I’ve been the circulator for trying to save the tube just prolongs the surgery. Even with a perfectly executed hydro dissection of the ectopic from the tube, the tube is going to bleed. And bleed. And bleed. Which the surgeon will try to stop, throwing everything but the kitchen sink at it.
Admitting defeat, they take the tube.
Cool, we could’ve done that like an hour ago.
I took over the room from the day shift nurse right after patient positioning but before the start of the surgical case.
Wasn’t that fun?
No, no it was not.
Nothing is worse than inheriting a room.
As I was getting report, I flat out told the nurse I was relieving that ectopics were my least favorite case. I would go even so far as to say they are the worst.
The surgeon heard me and asked me why these were the worst cases.
I am not sure if they were looking for a political answer or an ode to saving the patient’s life.
To their surprise, I said that ectopic cases were the saddest cases I’ve ever done.
Especially immediately before or after a major holiday.
I informed them that the worst of the worst was several years ago when I was the circulator on 10 ectopics in 7 days. Right after Christmas.
That was the worst worst.
Not only are you breaking the patient’s heart but these are not easy cases.
No matter how prepared the room is.
No matter how much was missing from the room preparation.
Not to mention the surgeon’s demands for things that are not on the preference card like a certain needle or the physically impossible contradicting orders from them and their assistant. No, I cannot turn on the light source and the CO2 and dim the room lights and the spotlights at the same time I am also setting up their suction. The gas and the light source are on the same tower but the room light switches and the spotlights are in an entirely different place in the OR, as is the suction. And then they express displeasure that I can’t do all four things at the same time.
Rude.
A friendly word to the CRNA, if there are calls from the field about changing suction and I am across the room attending to something else, please change the damned suction. That’s why there are 4 suction canisters on that suction tree. And don’t watch me in an avuncular manner as I scurry to change the suction out. That you are sitting RIGHT next to. Okay?
Hopefully, that will be the last worse case of the year. I mean the year has 7 more days in it. Anything could happen and will.
Just ask Murphy.
Dispatches from the Evening Shift 