Show Me Your Stethoscope

An article from William R. Blythe, MD on the importance of nurses…

“The truth about Nurses, from an ungrateful, selfish, arrogant Surgeon

Yesterday I posted a silly photo in support of this movement, but tonight I want to say something serious while there is ample attention.

When a patient comes to our hospital for surgery, these are the people who take care of them:

The Pre-Op Nurses meet the patient, make sure they are ready for surgery, complete mountains of paperwork, reconcile their medications, sign permits, check labs, answer questions, allay fears, and make certain the patient is properly prepared for surgery. And they put up with me.

The Circulator Nurse is in charge of the OR. She makes certain the room, equipment, personnel, implants, disposables, medications and every other detail are ready. She oversees that everything is checked twice, that everything is documented properly and that the proper surgery is performed on the right part and the right patient every time. Her job is to ensure that we do everything right, every time, with no exceptions. She makes certain that every sponge, needle, gauze, blade and specimen are properly accounted for. And she puts up with me.

My CRNA puts the patient to sleep and attends to them through every moment. She listens to their every breath and heartbeat. She makes sure they are asleep, safe and comfortable. She holds children her lap and talks to them like a mother while they go to sleep. She makes certain every patient goes to sleep and wakes back up as safely as possible every time, no exception. And she puts up with me.

The people who operate directly with me are Nurses or Techs, not doctors. They make sure we have the proper instruments and equipment. My Scrub hands me what I need before I ask for it. She can anticipate what I am going to need next better than I can many times. She makes my job easy and she makes me look like I know what I am doing when sometimes I am less certain. The person across the table from me is often an RNFA or SFA. They operate directly with me – tie the knots, cut the suture, retract, hold, pull, control the bleeders, close the wounds and a million other things. I simply could not do what I do without them. And they put up with me.

The PACU Nurses take the patients from the CRNA and recover them from anesthesia and surgery. They assess and dress wounds. They treat pain and anxiety and fear. They hold screaming babies in their arms until they are awake. They hold hands of grown men who are disoriented and fearful. They re-assure and calm the parents, children and spouses of the patients. They give wound, medication and discharge instructions, and they transfer patients to their room. They land the plane, and it’s as important a job as any in the world. And they put up with me.

The Nurses in the ICU and Floor take care of the patients, not me. The ICU nurses are infinitely more capable of monitoring and assessing sick patients than am I. I try to stay out of their way and let them do their job, and they let me know when they need me. The Floor Nurses take care of every detail of every patient: What and when they eat; medications; wound care; ambulation; checking vitals, labs, weights, sugars, pulse oximetry, I’s & O’s; draw and check labs; start and re-start IV’s; and countless other things that only nurses understand. They spend time with the patient and family all day. They educate and answer questions. They pray with the patient and family. They cry when their patients die. And they put up with me.

The truth is that if a patient is in the hospital for 48 hours, they may see me for the smallest fraction of that time. I say a brief hello before surgery, I operate, I speak to the family, and I make rounds each morning. I may spend 15 minutes each day at any one patient’s bedside. The rest of it – every second, every bit, every detail, everything – is performed by the Nurses. Honestly, the one who probably needs the stethoscope least is me.

And in the end, through it all, they put up with me!”Show Me Your Stethoscope

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