She Works Hard For Her Money

*** This post was left as a draft back in August.  I'll just publish it as-is.

Today has been mentally and physically exhausting.  I'm at work, and it's 10:27pm.  I have mostly finished my Kronos training, but I also had to teach some orderlies.  Their stuff is different from ours (techs and nurses), so when they would ask questions, I would mostly say, "I don't know."  There is even an orderly "Super User" working tonight, but for some reason, she doesn't feel like she can teach other people.  The whole thing is a mess, it's confusing, and it's a lot of work.  And it's a pain in my you-know-what.  I can only do so much with the level to which I have been trained.

Speaking of training, the robot was a nightmare today.  The surgeon (let's call her Dr. P.) was in a terrible mood.  She was relying on her very inexperienced residents as her first assistants, and when they kept making mistakes, she would yell at them.  I felt bad for one young doctor, who was having a really hard time with spatial orientation in laparoscopy (a very difficult concept: imagine using a tool that you can only see on a monitor, but which moves in the opposite direction when you manipulate it, and having someone yelling at you and calling you a "retard" when you don't get it right). The rep was making things more complicated than they needed to be, the instruments she wanted weren't working or weren't sterile or weren't available, the patient was really bloody, and the circulators were inexperienced.  Cute Kristy had done some cross-training today, and those two cases made her the most experienced circulator available.  With all of the issues we had, it really wasn't fair to place that kind of responsibility on her.  Lacey (another scrub) and I have scrubbed plenty of robots, but neither of us are really familiar with circulator responsibilities.  And the rep (who is paid to know the equipment backwards and forwards, who is supposed to be able to answer all of our questions) was not helping.  She was trying to tell me what to do, at the same time the surgeon is giving me orders, and there was so much going on and so many things not working that everyone was frustrated.  Thank heavens for Doug (who had technically left for vacation already).  He came in to help us out and smooth things over.  I give him a lot of grief, but Doug really is a good guy.

Getting thrown into stuff you don't really know how to do is not an uncommon thing.  Actually, it happens a lot.  With many surgeries, you can draw on your previous experience and fake your way through it.  That's one reason why I like my job--I learn new things every day, and I get to use my brain to figure things out.  The robot really isn't like that.  I received a fair amount of training to scrub robotic cases, and I feel pretty comfortable doing most of them.  But there's only so much I can do without seeing the circulator side of things.  Reps (vendors who work for the companies of the products we use) are usually a great help, and they can be very knowledgeable.  Not this one.  We (nurses and techs) need more training on the robot, from someone who can actually answer our questions.

I want to be a good employee.  I want to prove myself as an invaluable part of the team.  I don't want to be a complainer or a tattle-tail; I want to help fix the situation.  First, the surgeon should have had a more experienced first-assistant (i.e., an attending physician, colleague, or someone who at least knows enough about the robot to be useful).  She also should have stepped back and calmed down, instead of yelling at everyone for things beyond their control.  Yes, a lot of things went wrong, and there's no one cause.  But verbal abuse is never called for, even if it is said 'jokingly.'  Secondly, the equipment needs to be ready and available.  Surgeons are notoriously impatient, so whenever we have to get something that isn't close by, they get even more wound-up.  Third, everyone needs more training.  Period.  Not just those who already do robots, and not just staff members who are willing to be trained.  It needs to be mandatory.  Until it is, and until our managers know how much we are struggling, days like this will be all too common.