One of the things i was worried about when I started med school rotations was the possibility of having to pee during surgery. (At the time i didn't realize that having to pee during surgery is about as inconvenient as having to pee during rounds or having to pee when you're following your attending around clinic. As far as I can tell, there are no rotations you do as a med student where you can just go to the bathroom if you have to go to the bathroom) So I didn't drink much water during my surgery rotations and everything worked out fine.
Since then, I've rarely had to pee during surgery. I think most of this is that orthopaedic surgeries aren't all that long. Usually they're around 3 hours or so, if I do a 5 hour one then I count that as a long surgery. I've done 8 hour surgeries (Although I seem to only do those during nights and weekends. Thanks, world.) and i figure when I start my spine rotation they'll get longer since it takes an hour to position the patient and get everything set up, but for right now it's not usually a problem and I can drink coffee in the morning and be OK.
The exception to this is if you have 2 rooms going. This happens a lot over here because ortho is such a big money maker for the hospital. So while you're finishing up in one room, they bring the patient back to the next room and you can just walk over when you're done, instead of waiting for the room to get cleaned and anesthesia to bring the patient back. Seeing as how it usually takes in between 15 and 30 minutes to get the room set up for the next case, this really saves a ton of time. But it means that I'm rushed like hell because the attending leaves the room while I'm closing up and then I have to finish closing, move the patient, do the orders, and meet the attending in the next room in the time it takes anesthesia to put the patient to sleep and for the patient to be positioned, prepped, and draped. Those are the days where you pray someone's got a difficult airway and they need a laryngoscope or something. So I don't get any time in between surgeries. It means on those days I'm hungry and i need to pee like hell.
I was closing up the other day and i seriously had to pee. Like, it was fast moving from "urgency" to "emergency." But I didn't have time to take a bathroom break in the middle of the cases since i had to rush over to the next room. In these types of situations, you're forced to make a choice: either wet your pants, or announce to the room that you need to pee. I've tried asking to be excused, but then people think you're just trying to get out of helping.
Me: I REALLY need to pee. Is it OK if once i finish closing I go pee instead of helping move the patient? Will you be OK without me?
CRNA: Do you also have to take a shit?
Me: No, I just have to pee
Scrub Nurse: elbows me in the bladder How badly do you have to pee?
Circulating Nurse: hey stop that, Orthochick has to pee really badly!
They did let me leave and I bolted for the bathroom and did my thing. (and for the record, really, I just had to freaking pee) I then walked over to the next room to start the next surgery.
CRNA2: Did you get a chance to pee?
Scrub Nurse2: Did everything come out OK?
Circulating Nurse2: Are you feeling better?
Seeing as how these three people were completely different from the three people in the previous OR, word spread that I had to pee in the time it took me to actually pee.
You seriously cannot go to the bathroom in peace in this place. Either your pager goes off mid-stream, someone knocks on the door when you've just pulled your pants down, or you get made fun of for needing to take care of a biologic function.
Also, seriously, how desperate are we for conversation if me having to pee becomes a hot topic for discussion in the entire operating area?
In my part of the world anesthetics talk care of moving patient after surgeries. Surgeon close up, instruct the OT nurse if they wanted dressing and then the OT nurses, anesthetics and his nurse(in ortho cases) move the patient.
ReplyDeletePlus it is usually freezing in the OT. Cold make you want to be.
my sympathies. oh do you have my sympathies. family medicine for me.
ReplyDeleteI'm starting to wonder if there are any positions in medicine where eating and peeing aren't such freakin' big issues.
ReplyDeleteI would say Pathology, but I've had some frozen section days were there definitely wasn't time to do much of anything other than cutting and reading the slides. However, usually we can take lunch breaks and bathroom breaks like normal people. It's pretty sweet.
DeletePsychiatry is pretty good about letting you eat and pee as well.
DeleteI was wondering about this myself..... I was in pre op waiting on my ORIF and my surgeon came in to see me drinking coffee!! I remember thinking to myself that I would never be able to drink coffee without access to a bathroom! (Yes, it might have been the medication talking too- LOL)
ReplyDeleteThey made fun of you and talked about you because no one asks permission to pee between surgeries--they just do it. Like an adult.
ReplyDeleteThose are the days where you pray someone's got a difficult airway and they need a laryngoscope or something.
ReplyDeleteUh, what do you think they use for an easy airway?
Not to be snide, but does no one from the surgical team accompany the patient to recovery? Around here it's considered pretty disrespectful to anesthesia not to do that (not that we have CRNAs) .
Sorry, I meant a glideoscope.
DeleteIt depends on the hospital. At the one I"m at now, the CRNA and the circulating nurse wheel the bed to PACU but I've been in other hospitals where it was the job of the resident and whoever was doing anesthesia. You get written up if you don't help move the pt from the OR table back to the bed. (and if you're a resident. The attending is long gone by that point.)
-orthochick
Yet another reason why I went into ophtho... where an hour surgery feels long. But I feel your pain about feeling unable to take even a short break when bouncing between rooms. It still kills me that everyone else in the room (circulating RN, scrub RN, CRNA) is relieved for multiple breaks and lunch, and the surgeons have no time to eat or relieve themselves without interruption. Living the dream, baby!
ReplyDeleteThe surgeon's time is too valuable a resource to waste on such useless, unprofitable activities as urination. Gotta keep those magic hands working.
DeleteIf you take a pay cut down to what the nurses make, then you too can take breaks and maybe even eat lunch.
Looking forward! By the way, just wanna say I love Orthochick's posts!
ReplyDeleteCompletely agree - great reads!
DeleteOh my gosh I SO remember this and it has been ten years now I'm out of residency. Hard for people for haven't gone through med school/residency to understand why it is hard to find the time to pee! and eat and drink! I'm in solo private practice now and still I find eating, drinking & peeing are way down there on the priorities because there's always something else more important to do. Seems very disrespectful to call patients while chewing.
ReplyDeleteSurgey needs to change culture. I think every human being should have the right to eat, drink and urinate. You should not be chastised for needing a 5 minute pee break. Sure I can remember a few days/nights in the ICU where there was no time for any of those, but they should be the exception.
ReplyDelete- Medicine Resident
I've been on plenty of Medicine rotations where peeing was frowned upon as well. Only, there wasn't a good reason, since there was never THAT much urgency and there was always a bathroom nearby. It's like they were trying to be all hard core like surgeons. Only they just.... weren't.
DeleteShe's a resident. She makes less than the nurses.
ReplyDeleteThis. So much freaking this. Nurses make tons of money, and everyone knows they rule the hospitals anyway, while having the physician to blame for when things go wrong.
DeleteHow much do you think nurses make? I wouldn't say that $40,000/yr average it "tons of money". I have seen MANY physician place the blame on the nurse when it was their fault - nurses catch the physicians mistakes!
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