Spinal Interventions - the spectator sport

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knoxdoc

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I get annoyed when asked if family members, friends, lovers, etc can come into the fluoro suite to watch a procedure. Some feel that that they will be able to comfort the patient, and some just want to see what will be done. I don't allow it, unless it is a minor. There are too many reasons it can make my life miserable:

1) The observer passes out watching, smacks his head on the counter and develops an ICH.
2) The observer points out how big the needle is to the patient
3) The observer wants to give me pointers or tell me the needle is in the wrong location
4) Female observer calls weeks later to ask if her misscarriage was caused by the radiation in the room.

I don't want to deal with any of the above, so I just say NO. What do you folks do?

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I dont let family but often have other docs observe if I have them come to office for marketing lunch or something. had a neurosurgeon observe a TFESI today.
 
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I say no. Radiation, sterility, state regs, blah, blah, blah..."You can have a picture, though" seems to satisfy most.

Had enough of this with crowds of family making misguided demands to watch procedures (in my "previous life") such as LPs, codes, complex wound repairs, then people fainting, puking, heavy breathing in the corner, getting dizzy and now your patients are multiplying. Been there, done that. Families watching codes and death pronunciation? This is actually recommended now. Want to watch grandpas thrombosed hemorrhoid excision too? Really? WTF?!

Unnecessary drama. I say no, if at all possible. If it's a doc and they seem reasonable: okay-exception that proves the rule. Even then, docs being docs they're going to obsess about every possible complication.
 
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Anything's possible for the right pwice...muahahahaha:naughty:
 
Anything's possible for the right pwice...muahahahaha:naughty:

Never except if I absolutely need a translator for procedure.
Run of the mill stuff like ILESI/facets/MBB/SIJ/hips, etc no one not even a translator is ever in the room. I've learn how to say numbing medicine, relax, and done in about 4 languages. Those are the only 3 words you need to know for most of what we do.
I don't care how much they whine or beg for a family member to be in the room. It only makes my life more miserable, exposes me to liability, and my nurse can hold their hand just as well as their spouse can.
 
can family members 'watch surgeries'?

same reason they cant pain procedures.
 
interpreters if absolutely necessary

and I have had one family member (daughter) come in for a patient who was abused as a child with needles, more to comfort the mother as she got injections from me --- the daughter was an RN...

that is the only exception I have ever made.
 
General rule, and my staff usually gets the question first, is NO. Family acting as interpreter not ideal but will allow. Patient or especially younger patient who is a nervous wreck then maybe. Soon people will bring the Ipad in and film the procedure. I guess I could put nice chairs in the room and charge admission and refreshments as that would reimburse more.
 
when i have an adult patient who is developmentally delayed, or a younger patient for a hip injection ill consider it. if the person watching is a doc and they ask ill do it. id probably want to do the same if i was in their position. otherwise -- no.
 
when i have an adult patient who is developmentally delayed, or a younger patient for a hip injection ill consider it. if the person watching is a doc and they ask ill do it. id probably want to do the same if i was in their position. otherwise -- no.


I trust the doctors that I have treating a family member. I would not want to make him nervous by looking over his shoulder. If I was a patient I would want to be treated the same as Joe Blow walking in off the street. In my experience when docs try extra hard and vary their routine that is when complications occur.
 
I start by saying to the spectator, we generally don't allow it, because of radiation safety considerations as we wouldnt want to expose you unnecessarily to radiation... Many of them when they hear this decide on their own that they dont want to stay in the room after all. If they still insist, I dont argue, and I have them wear lead. Some people at this point, also decide to exit, as the lead makes them think twice about radiation exposure (although minimal). If they are undeterred and still want to observe, then yes, if anything goes wrong, they will be witness to it, and I would expose myself to liability...but i also dont think it helps to outright refuse to let them watch as they might wonder what I am trying to hide or that maybe I am not confident in my abilities.
 
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