- Joined
- Apr 8, 2005
- Messages
- 406
- Reaction score
- 292
Seriously though. As we stare down the proverbial barrel of the largest pandemic many of us have ever seen, we have all accepted significant disruptions in our day to day activities and have suspended many of our behavioral norms. Gyms, bars, and restaurants are closed....people have cancelled international and domestic travel....nobody wants to get on public transportation. I live in an extremely populated area and the streets are abandoned....sitting on my patio on a Friday night and hearing nothing is a little creepy to be honest.
Despite some of our natural (being surgeons) skepticism, this thing looks legit. Reports coming out of Italy and Seattle look like fictional end of the world scenarios....they remind me of watching CNN international news feeds from Fallujah (or Baghdad, Sarajevo, Saigon, Normandy....pick your generation) where they interview some poor exhausted bastard of a physician who desperately needs a hot shower, a meal, two cups of coffee ....or maybe a bottle of bourbon and a handgun, depending on how you personally handle stress. And you watch this on the news from the comfort of your couch, hearing pleas for help and how they're running out of IV fluid and bandages in a war zone, and you think to yourself.....wow thats a bad deal, this is why people go into dermatology after all. Looking around myself it is somewhat apocalyptic....rednecks across the world are stocking up on ammo, the store shelves are empty, politicians are scrambling around but not doing anything....you could convince someone it's the absolute end of civilization as we know it.
War is hell and we should all just embrace the suck right?? So when we hear reports coming from around the world about shortages of masks, gloves, ventilators....well that's all just consistent with the war zone. Like that poor guy on CNN who found himself in a hospital getting bombed intermittently, we're a bunch of well trained capable people and we're going to do the best we can with what we have left. We can leave policy to those people with the clipboards, as physicians we'll just deliver what we're trained to do even if we have to slapdash something together to make it work.....challenge accepted.
So when the CDC says we're running out of supplies, we all just need to make do. I mean really you just have to protect yourself from the obvious spray right....so you can use a scarf or a bandana. You know how cool I'm gonna look running around the hospital with a bandana?!?!?!
Because what's a surgeon to do?? Culturally we've always been gladiators, warriors.....we've all stared death in the face many times. So I've been going to work, doing what I have to do, and preparing for the tidal wave of **** to hit my shores. Like General Patton walking up and down the trenches I've been mentally preparing my teams for mass destruction....I've sent out ECMO guidelines, stocked up on oxygenators and cannulas, double checked all of our equipment carts....at the end of the day I go home and pour myself a little scotch, load my pipe with the best damn blend of tobacco from my local place, put my pager on the table in front of me and dare it go off. While half the anesthesiologists are hiding under their beds at home we still have work to do, and when the work comes we'll do it. We always have.
But my mind wanders....so if we're out of N95s do I just put on a regular mask?? and then put my cool ass bandana on top of it?? Or is the bandana just when we're totally out of masks? Now that I think about it....normally outside of our cardiac ORs there's like 5 different masks to choose from. Like many of you I have one that I prefer...when you have to wear the damn thing for hours and sew a 1mm distal I think I'm allowed to be a little particular. The past week instead of 5 to choose from there's been like 2...and not a lot of backup boxes on the shelves. Are we running low already or is this a central supply stockpiling thing so people don't hoard them....I hope it's the first one. But i've already heard from the nurses that we are running low on N95s.
So bandana it is.....but what would happen on a normal day if I walked into a TB isolation room without an N95.....and a bandana instead?? Like in a non pandemic situation....for example one with a disease like TB that's way more treatable. Would someone not completely lose their **** about the breach of protocol?? There would yelling and screaming, weeping and gnashing of teeth.....and most importantly the inevitable write up that would go to....someone....still don't know to be honest.
I'm pretty sure I almost got fired as a resident for not getting my N95 fit test done in a timely fashion. Not because I didn't want to...its just that employee health was only open from like 9am to 3pm...the entirety of which i'm scrubbed in most days. I got some impressively hostile emails.....as a grown ass man though my face hasn't changed size since....junior high maybe? I've been over 6 feet tall for like 25 years, I don't think I'll be squeezing into a small anything for the remainder of my days on this earth.
Or what if I rolled into the OR without a mask and had on a bandana instead??? Would OR nursing not totally freak out? Wasn't it just a few months ago that we were banning the cloth hats and everyone had to wear bouffants?? I had a nurse get in my face when I was running into a peri-code situation because I had a cloth hat on in August...that wasn't that long ago. I remember arguing with them about this...asking them for evidence that cloth hats were dangerous. They didn't have any..... but they weren't going to let that stop policy. I got written up for the cloth hat a few times and that went to....someone....still not sure. Anyway.
Or have you ever worked in a hospital where you can't wear scrubs outside the OR? You have to wear a cover gown or a white coat over it...to keep it clean I guess?? Never got a straight answer really, but the insinuation is that it keeps the germs off the scrubs for when you go back to the OR.....which is a policy that's almost insulting to anyone who passed high school biology.
I've been trying to picture in my head what a pile of discarded N95s looks like after the yearly fit test....for every provider....in every hospital...in every state.....and then throw on some cover gowns......and all the isolation gowns from someone with a history of MRSA (treated 20 years ago).....and we just thought it was the tree huggers that had a legitimate complaint here....
This week the hospital is mostly deserted....I've seen other surgeons and trauma surgeons.......OB is still around. Some anesthesiologists. No one from JCAHO...no nurses with clip boards....seems like infection control policy has taken a back seat to the pandemic, and I can drink coffee while walking down the hallway with reckless abandon....I feel like James Dean, born rebel...with a cause I guess?
In the midst of a widely spreading infectious disease....shouldn't the regulatory people be here on high alert? Policing all these fundamentally precious rules and regulations? Now that the **** is hitting the fan, I look around me and I see my fellow physicians and nurses in the trenches, doing the best they can with what we have. All the people making the rules, enforcing the policies.....haven't seen them. Administration is available by email though.
Desperate times call for desperate measures for sure.....but where is the mighty JCAHO in all this? You know....the people who every hospital shakes in fear at the thought of....has anyone seen them? Are they out fund raising?? Or working in the N95 factory?? They always told us these policies are key for safety, it is about the patients after all, and they have to protect them. As someone with a doctorate level education, your opinion on this matter is not relevant. You will shut up, sit down, get your fit test, put on the bouffant, throw away your coffee....or suffer mighty consequences.
So where are these noble princes of regulation? Are they walking around trying to secure PPE? Or now that the plaque is here they're at home with their families, hiding in the safety of their own homes, with no skin in the game.....no way their kids are going to be exposed to a deadly virus, even if i offer them a bouffant and a cover gown.........and it is now with a profound, sudden lack of self righteousness, they are ready and willing to let me (and you) run into battle with a bandana.
I'll be the guy in the black one, because its my favorite color
Despite some of our natural (being surgeons) skepticism, this thing looks legit. Reports coming out of Italy and Seattle look like fictional end of the world scenarios....they remind me of watching CNN international news feeds from Fallujah (or Baghdad, Sarajevo, Saigon, Normandy....pick your generation) where they interview some poor exhausted bastard of a physician who desperately needs a hot shower, a meal, two cups of coffee ....or maybe a bottle of bourbon and a handgun, depending on how you personally handle stress. And you watch this on the news from the comfort of your couch, hearing pleas for help and how they're running out of IV fluid and bandages in a war zone, and you think to yourself.....wow thats a bad deal, this is why people go into dermatology after all. Looking around myself it is somewhat apocalyptic....rednecks across the world are stocking up on ammo, the store shelves are empty, politicians are scrambling around but not doing anything....you could convince someone it's the absolute end of civilization as we know it.
War is hell and we should all just embrace the suck right?? So when we hear reports coming from around the world about shortages of masks, gloves, ventilators....well that's all just consistent with the war zone. Like that poor guy on CNN who found himself in a hospital getting bombed intermittently, we're a bunch of well trained capable people and we're going to do the best we can with what we have left. We can leave policy to those people with the clipboards, as physicians we'll just deliver what we're trained to do even if we have to slapdash something together to make it work.....challenge accepted.
So when the CDC says we're running out of supplies, we all just need to make do. I mean really you just have to protect yourself from the obvious spray right....so you can use a scarf or a bandana. You know how cool I'm gonna look running around the hospital with a bandana?!?!?!
Because what's a surgeon to do?? Culturally we've always been gladiators, warriors.....we've all stared death in the face many times. So I've been going to work, doing what I have to do, and preparing for the tidal wave of **** to hit my shores. Like General Patton walking up and down the trenches I've been mentally preparing my teams for mass destruction....I've sent out ECMO guidelines, stocked up on oxygenators and cannulas, double checked all of our equipment carts....at the end of the day I go home and pour myself a little scotch, load my pipe with the best damn blend of tobacco from my local place, put my pager on the table in front of me and dare it go off. While half the anesthesiologists are hiding under their beds at home we still have work to do, and when the work comes we'll do it. We always have.
But my mind wanders....so if we're out of N95s do I just put on a regular mask?? and then put my cool ass bandana on top of it?? Or is the bandana just when we're totally out of masks? Now that I think about it....normally outside of our cardiac ORs there's like 5 different masks to choose from. Like many of you I have one that I prefer...when you have to wear the damn thing for hours and sew a 1mm distal I think I'm allowed to be a little particular. The past week instead of 5 to choose from there's been like 2...and not a lot of backup boxes on the shelves. Are we running low already or is this a central supply stockpiling thing so people don't hoard them....I hope it's the first one. But i've already heard from the nurses that we are running low on N95s.
So bandana it is.....but what would happen on a normal day if I walked into a TB isolation room without an N95.....and a bandana instead?? Like in a non pandemic situation....for example one with a disease like TB that's way more treatable. Would someone not completely lose their **** about the breach of protocol?? There would yelling and screaming, weeping and gnashing of teeth.....and most importantly the inevitable write up that would go to....someone....still don't know to be honest.
I'm pretty sure I almost got fired as a resident for not getting my N95 fit test done in a timely fashion. Not because I didn't want to...its just that employee health was only open from like 9am to 3pm...the entirety of which i'm scrubbed in most days. I got some impressively hostile emails.....as a grown ass man though my face hasn't changed size since....junior high maybe? I've been over 6 feet tall for like 25 years, I don't think I'll be squeezing into a small anything for the remainder of my days on this earth.
Or what if I rolled into the OR without a mask and had on a bandana instead??? Would OR nursing not totally freak out? Wasn't it just a few months ago that we were banning the cloth hats and everyone had to wear bouffants?? I had a nurse get in my face when I was running into a peri-code situation because I had a cloth hat on in August...that wasn't that long ago. I remember arguing with them about this...asking them for evidence that cloth hats were dangerous. They didn't have any..... but they weren't going to let that stop policy. I got written up for the cloth hat a few times and that went to....someone....still not sure. Anyway.
Or have you ever worked in a hospital where you can't wear scrubs outside the OR? You have to wear a cover gown or a white coat over it...to keep it clean I guess?? Never got a straight answer really, but the insinuation is that it keeps the germs off the scrubs for when you go back to the OR.....which is a policy that's almost insulting to anyone who passed high school biology.
I've been trying to picture in my head what a pile of discarded N95s looks like after the yearly fit test....for every provider....in every hospital...in every state.....and then throw on some cover gowns......and all the isolation gowns from someone with a history of MRSA (treated 20 years ago).....and we just thought it was the tree huggers that had a legitimate complaint here....
This week the hospital is mostly deserted....I've seen other surgeons and trauma surgeons.......OB is still around. Some anesthesiologists. No one from JCAHO...no nurses with clip boards....seems like infection control policy has taken a back seat to the pandemic, and I can drink coffee while walking down the hallway with reckless abandon....I feel like James Dean, born rebel...with a cause I guess?
In the midst of a widely spreading infectious disease....shouldn't the regulatory people be here on high alert? Policing all these fundamentally precious rules and regulations? Now that the **** is hitting the fan, I look around me and I see my fellow physicians and nurses in the trenches, doing the best they can with what we have. All the people making the rules, enforcing the policies.....haven't seen them. Administration is available by email though.
Desperate times call for desperate measures for sure.....but where is the mighty JCAHO in all this? You know....the people who every hospital shakes in fear at the thought of....has anyone seen them? Are they out fund raising?? Or working in the N95 factory?? They always told us these policies are key for safety, it is about the patients after all, and they have to protect them. As someone with a doctorate level education, your opinion on this matter is not relevant. You will shut up, sit down, get your fit test, put on the bouffant, throw away your coffee....or suffer mighty consequences.
So where are these noble princes of regulation? Are they walking around trying to secure PPE? Or now that the plaque is here they're at home with their families, hiding in the safety of their own homes, with no skin in the game.....no way their kids are going to be exposed to a deadly virus, even if i offer them a bouffant and a cover gown.........and it is now with a profound, sudden lack of self righteousness, they are ready and willing to let me (and you) run into battle with a bandana.
I'll be the guy in the black one, because its my favorite color
