Does This Count as Micromanagement?

[Winged Scapula]

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So I threw my first mini-hissy fit as an attending today.

I show up early for my cases today (only because I don't have block time so don't have the coveted 0730 start) and since the patient is there and ready to go, I ask if we can start early seeing as no one is in my room. Sure, I'm told except anesthesia isn't here.

That was NOT what my fit was about. Yes, for some reason the anesthesiologist who was supposed to be covering the case didn't show; the hospital called her group and got someone else to come in.

Ok, so now we're starting 1.5 hrs late, although its actually on time since I was 1.5 hrs early. So I've been relaxing in the OR lounge waiting for them to tell me gas is here, and we're ready. I've already seen the patient in the pre-op area, done all my paperwork, etc.

The circulator comes to get me in the lounge and I cruise in to the room to see the patient asleep, prepped and draped. This is where I had my fit. My reasoning being that since I did not see the patient be wheeled into the room, I could not be sure that it was MY patient, since all that was exposed was a random boob. Nor was I present to verify which side we were operating on and she was not marked by me yet.

Obviously I looked around the drape to see it was my patient, but I was a bit miffed. I mean, what if it wasn't and I didn't notice? What if we were operating on the wrong side, because no one asked ME what side I was planning on operating on and now with the patient asleep (which was also a problem because I only asked for local with sedation not general) I couldn't verify one more time with her?

Am I micromanaging? They tell me that the "other surgeons" like them to hurry and prefer that they are not called into the room until prepped and draped. Obviously our attendings in residency commonly do that but there's a member of the surgical team (the resident or fellow) in the room when the patient comes in and before the patient is draped.

Is this something that I'll eventually end up doing and just assuming that this place (which somehow can never seem to get my preference cards right...if I can't trust them to copy my cards for the surgicenter and the main ORs, how can I trust that they'll do this right) does it right?

/rant

 

[DrDre311]

I think you have a right to be irritated if gas doesn't show and then when they do they can't even get the type of anesthesia right. If you were to operate on the wrong patient or wrong side you'd definitely be the guy at the top of the list of people named in the malpractice suit so I'd say a fit of some type was in order.

 

[Winged Scapula]

I think you have a right to be irritated if gas doesn't show and then when they do they can't even get the type of anesthesia right.

That didn't bother me as much as we ended up starting on time (so my other cases weren't delayed). I am rather used to having to correct them about how I do my cases; my partner uses general on everyone, I prefer local with sedation for all but axillary and mastectomy cases.

If you were to operate on the wrong patient or wrong side you'd definitely be the guy at the top of the list of people named in the malpractice suit so I'd say a fit of some type was in order.

That was what I was more upset about. Every darn hospital I've worked in has an excessive amount of oversight in regards to patient ID, etc. In fellowship it used to drive the anesthesia attendings crazy that I, as the fellow (ie, the one doing the case), was not allowed to do the time out, ID the patient. I could DO the case without the attending in the room, but he had to come and give it a blessing.

Any rate, as you say if there was a problem I'd be the one in trouble while the rats fleed the sinking ship denying any knowledge of leaving port without the "captain".

 

[Faebinder]

If neither you nor a surgery resident spoke to the patient and marked the boob before surgery... then it's okay to have a fit. Your target should be the circulator. I would go as far as telling, "If I was operating on your breast, wouldn't you like me to talk to you before you go under and make sure it was the correct breast? Would you feel comfortable sleeping without me talking to you."

Sometimes that message gets across. But if you really want to pound it (which you should), I would ask for a different circulator unless this particular circulator has been good with you in the past and this is just an unusual F-up.

You were well within your right. I should tell you the story about the green filter applicator that broke inside the WRONG patient and turned out to be 6 months after expiration date. Being the wrong patient made the first two mistakes worse in the malpractice lawsuit.

 

[Blade28]

There's no way I'd be OK with my patient already being prepped and draped without my approval first. Who's to say the correct patient and/or side is prepped? If this is what other attendings want, fine, but the OR staff should know this isn't standard practice. It's not like your resident went ahead, brought the patient into the room and you told them over the phone "go ahead and prep and drape."

Because if something goes wrong, who do you think they're going to blame?

 

[Chronic Student]

Every surgeon has their preferences. Some like to do their own prep, some want particular instruments, some don't want certain anesthesia providers, etc.

The bottom line is you are the surgeon and it is your patient.

Tell them what you want and have them do it. I am not reccomending that you try and get everything perfect. You and I have both been around the OR for enough years to know that there is no such thing as a perfect case. Pick your battles. This obviously bothers you, so get it fixed.

I certainly, (nor my boss) would ever want to operate on a patient that we had not been with in the room as they went off to sleep/draped. I really don't think you are being unreasonable.

There are some folks that don't care who they cut on and you are not one of those people.

Just my .02

 

[TXSurgResident]

Sounds like a comedy of errors to me... well within your right to pitch a fit.

In the vein of attending fits- I wanted to bounce an idea off the blogosphere:

Seems to me like nothing makes the OR people stand up and take notice (other than audible bleeding) than when the "nice" attendings are pissed/disappointed/irritated with foul ups or mistakes (as I'm sure you are, WS😉).

When the usual suspects let out their constant stream of "why don't we have this... this case is ridiculous... this OR is hopeless... these residents suck", it doesn't seem to have any effect at all (unless they are directly yelling at someone).

Anyone else out there concur?

 

[Castro Viejo]

Anyone else out there concur?

Word. Mean guy who's always screaming and yelling and carrying on usually doesn't get anyone's attention. It's expected. It becomes almost amusing after a while as you can usually set your watch by when the a$$hole gets mad.

Nice guy who just wigs out and busts a hole in the wall? Sphincters tighten and that lump in everyone's throat grows larger and larger by the second.

As the Captain of the Ship, the surgeon bears ultimate responsibility for anything that happens to a patient good or bad. Having a patient prepped and draped without your knowledge, as if to direct you to operate where they've exposed for you, is presumptuous and stupid. Until they know your preferences and you're comfortable with them, I don't think it's unreasonable for you to make this very clear to them and to have them understand that your neck is the biggest one on the line.

 

[Winged Scapula]

If neither you nor a surgery resident spoke to the patient and marked the boob before surgery

I had spent a considerable amount of time with the patient and her family prior to going back to the room, so that wasn't the issue. She was marked by the hospital and I had verified with her that was the correct side, however, I like to verify ONCE AGAIN when we are in the room, that it is the correct patient, the correct side and the correct operation. I would hope they wouldn't have taken her back without me seeing her first (but you never know). That's why I wanted to know if I was micromanaging by insisting that I verify that its my patient under those drapes.

These community hospitals where they mark the patient, they do the consent, etc. seem to take a lot of liberties that I'm not used to.

... then it's okay to have a fit. Your target should be the circulator. I would go as far as telling, "If I was operating on your breast, wouldn't you like me to talk to you before you go under and make sure it was the correct breast? Would you feel comfortable sleeping without me talking to you."

That is the issue. The circulator was very very apologetic and said it was her fault, which I agreed with.

Sometimes that message gets across. But if you really want to pound it (which you should), I would ask for a different circulator unless this particular circulator has been good with you in the past and this is just an unusual F-up.

I'm new there so I don't get a particular circulator each time and haven't enough experience there to know who's good and who isn't. All I know is that everytime I operate there there is some sort of problem...they make it very hard for me although they are very good at the arse kissing (which they should be because I"m close to telling them I am not going to bring cases there anymore...not because of this, but the continued problems).

You were well within your right. I should tell you the story about the green filter applicator that broke inside the WRONG patient and turned out to be 6 months after expiration date. Being the wrong patient made the first two mistakes worse in the malpractice lawsuit.

Its scary isn't it? I was seeing a patient a few weeks back for a change in her mammogram. Got the films up and she and I are looking at them and I think, "hmmm, these boobs look TOTALLY different than last year.". Guess what? Wrong patient for the current films. Not only had they sent the wrong patient films but the films appeared to be the ones which the radiologist had dictated there was a problem on, as the issue matched to the report.

First rule: always check the patient's name, the label, etc. Thank God I hadn't taken her to the OR based on the reports.

 

[opr8n]

i personally want to be there before any timeout and I like to drape the patient

of course this is also b/ ci am an anal resident who wants to be on top of things

but could you imagine if I was there and screwed things up and the attending didnt ask and we operated on the wrong pt or side??? 😱 Id be in deep dodo

no, your fit was appropiate
when its the circulators and scrub techs malpractice on the line, they can do whatever they want
the surgeon is the captain of the ship in the OR, b/c you have the most to lose
Its your OR, all your decsions
I dont think surgeons should have to apologize for getting fussy when things arent like what they want

But at the same time, it might help to have these things on your card
Im already startiong to make my cards and Im not that close yet to being an attending

 

[SocialistMD]

The circulator comes to get me in the lounge and I cruise in to the room to see the patient asleep, prepped and draped. This is where I had my fit. My reasoning being that since I did not see the patient be wheeled into the room, I could not be sure that it was MY patient, since all that was exposed was a random boob. Nor was I present to verify which side we were operating on and she was not marked by me yet.

Obviously I looked around the drape to see it was my patient, but I was a bit miffed. I mean, what if it wasn't and I didn't notice? What if we were operating on the wrong side, because no one asked ME what side I was planning on operating on and now with the patient asleep (which was also a problem because I only asked for local with sedation not general) I couldn't verify one more time with her?

If you have not told them that you want to roll back with your patient where all other surgeons at your hospital don't, you can let them know the way you prefer to do things, but your practice deviates from the norm at that hospital, so don't get too upset with them until it happens again (after you've told them how you like to do things).

I separated the above quote for a reason. It is a nice demonstration of action and reaction. You weren't sure if it was your patient, so you checked. I'm sure you also checked to make sure it was the correct side. It's the right thing to do. It isn't micromanagement if you don't trust your team and it's your butt on the line, so don't worry about that. Just let them know how you want things done in your OR and then blow up next time if they haven't done it your way.

 

[Winged Scapula]

When the usual suspects let out their constant stream of "why don't we have this... this case is ridiculous... this OR is hopeless... these residents suck", it doesn't seem to have any effect at all (unless they are directly yelling at someone).

Anyone else out there concur?

Absolutely. We've all worked with those types of surgeons and as Castro notes, you tend to tune it out.

Believe me, I've operated at this hospital enough for them to peg me as the "nice guy" so when I was quietly pissed the room was silent except for the stream of apologies from the circulator and the scrub, even the anesthesiologist (who apparently told them we could start, even though I didn't know she had arrived).

After awhile, I got tired of all the quiet and told them to turn on the music. But it is an advantage of being the nice guy; when you're mad everyone takes notice.

 

[surg]

I have on my card, that *I* (and not my resident unless I specifically say so) have to to mark each patient for lumpectomies while they are in preop and awake. I usually don't hang out in the OR lounge (because if I did, we'd never get in the room. ahhh... the joys of academic hospitals) so I don't have an issue with going back since I usually hang out in the room looking slightly put out that I'm in there by myself. Thus I am virtually always there for draping.

Whatever you need to do to feel absolutely 100% sure that you are operating on the correct person, on the correct breast, on the correct lump, is ok by me. You can't be too careful (just as my personal thing is that, during the timeout for the part where we confirm the side, I want to hear "correct" and not "right" for absolute clarity). No one should ever fault you for micromanaging the timeout/confirmation process. Other stuff... well that's a different discussion.

 

[ESU_MD]

you should have the OR staff do whatever YOU prefer.

If that means seeing the patient off to sleep, then so be it. Thats the beauty of surgery. After all these years we can practice however the heck we want, as long as you can do so safely.

Personally,
I like to see the patients in the holding area, mark them, talk to them/family etc... then would be glad to see them next in the OR, preferably with the exposure already done by the juniors.

 

[Pir8DeacDoc]

I don't have any idea what the burden of actually being an attending is in terms of fear/anxiety/worry.

I tend to be detail oriented but a touch less anal retentive than some others. That being said, I could imagine that if I walked into an OR and there was a huge green circle on a prepped and draped boob then that's my target. I would feel comfortable checking the ID bracelet or the face (if it wasn't up the bouffant cap) and go to work. Did you recognize the green circle or whatever you mark the site with as being your own?? In the future I would advise the staff to handle this differently but I can't see a reason to make a big stink. Although truth be told it sounds as though this was just the culmination of events at this specific place and maybe not the result of this specific incident.

 

[Winged Scapula]

But at the same time, it might help to have these things on your card

You presume too much my friend.

Like that they actually have found where they put my cards that I gave them months ago. Or the cards that were supposedly made up each time I do a case there and they can't find my cards. I could make cards that say anything and it wouldn't matter because they wouldn't have them.

If you have not told them that you want to roll back with your patient where all other surgeons at your hospital don't, you can let them know the way you prefer to do things, but your practice deviates from the norm at that hospital, so don't get too upset with them until it happens again (after you've told them how you like to do things).

Good point. I've always rolled back to the room with the patient and so didn't realize that this was not common practice. Frankly, it deviates from every other hospital I've ever worked in but hey...guess its what " all the other surgeons" do here.🙄

But I have no doubt it will happen again.

I have never seen a private surgeon object to this practice. In fact, in my time at civilian hospitals, the majority of the time I preop the patient, and the surgeon never sees them until they are out and ready to go in the room.

That being said, I have no desire to practice that way.

I see the OR staff constantly throw fits over their stupid "timeout" thing. So how did they do a timeout without you present? You should report them all to the BON. 🙂

They did the time out when I arrived. Seems sort of after the fact since the patient was already asleep and prepped. Kills me; you could barely wheel the patient into the room during residency and fellowship without the attending being in the room and here all that was left was to place knife to skin.

To show them a lesson, I shoulda vociferously disagreed and tore the drapes down.😛

Personally,
I like to see the patients in the holding area, mark them, talk to them/family etc... then would be glad to see them next in the OR, preferably with the exposure already done by the juniors.

That's what I do...go to holding, see patient, mark them, review consent, review post-op instructions/plans, etc.

But I don't have juniors to do the dirty work for me.😛

I don't have any idea what the burden of actually being an attending is in terms of fear/anxiety/worry.

Its exhausting. I only did a few cases that day but I was beat when I got home; not physically but psychologically. It really can be wearing.

I tend to be detail oriented but a touch less anal retentive than some others. That being said, I could imagine that if I walked into an OR and there was a huge green circle on a prepped and draped boob then that's my target. I would feel comfortable checking the ID bracelet or the face (if it wasn't up the bouffant cap) and go to work. Did you recognize the green circle or whatever you mark the site with as being your own??

Who the hell knows? The drapes were placed so that my initials were covered. Like I said, it was a random breast as far as I was concerned. I verify ID in 3 ways: facial recognition of the patient, checking their arm band and then showing them the consent, asking if this is them and if this is their signature.

In the future I would advise the staff to handle this differently but I can't see a reason to make a big stink. Although truth be told it sounds as though this was just the culmination of events at this specific place and maybe not the result of this specific incident.

It wasn't a BIG stink, just a little hissy fit. But you're probably right...this place really makes things trying for me. EVERY day there's something...no H&P in the chart (so rather than call my office to get another one FAXed over, they want me to complete a new one. No thanks.), waiting for patients to come over from Rads or Nuc Med (and waiting because of lack of transport), not having my cards, don't have instruments I want, etc.

 

[opr8n]

You presume too much my friend.

Like that they actually have found where they put my cards that I gave them months ago. Or the cards that were supposedly made up each time I do a case there and they can't find my cards. I could make cards that say anything and it wouldn't matter because they wouldn't have them.


.

that stinks, its way different where i work
we have the card nazis
I cant tell you how many times ive had attending fume b/c some circulator says "its not on your card"

 

[Pir8DeacDoc]

I was sort of speaking generically.. not really saying that you "caused a big stink"...


Hope today is a better one for you!

 

[Winged Scapula]

that stinks, its way different where i work
we have the card nazis
I cant tell you how many times ive had attending fume b/c some circulator says "its not on your card"

Again you presume it will not be that way whenever they do get around to making my cards or finding the ones I gave them.

Every hospital I've ever worked at has the same response when you ask for something you ALWAYS use, "well its not on your card".🙄

 

[kate0834tkjn]

Just wondering what your partner had to say about the situation, just because it sounds like s/he works at this hospital a lot. And does s/he think you were overreacting?

Personally, I definitely don't think it was unreasonable. I think if you've clearly made your preference known, even if it's not what's usually done at the hospital, you're entitled to be annoyed. Furthermore, this was a patient safety issue, not some personal pet peeve. And as a med student who was often yelled at by surgeons on my rotation, I didn't really mind when I was being yelled at for pulling too hard on a retractor, or forgot to check on an important lab when on call, or even cutting sutures too long because I clearly made a mistake and a patient's care could have possibly been affected by these mistakes.

 

[Winged Scapula]

Just wondering what your partner had to say about the situation, just because it sounds like s/he works at this hospital a lot. And does s/he think you were overreacting?

Ah, she never thinks I overreact. If anything, I am much calmer than she is. 😀

She gave a PC answer which is that it doesn't matter what others want or do as a matter of practice, but rather what makes me comfortable. Perhaps she has them prep and drape but figures what I want and prefer is more important.

And as a med student who was often yelled at by surgeons on my rotation, I didn't really mind when I was being yelled at for pulling too hard on a retractor, or forgot to check on an important lab when on call, or even cutting sutures too long because I clearly made a mistake and a patient's care could have possibly been affected by these mistakes.

Don't sweat that...students NEVER cut sutures the right length. Always too short or too long, never just right.

 

[jbean]

You could also just make your marking with your initials in a place where the prep and drape won't hide it. Then you would always be sure.

 

[Winged Scapula]

You could also just make your marking with your initials in a place where the prep and drape won't hide it. Then you would always be sure.

I could but that would mean I would be changing my practice to suit them and their assumptions that they know what I want.

I don't place my initials near where I am working because I have drawn other incisions, circled biopsy marks etc. on them. I am the Queen of the Purple Pen. My initials are generally out of the area.

But perhaps I will move it lower, grudgingly.😀

 

[Cheisu]

My reasoning being that since I did not see the patient be wheeled into the room, I could not be sure that it was MY patient, since all that was exposed was a random boob.

Is it just me, or was that extremely funny? lol

So, Dr. Cox. Please inform us. What really does make a boob "random"?

 

[SocialistMD]

What really does make a boob "random"?

Posting at 4:23 AM. 😉

 

[supercut]

Patient safety is not micromanaging. The scenario you described is a situation that is high risk for wrong site or wrong patient surgery. If that had happened, it would be your a$$ on the line, not anybody else's. Is this scenario consistent with this hospitials time out procedure?

Just becuase "other surgerons" want to do things that way....doesn't mean you have to. You were well within your right to be upset and speak out.

Just as an aside, have you ever been at a hosptial were the surgeon's preference cards are paid any attention to? I never saw that happen anywhere I was as a student or resident. Almost always there was an instrument/suture/mesh that wasn't set up on the table and the surgeon would say "that's on my preference card". Didn't seem to matter.

 

[PediBoneDoc]

welcome to being an attending Wing😉

although i understand you frustration, if you talked to the patient prior to surgery, marked the sight (it is suggested that it is done in the area of the incision, which i never do), and did the jcaho require time out, you are relatively safe. these are all safe guards to prevent wrong side surgery. the time out (as suggested by jcaho) require that everyone in the room involved in the patient's care stop what they are doing, listen to the nurse state the patients name, site of surgery, and type of surgery done, and agree with this care plan.

i understand the frustration.

preference cards are just a source of my frustration. "i do this the same way every time." you wonder why surgeons say this, because sometimes it is like reinventing the frickin wheel.

dealing with residents and med students, although fun for me, it is like starting over every time a new rotation begins. you have to train them about your quirks and preferences. some people are a little more tolerant than others.

the attending side is different than the resident/fellow side of things because of a feeling of obligation to the patient, and ownership of the procedure and outcome. hang in there, choose your battles, and always do the next right thing.

 

[Winged Scapula]

Is it just me, or was that extremely funny? lol

Its you.

So, Dr. Cox. Please inform us. What really does make a boob "random"?

A breast that I cannot clearly identify as belonging to any particular patient. Really, we are grown-ups here and should be able to discuss breasts without becoming juvenile about it. At least you have an excuse, being 16, but I'd advise you to grow up.

 

[dr.evil]

I know EXACTLY what you mean about the preference cards. I did 35 lap choles before they got the right stuff, which is amazing because I only wanted like 4 things different than my partner. I also always have the wrong port opened on the back table when I place a port. That is the frustrations of the first year of practice for sure.

As far as the prepping thing goes, we are now required to mark our own patients in the pre-op area. The circulator calls me when she is moving to the room. So I can be there or she can prep and call me when she is ready. Either way, each surgeon is happy because they can just roll in and cut or be there when the patient rolls in. I usually just tell them to go to sleep and prep away to speed up my life.

As far as the anesthesia, I've given up that battle. "EVERYONE" uses general anesthesia for most things here. That drove me crazy initially as I use local/MAC for ports, breast biopsies/lumpectomies, a lot of inguinal hernias, etc. I just let them do whatever they are comfortable with now.

You've got to pick your battles. The main battle I haven't given up on in regards to anesthesia is epidurals. They are pretty aggressive here and will try to put an epidural in everyone. I do VATS here and I definitely don't need an epidural for that. It just adds time and risk to my patient.

The preference card thing cracks me up though. 10 months here and still not a clue how those things get corrected. Oh, wait a minute, they don't!

 

[Winged Scapula]

RE: Preference Cards

True, I do recall when in training that the cards were only of minimal importance to the OR staff. For some reason, when they get something out that you don't need its because its "on your preference card" and when they don't they just shrug, even when say, "its on my preference card."

RE: Marking Patients

Like PediBoneDoc, I don't care if JCAHO tells me to mark where I would be making the incision; I have lots of other marks there detailing my incision and area of dissection, biopsy tracks, etc. Interestingly, the hospitals here also mark the patient when they arrive in the holding area (they have stamps that say "yes") and these are no where near the incision but that's ok, because I wouldn't expect them to know where I am placing my incision.

RE: Time Outs

As far as I am concerned, a time out involves identifying the patient. When the patient has not been brought into the room by me, is covered when I arrive and I have to go under the drapes to see their face and their arm band, I am not happy. Time Outs should be done BEFORE someone is prepped and draped. I do not know what JCAHO requires and perhaps I am being picky, but as everyone notes, if I were to make a mistake, it would be my arse on the line.

I am especially sensitive to this because cases are often rearranged in order so there is a high potential, at least in my mind, for me to assume we are operating on John Smith when in fact its Jane Doe.

 

[PediBoneDoc]

I do not know what JCAHO requires and perhaps I am being picky, but as everyone notes, if I were to make a mistake, it would be my arse on the line.

I am especially sensitive to this because cases are often rearranged in order so there is a high potential, at least in my mind, for me to assume we are operating on John Smith when in fact its Jane Doe.

everyone should do what makes them comfortable. i refer to this as the things you do to help you "sleep better." resident asks me why i do i put a screw there, i say "it is the sleep better screw." you have to do the next right thing and if you can't sleep, you did not do what you feel was right regardless of what the standard of care is in your hospital.

for me, seeing the face is not that important. as long as i know the patients name and it is confirmed by the id bracelet. but i also don't do similar cases everyday. elbow fracture, spine and then a tibia fracture, it is hard to get them mixed up like right and left breast. sometimes the casts and deformities give them away. i am also there usually before the prepping.

i think something that would get my blood boiling, and has cause a rant or two, is having case order switched without being told. that would cause me to become the "not so nice guy". one more than one occasion i have had an infected case move to first case before a scoliosis case. in my book, that is a no no.

 

[DrDre311]

you know, after graduating from college and medical school, you'd think I would be a little more mature than I was at 16. However, my juvenile sense of humor is still completely intact--I've just gotten a little better at hiding it and knowing when it's appropriate to make an inappropriate joke. This situation is pretty common, especially with male docs and surgeons in particular. I know we're supposed to be mature, but come on, have you ever asked an attending urologist to tell you his favorite penis joke? Priceless.

 

[Winged Scapula]

you know, after graduating from college and medical school, you'd think I would be a little more mature than I was at 16. However, my juvenile sense of humor is still completely intact--I've just gotten a little better at hiding it and knowing when it's appropriate to make an inappropriate joke. This situation is pretty common, especially with male docs and surgeons in particular. I know we're supposed to be mature, but come on, have you ever asked an attending urologist to tell you his favorite penis joke? Priceless.

And there's nothing wrong with that and its not necessarily immature.

My comment was meant for the 16 year old who thought the mere mention of the word boob <snicker snicker> was funny.

I expect people to laugh when a joke is made but not when we are referring to body parts or functions in the abstract.

 

[DrDre311]

My comment was meant for the 16 year old who thought the mere mention of the word boob <snicker snicker> was funny.

I expect people to laugh when a joke is made but not when we are referring to body parts or functions in the abstract.

Ever hung out with a bunch of orthopods?

 

[PediBoneDoc]

Ever hung out with a bunch of orthopods?

hey watch it. i resemble that remark 😀

 

[Winged Scapula]

Ever hung out with a bunch of orthopods?

Yes.🙄

Never mind.

 

[Cheisu]

Its you.



A breast that I cannot clearly identify as belonging to any particular patient. Really, we are grown-ups here and should be able to discuss breasts without becoming juvenile about it. At least you have an excuse, being 16, but I'd advise you to grow up.

Oh yes, Dr. Cox. Please, allow me to repost some of YOUR posts in the "things you have to do but can't because you're scrubbed in" topic. Some of those were extremely mature.

Let me go find them 🙂

 

[Cheisu]

And there's nothing wrong with that and its not necessarily immature.

My comment was meant for the 16 year old who thought the mere mention of the word boob <snicker snicker> was funny.

I expect people to laugh when a joke is made but not when we are referring to body parts or functions in the abstract.

No. The fact that you, a surgeon felt that you had to use the slang term, "boob", instead of "breast" is funny. And the fact that you called it random.

If you were trying to be mature, then why didn't you just say "breast". Have you ever used the word "boob" with a patient?

 

[smq123]

Oh yes, Dr. Cox. Please, allow me to repost some of YOUR posts in the "things you have to do but can't because you're scrubbed in" topic. Some of those were extremely mature.

Let me go find them 🙂

Seeing as how Winged Scapula has previously defended your pretty indefensible comments, and made allowances for your clear immaturity (even when other posters were not willing to), maybe we shouldn't try to antagonize her, hmmm?

Come on. You said something that was pretty immature - which, considering the topic (how to ensure patient safety), was out of place and almost inappropriate. Let it go.

 

[SLUser11]

Oh yes, Dr. Cox. Please, allow me to repost some of YOUR posts in the "things you have to do but can't because you're scrubbed in" topic. Some of those were extremely mature.

Let me go find them 🙂

No. The fact that you, a surgeon felt that you had to use the slang term, "boob", instead of "breast" is funny. And the fact that you called it random.

If you were trying to be mature, then why didn't you just say "breast". Have you ever used the word "boob" with a patient?

Seeing as how Winged Scapula has previously defended your pretty indefensible comments, and made allowances for your clear immaturity (even when other posters were not willing to), maybe we shouldn't try to antagonize her, hmmm?

Come on. You said something that was pretty immature - which, considering the topic (how to ensure patient safety), was out of place and almost inappropriate. Let it go.

Agree with smq.......still, that was a better than expected comeback.....

 

[nonesuchgirl]

Oh yes, Dr. Cox. Please, allow me to repost some of YOUR posts in the "things you have to do but can't because you're scrubbed in" topic. Some of those were extremely mature.

Let me go find them 🙂

Completely different topic. The scrubbed-in thread was meant to be amusing.

This one was serious.

The end.