Pet Peeves

[OB1🤙]

I have a thousand, but will start with two.

1) "Glide-uh-scope." It's pronounced glide-scope. Why complicate your life with the extra syllable? Was at a code yesterday and someone was doing the clucking hen feather flapping dance, trying to find the "glide-uh-scope" and the "glide-uh-scope stylet." Ugh.

2) The restrictor leash that every emergency room in the country apparently feels compelled to attach to their large bore IVs to make them run like 22s.

What are yours?

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[soonerfrog]

Sonameter. Mother. F'ing SONAMETER!!! How did this A) even get started in the first place and B) manage to last this long?!?!? I still hear it ever so often. I no longer have the willpower to correct people.

 

[Urzuz]

Messy and disorganized anesthesia carts/machines

 

[Pooh & Annie]

Case finishes, everybody except anesthesia forgets there's a patient there. They chart instead of taking legs out of lithotomy (then yell when the patient moves their legs in lithotomy). Imaging monitors sitting just above the patients head/body in our GI suites and nobody thinks to get them out of the way. Charting instead of removing foley/grounding pad/whatever else. And I don't get fired up about it, but no one but us understands that with the majority of surgeries the most dangerous/sensitive times are at induction and emergence, NOT during the surgery. The catch-22 is the better you do your job the less dangerous everything seems to everyone else.

 

[pgg]

Pre-charting.

Nothing gets me more bent than going in to give someone a break, and they've charted ahead vitals or already written the extubation notes or PACU transfer bit ...

... except the guys who put their monitors in cardiac bypass mode to disable all alarms.

 

[G0S2]

1- 22g iv in AC placed in ER in pts with huge hand veins.

2- nonfunctional crusty iv in surgical pt coming from floor.

3- full body drape protocolized central lines with a nurse checking off on a sheet whether you are meeting all the standards.

4- "Emergency " epidurals on OB

5- bad surgeons.

 

[Spinach Dip]

Anesthesiologists who think they know the patient better than the patient knows themselves.

 

[OB1🤙]

Sonameter. Mother. F'ing SONAMETER!!! How did this A) even get started in the first place and B) manage to last this long?!?!? I still hear it ever so often. I no longer have the willpower to correct people.

Oh hell yes. This. If anyone says this to me, I fire back with "Today I got a cheeseburger for 99 sonts. And shoot, I got bit by a sontipede the other day."

 

[Yangkower]

1. Meta - pro- lol
2. The patient is moving. Yep its a MAC case and your local sucks.
3. Patient "Doctor I woke up during my last surgery"
Me "What kind of surgery?
Patient "Colonoscopy"
4. EF 's < 40%

 

[IlDestriero]

1- 22g iv in AC placed in ER in pts with huge hand veins.

2- nonfunctional crusty iv in surgical pt coming from floor.

I had 1 today and 2 yesterday.
LOL

 

[OB1🤙]

People that intubate close enough to the mouth to get corneal abrasions from the patient's teeth.

 

[G0S2]

Anesthesiologists who think they know the patient better than the patient knows themselves.

There are quite a few pts where I know I have way better insight into their comorbidities than they do.

 

[deleted162650]

People that intubate close enough to the mouth to get corneal abrasions from the patient's teeth.

HA. We regularly have paramedic "interns" in the OR to gain airway experience and everyone of em feels the need to make-out with the pt in order to intubate them.

 

[loveumms]

Having to tell someone to do the same thing - eight times in the same day.

Being called "anesthesia" instead of Dr. Loveumms or Loveumms or anything but "anesthesia"

Being called nurse (because I'm a female so I automatically have to be a nurse, right?)

 

[soorg]

People who wear shoe covers over their clogs

Wise-ass tech who thinks she's smarter than you bc she knows how to drape
and bc surgeon lets her call him by his first name

Circulator who feels the need to do three time-outs.

Pre-op nurse who notes that your 57 y/o pt had a history of pneumonia when they were 6.

Pt's who claim they have gastritis, but only with "really spicy foods."

Pt's who claim they have asthma, but "I've never had an asthma attack," or "I have high blood pressure, but I'm not on any medications for it."

Santimeter, meta-pro-lol, and Glide-es-scope have all been driving me nuts for the last decade.

People who spell it "parasthesias."

 

[Spinach Dip]

There are quite a few pts where I know I have way better insight into their comorbidities than they do.

"Do you have any heart problems Mr Smith?"
"Nope."
"But I see you are under the care of a cardiologist."
"Yeah. He told me I have heart problems."

 

[jwk]

Pre-tearing little strips of tape for the eyes or ET tube. PLEASE - if you do my anesthesia, do NOT use that nasty crap on my eyes.

3 layers of tape on an ET tube, which includes tape over tape, which I have NEVER understood in 30 years.

Nurses who think the IV only needs the little clear plastic sticky dressing and the two 1" pieces of 1/4" steri strips that come in the "IV start kit" and think they've done a good job taping the IV.

 

[okayplayer]

Vasodilitation

 

[sleepallday]

three hour lap chole's

 

[pgg]

Vasodilitation

Preventative. Preventatatatatatatative. No. One T. Yeah I know two Ts is an accepted spelling. But it shouldn't be.

 

[OB1🤙]

"I DL'ed him with the Glidescope."

Or written on a record as "DLx1 with Glidescope, G1 view."

I don't think DL means what you think it means...

 

[deleted9493]

Giving a good hand-over to a computer-fixated PACU nurse, only to have questions asked which were just addressed in said hand-over.

The yelling of OR staff at an emerging patient...as though they are fully able to be re-directed.

OR staff messing around with the patient's head/neck whilst I am trying to extubate them smoothly.

Subjective excuses for why procedures weren't successful. Nobody cares!

 

[Monty Python]

Giving a good hand-over to a computer-fixated PACU nurse, only to have questions asked which were just addressed in said hand-over.

Taking a comfortable, stable, extubated, peacefully-snoring patient to the PACU, only to have them violently shaken and/or yelled at by the PACU staff, needing to obtain their "pain score," followed by the well-meaning student nurse reflexively jamming a nasal cannula in place despite room air SaO2 >95%. Well just look at the patient and use your thinking skills versus acting as a robot with a license.

 

[8ball]

****loads of opioid as the sole post-op pain management plan

and the invariable "don't care if they're nauseated 12 hrs later, not my problem"

that kind of infuriates me

 

[Consigliere]

CRNAs.

 

[sevoflurane]

Showing up @ 7:00am while the podiatrist shows up regularly @ 7:40 for a 7:30 start. Then hearing the whining and crying when we take away his 7:30 start time.

 

[sevoflurane]

It's 2pm and you're on your last case and we are on skin... it's 75 degrees outside, sun is out, no clouds in the sky... ready to exit the shop and have some fun.

Then...

The F'n count is off and fluoro can't get to us for 10 minutes... and radiologist on call is nowhere to be found.

Ohh yeah... That'll get me steaming.

 

[BuzzPhreed]

1) "Glide-uh-scope." It's pronounced glide-scope. Why complicate your life with the extra syllable?

I think I know where this comes from. In academic programs, there are often a lot of anesthesiologists who are non-native English speakers. They tend to over-inflect and occasionally add extra syllables to words. The residents (and others) hear this repeatedly and start to think this is the way it should be pronounced. All of the sudden "glide-scope" becomes "glide-uh-scope".

Ironically, sometimes proper pronunciation gets truncated. I've yet to meet a non-native English speaker, especially native French speakers, who can pronounce the word "idea" correctly. Invariably they say "i-DEE". This is one of the rare four-letter words that actually has three syllables. Always screw that up.

 

[BuzzPhreed]

The yelling of OR staff at an emerging patient...as though they are fully able to be re-directed.

Or the counter to this. The instant after pushing the propofol and before the tube is in the scrub tech standing in the background immediately cranks the background music to a level that would embarrass AC/DC at Wembley Stadium. There also seems to be a direct correlation with the level of music and the difficulty of the airway.

 

[GaseousClay]

Circulating nurses on their hands and knees for surgeons and giving me attitude for asking to send of ANOTHER blood gas.

Neuromonitoring folks getting up in my space, trying to put their needles in my patient while im still intubating or putting in lines.

 

[Pooh & Annie]

People who take zero responsibility for their own health/fitness then get ridiculously expensive care/resource usage for their very predictable illnesses.

 

[BuzzPhreed]

People who take zero responsibility for their own health/fitness then get ridiculously expensive care/resource usage for their very predictable illnesses.

Yeah, but we probably wouldn't have jobs if everyone took proper care of themselves.

 

[OB1🤙]

Knee-jerk EKG/cxr/cbc/lytes/coags on healthy people for minor surgery.

 

[OB1🤙]

Hyperchloremic acidosis after going bananas with liters of NS.

Bonus peeve: when that iatrogenic acidosis is misinterpreted as something intrinsically wrong with the patient.

Super bonus peeve: giving bicarb to "correct" said hyperchloremic acidosis.

 

[deleted9493]

In the adult world: using 1+ MAC of agent, in conjunction with paralytic and then treating hypotension with loads of fluid.

 

[GaseousClay]

super morbidly obese in-house patient who's IV blew the day before, no one bothered to replace it, thinking "oh anesthesia will just line him up" and the patient's been npo with no IV fluids for 20 hours before a big case.

 

[BuzzPhreed]

Hyperchloremic acidosis after going bananas with liters of NS.

Bonus peeve: when that iatrogenic acidosis is misinterpreted as something intrinsically wrong with the patient.

Super bonus peeve: giving bicarb to "correct" said hyperchloremic acidosis.

Haha. Yeah. Who uses normal saline anymore anyway? Lot of myths, dogma, and bad info about basic physiology out there. Everyone gets Plasmalyte whenever available. Even the ESRD patients who supposedly can't tolerate additional potassium. Again, people don't understand basic physiology and osmolality. Especially, for some reason, the renal docs. No one thinks anymore. They just regurgitate dogma. I've never caused a hyperkalemic crisis in the past 11 years giving mixed-electrolyte potassium containing solutions. Why does this myth persist?

 

[deleted171991]

I've never caused a hyperkalemic crisis in the past 11 years giving mixed-electrolyte potassium containing solutions. Why does this myth persist?

Because people tend to focus on the 70 mEq of extracelullar K+ the average person has, while ignoring the 3500 intracellular ones.

 

[Consigliere]

Chicks that want to have sex in the missionary position. Oh no sweetheart: DOGGY STYLE.

 

[Ezekiel2517]

Where this specialty is heading

 

[BuzzPhreed]

Because people tend to focus on the 70 mEq of extracelullar K+ the average person has, while ignoring the 3500 intracellular ones.

Especially when it's diluted in a liter of fluid that is going to stay in their system until they get dialyzed again. It doesn't "concentrate" and cause a problem. Don't believe me? Check a serum potassium level after you give them a liter of Plasmalyte. My bet is that it will be lower than when you started.

 

[BuzzPhreed]

On that note, another pet peeve...

Fleas ordering kayexalate for every patient with a potassium level above 5.5 mEq/L. Then having to give them potassium supplementation post-op because the K+ is now 2.9 mEq/L.

 

[IlDestriero]

It's 2pm and you're on your last case and we are on skin... it's 75 degrees outside, sun is out, no clouds in the sky... ready to exit the shop and have some fun.

Then...

The F'n count is off and fluoro can't get to us for 10 minutes... and radiologist on call is nowhere to be found.

Ohh yeah... That'll get me steaming.

You forgot the part where the surgeon leaves and lets the fellow close with the medical student...

 

[urge]

Circulator covering the patient with blankets when I'm trying to put EKG dots on.

 

[DreamLover]

For me, it's when the surgeon decides to chat it up at 100 decibels with everyone in the OR during induction.

I also have one urology attending that thinks it's appropriate to start shaving the groin etc just prior to induction while the pt is staring at me...

I also can't stand that every one calls me nurse because I'm female even if I just introduced myself by title and name in the prior breath.

I also can't stand it when I've waited FOREVER for my circulator to be ready for me to bring my pt to the OR and then they don't page me when they're ready but better yet, they come and ask everyone under the sun if they've "seen me" because they're "ready" for me to take the patient to the OR.

I can go on and on

 

[jwk]

I also can't stand it when I've waited FOREVER for my circulator to be ready for me to bring my pt to the OR and then they don't page me when they're ready but better yet, they come and ask everyone under the sun if they've "seen me" because they're "ready" for me to take the patient to the OR.

Just curious - are you taking the patient to the OR with the nurse, or are you personally taking the patient to the OR - and if the latter, WHY?

 

[DreamLover]

Just curious - are you taking the patient to the OR with the nurse, or are you personally taking the patient to the OR - and if the latter, WHY?

I take the patient back with the circulating nurse....of which I'm ALWAYS waiting on

 

[Tuohy]

1. A**holes who walk around with gloves on touching everything in sight before, during and after patient care-strong work!

2. Blasting music upon emergence-yeah, that's how I want to wake up when I have anesthesia

3. Ignorant surgeons (typically orthopods) who state "My patients don't hurt after surgery". How would you know when you are sitting at home on your a** when your intern triages everything. Next day's progress note-subjective section: Pt. in NAD

4. Older attendings who need to do MOCA more than any younger attendings-Dogma such as "I don't want to put him to sleep because of his heart (no specific reasons can be listed as to what is wrong with said heart)"

 

[geogil]

MeTROPolol.
AneSTesia
IV tylenol for a patient who is awake and eating.
"turning the room over for me" = putting a new sampling line on the machine.
Requirement to put a Buretrol on pump tubing for a healthy 6 year old.

 

[Colba55o]

1. OB nurses, who call for stat epidurals and tell screaming mom, "Oh here comes Dr. so and so, he will take ALLL your pain away!"
2. Calling anxiolytic "happy juice" or "the good stuff". As in brilliant pre-an nurses who tell every patient, "Dr. so and so will give you the good stuff!" Please stfu