I have to cringe!!!


I have to cringe!!!

Postby Jewelz on December 31st, 2010, 12:54 pm

One of my patients from last night was involved in a snowboarding accident yesterday. He injured his cervical spine, in addition causing some central spinal cord compression. Our oncall neurosurgeon decided to schedule surgery this morning to fuse this kids cervical spine. This adolescent was vacationing here in Idaho with his parents. They live in Northern California.

Last night my patient's dad asked me what I thought about the surgeon (or butcher). Of course, I can't tell him to turn and run! Or, your kid will never be the same. :-( So I thought I'd use the little birdie in the ear approach and advised him to seek a second opinion before signing the surgical consent. I told him it is their right, and that he could change surgeons if he felt uncomfortable with their current choice. Spine surgery is a big deal and there's nothing wrong with a second opinion.

The surgery was scheduled for this afternoon. Well guess what? The OR called me at 0615 to give me a heads up that the surgeon had chosen to make my kido her first case. Talk about my stomach turning instantly. . So I woke up the patient and his father. Let them know the situation. The father was hesitant. I reminded him he could always talk to the surgeon, change his mind, and hold off on signing the consent for surgery. FYI forum friends, when a nurse throws out the idea to seek a second opinion. There's a good reason for it. Now I have to cringe and hope for the best. It was just a hard night anyway, and thats just one of my stories.
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Re: I have to cringe!!!

Postby susan60625 on December 31st, 2010, 2:33 pm

Jewelz, my mother's best friend was a surgical nurse. She was loud, obnoxious and never held back her opinions. Of course, I loved her to death! She always told us that WHENEVER you're told to have surgery, GET A SECOND OPINION! There were very few surgeons that she felt deserving of not needing that. Most of them she always said were "knife-happy butchers" who that that cutting was the only answer! She died this past summer from cancer, and I miss her dearly. She always told it like it was. :(
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Re: I have to cringe!!!

Postby sherr on January 1st, 2011, 7:59 am

Jewelz....I agree with you.....but becareful where you tread. You did the right thing but neurogenic shock from waiting so long could be a worst complication. No neurosurgeon is going to diss another.....the old boys club rule. Although....I believe you did the right thing and was a great advocate for your patient....in the long run we know who the real healers are...*winks*. Would have done the same.
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Re: I have to cringe!!!

Postby tkw5002 on January 1st, 2011, 10:48 pm

Jewelz, how is he doing? Did he make it through his surgery ok? That is so scary having surgery anywhere near the spine. I'm hoping the surgery goes well and he has a safe and healthy recovery!!!!!!!
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Re: I have to cringe!!!

Postby Jewelz on January 2nd, 2011, 12:50 am

I've been off work since Friday morning. Went down to surgery on my way out to check and see if they went through with the surgery. The surgery had just started as I was leaving. I won't go back to work until Thursday. Even during an emergent situation they could have received a second opinion. Heck, she waited until the next morning to do surgery. We always have a backup oncall Neurosurgeon. Yes, this kido needed surgery to relieve cord compression . But really, is this the right surgeon to be operating on this Kiddo? In this situation most Neurosurgeons would have ordered IV corticosteroid treadments before surgery to help decrease compression damage (usually its most beneficial within the first 8hrs of injury). Corticosteroids like solu-medrol or Decadron are commonly used to help increase blood flow to the cord, and to decrease inflammation from cord compression. The patient had no allergies. Why not decrease some of the inflammation? I'm not a Doctor. But there are surgeon who shouldn't be operating. The charge nurse and I both cringed at this situation. When I go back to work, I really don't know if I want to know the outcome. :(
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