What is going on here?

Chapter 10

Wednesday 10 p.m.

     Yvonne, the circulating nurse in OR # 2, helped Susan, the surgical technician, in covering Terri Shultz with a sterile surgical drape.  Terri had already been prepped and her legs put in stirrups.  Yvonne looked at the clock and realized she had too much time left in her shift. 

                  She thought of all the added-on emergency cases that had piled up and canceled her dinner.  Her hands shook with fatigue and hunger.  Her stress tolerance had decreased over the last two hours to where she felt like screaming.  Perspiration trickled down the side of her face.  She felt her damp scrubs sticking to her.  The sensation was not pleasant.  Yvonne was not feeling pleased or pleasant.

                  Yvonne turned to her paper work.  She had three forms to fill out for a case that wouldn’t last longer than five minutes.  She knew she wouldn’t be able to finish by the time the case was over which she was supposed to be able to do.  She started filling in the blanks and marking the appropriate boxes that applied to the dilatation and curettage case.

                  Out of the corner of her eye, she saw Dr. Baker enter her OR.  He had better not need anything.  Susan had everything he needed.  Yvonne turned back to her paperwork keeping her ear on the movements of Susan and Dr. Baker.  She relaxed.

                  “Oh, nurse.”  Dr. Baker said.  “I have something for you.”

                  Yvonne sighed and got a specimen cup for the something.  She took off the lid and held the cup for the doctor to drop his treasure in.

                  “You forgot this when you did the prep.”  He had a pair of Russian forceps in his hand holding some small object.  He dropped it in. “You don’t need to save it.”

                  Yvonne looked at the green oval pill that Dr. Baker had dropped into her cup.  “Oh, thank you, doctor.”

                  Noting the nurse’s sarcasm Dr. Baker looked at her.  “Are you okay?”

                  “No.  But the situation can’t be changed by you.”

                  “Oh.”  He looked at his nurse and saw the sweat on her face and her furrowed brow.  He went back to his work not saying another word.

                  Dr. Baker turned toward Susan who held a curette and a nonabsorbing pad to him.  He proceeded to start and finish the dilatation and curettage in less than five minutes.

                  Stripped of his gown and gloves he retrieved Terri Shultz’s chart from the anesthesia machine.  Dr. Baker asked the nurse anesthetist, “Is she okay?”

                  “No problems,” said Maria Myers, CRNA.

                  Yvonne left her paperwork to help Susan remove the drapes off of Terri.  Yvonne cleaned the Betadine off.  Susan and she took the patient’s legs out of the stirrups and covered her up.  Yvonne put the safety strap on and went to the head of the bed.  She remained there in order to assist Maria if she needed help. 

                  Terri woke up quickly and gently.  Maria signaled to Yvonne that Terri was ready to be moved.

                  Yvonne brought up the body roller and placed it under Terri while Susan having brought up the gurney held Terri on her side.  On the count of Maria’s three Terri was rolled over to the cart with ease.  With Yvonne at the foot of the bed to steer and Maria at the head of the bed to watch the patient, Terri was taken to the post anesthesia care unit.  Yvonne took her paperwork and the specimen container and left for the front desk.  Maria was left to give report to the recovery room nurse.

OR Nursing Station

                  Janice leaned over the desk to hand Dr. Baker a message that he had gotten while busy with surgery.  “It’s from 4 West nursing unit about a Mrs. Rourke.”

                  Dr. Baker didn’t even acknowledge her but kept on going to the dictation room.  Janice took off her surgical bonnet and threw it on the floor in disgust.

                  Yvonne entered the station area and smiled, “Whoa, now that is really threatening to throw that one ounce of bonnet on the floor, Janice.”

                  “Oh, I’m just frustrated with Dr. Baker.  He wouldn’t even look at the message I took for him while he was working.  I love to be treated as invisible.”

                  “Don’t we all.  But look at this and tell me what it is.”  Yvonne opened the specimen container for Janice.  “Dr. Baker took it out of the patient’s vagina because I had missed it when I did my prep. I wasn’t looking for a tablet to be in the vagina.”

                  Janice leaned over the container studying the tablet.  Dr. Baker came up to the nurse’s station.  “Do you have a message for me?” asked Dr. Baker.  He saw what the two women were looking at.  “Why do you have that tablet still?  I told you it was nothing and to get rid of it.  Why am I having to check up on your work.?”

                  Beet red, Yvonne replied, “I was just wondering what it was and why it might be in the girl’s vagina?”

                  “Look, I told you what to do with it.  Now, get rid of it.”  Dr. Baker stomped off with his message in hand.  He figured he’d given them enough yelling to force compliance, but it worried him just the same.  The green tablet was a loose end.  Concerned, he went into the doctor’s locker room.

                  Kate joined Janice and Yvonne at the nurse’s station.  They showed Kate the green tablet and ask her if she knew what it was.

                  “Sure do.  My mother takes it for her arthritis.  It’s methotrexate.”

                  “Methotrexate?”  Yvonne grabbed the Physicians Desk Reference that contained massive information about drugs and included pictures of some of the drugs.  Yvonne flipped to the picture section and found the drug.  “Yes, you’re right it is methotrexate.  But what would it be doing in a woman’s vagina?”

                  “I don’t know but Dr. Baker wants us to get rid of it and forget about it.”

                  “Well, that’s great Janice, but my name is on the operative report and I’m supposed to know and document everything that goes on in the room.  I’m in the dark and in trouble because the doctor wants me to get rid of it.  Now, you are my supervisor and I’m going to document that I turned it over to you and that Dr. Baker wants us to throw it away.”  Yvonne paused.  “Sorry, but I’m going to cover myself here. I don’t know what exactly is going on.”

                  “Well, you document it all you want to.  I’m throwing it away like Dr. Baker told us to do.  Now, that’s the end of that.”  Janice turned to Kate.  “Now do you want to count narcotics with me; so I can get out of here and you can document any thing you want.”

                  Kate took the narcotics keys from Janice opened the narcotics box and began to count.  Yvonne finished her paper work and sent it through the pneumatic tube system to the post anesthesia care unit.  Yvonne stomped off.

                  Janice and Kate were quickly through with the count and Janice headed to the female locker room, also.  Kate went to the operating room where an abdominal aortic aneurysm was being done.

                  As Janice passed the doctor’s lounge, Dr. Baker stuck his head out.  “Janice, I have some new pictures of the boys.  Do you want to see them?”

                  Janice had known Dr. Baker for decades and had watched his sons grow up.  New pictures were always a welcome sight.  “Sure.”  She followed Dr. Baker into the locker room.