Nursing Documentation Of Patient In Operative Room: Fill & Download for Free

One of my favorite experiences in residency involved this situation. Until that day, I thought doctors were obligated to treat all patients, but they are not.I was on an OB/Gyn rotation and the surgeon was seeing a patient for pre-op regarding her planned Bilateral Tubal Ligation (“tubes tied” to achieve infertility). As is required by law, he was consenting her with risks/benefits, etc. When he said, “there is a 4–5% chance of eventual failure or regrowth (that’s different now, but was accurate at the time) and possible pregnancy due to this,” the patient interrupted, chuckling, and said, “that’s alright, if that happens I’ll just sue you.”Now, there are some things you don’t joke about. First to mind is saying you have a bomb while boarding an airplane. A close second is telling a doctor you plan to sue him/her. Without losing composure at all, the surgeon replied, “Well, thank you for the warning,” then rose and walked out of the room, leaving her sitting there, then went straight to his next patient.Much later, the patient poked her head out the door and asked the nurse if he was coming back. When the nurse asked the surgeon, he said, “oh, no, she can go. We won’t be operating on her.” That ended up being a huge mistake since his was the only Gyn group within a 1.5 hour drive and now all his partners could see documentation of her threat, serious or not, in her chart. She did not have surgery in our small town.

“Legally”, any licensed physician may do whatever they deem necessary to help a patient, regardless of their diagnosis. A Medical License, issued by each state, gives a physician the right to intervene in any medically acceptable way to diagnose and treat human disease. They could, in fact, build their own radiation therapy department, order and administer chemotherapy drugs or perform surgery in their office with the help of an anesthesiologist or nurse anesthetist.I doubt that anyone would undertake interventions such as these if they were beyond the scope of their training, but “legally” they could.In reality, resources such as operating rooms, Intensive Care Units, Oncology wards and most radiation therapy facilities are run by hospitals or other entities which require credentials in order to use them. A “credentials committee”, made up of elected/appointed physicians practicing in that entity, review the applications of any doctors wishing to practice there. Credentialing almost always requires specialty board certification as well as complete documentation of every day that doctor has spent since graduating from medical school. Privileges are granted for procedures that fall into the categories covered by that persons training and certification. (i.e. Medical Oncologists can give chemotherapy, Radiation Oncologists prescribe radiation therapy, Colon and Rectal Surgeons operate on the bowel, Thoracic Surgeons operate on lungs, etc.)

I never thought of a patient in that manner. Emotional detachment is what it is called. As a surgeon I have seen 1000's of patients undressed (it is the first thing that they do after putting you to sleep so as to make sure there is no body contact with metal due to jewelry that was not removed. The anesthesiologist, surgeon, and nurses position the patient for surgery and make sure for longer operations that the patient will be kept warm.I would be more likely to notice a nice sports car when changing the plugs than looking at a patient sexually or being attracted. Like many medical professionals I have had patients make suggestive remarks. There was always a female in the room when I examine a female and this is documented. If the suggestions become too bad, I wrote the patient a certified letter saying she needs to find another orthopedic surgeon and I would be available for emergencies only for the next 30 days.