These two patients were admitted in two different wards and had two different nurses looking after them. What they had in common was that both of them were to undergo an operation in our OT that day. One was scheduled to undergo a diagnostic laparoscopy while the other was to have an emergency cesarean section. The standard procedure is that the nurse prepares the patient for OT, including confirming removal of undergarments and ornaments, putting a name tag on the patient's dress, covering her hair with a cap and giving her premedication.The House Officer is supposed to confirm that the preparation is as expected. I was to assist the House Officer perform laparoscopy. The patient was anesthetized, and lithotomy position was given. Then I suddenly realized that the patient had her um... upper undergarment on, so far covered by the OT dress but not partly exposed. The nurse had goofed up, and the House Officer had been too busy or lazy to do her job. The anesthetists had also goofed up. They had inserted the chest leads of ECG under that garment, probably happy that they would be held in place by the tight garment and would not come off due to poor adhesive.
"Have we started leaving the undergarments on when patient go to OT?" I asked.
"Arrey, the patient's bra is still there" my Registrar declared. She did not feel awkward to say that word aloud in OT. Houseman, remove it."
"It should not be worn because it is a tight garment and may restrict ventillatory movements under anesthesia" I said. I don't know how they managed to remove the garment while the patient had chest leads, IV line and pulse oxymeter attached. I was to embarrassed to watch.
The other patient was sent from the labor room. She had no hospital dress. Instead she was wearing an OT gown, which covered her full height all right, but was open along the entire front. It was held in place by three strings, one at the upper end, one in the middle, and one a little lower down. The poor woman was clutching it around herself, trying to cover her modesty desperately despite labor pains. I called the ward and spoke to the nurse.
"Why did you send the patient without a hospital dress?" I asked her.
"I asked the doctor" she said "who said it was OK."
"The doctor says she asked you to give the patient hospital dress" I said. "The poor woman is almost naked., that too in front of all people in OT."
"I am new in this ward" she said.
"So what?" I was getting quite angry by then. "You must know hospital routine - giving a dress to a patient is the most basic of nursing care."
"OK. I am sorry" she said.
"But what about the patient on the OT table? She is still almost naked" I said.
"I said sorry, did I not?" she retorted.
I knew I could not improve things any way. After all, I was not involved in the selection process of the employees, nor were they answerable to me. I could just wonder at the coincidence, one patient being unduly clothed and the other hardly at all. Perhaps there was a cruel balance there, positive and negative nullifying errors due to extremes in each other.
"Have we started leaving the undergarments on when patient go to OT?" I asked.
"Arrey, the patient's bra is still there" my Registrar declared. She did not feel awkward to say that word aloud in OT. Houseman, remove it."
"It should not be worn because it is a tight garment and may restrict ventillatory movements under anesthesia" I said. I don't know how they managed to remove the garment while the patient had chest leads, IV line and pulse oxymeter attached. I was to embarrassed to watch.
The other patient was sent from the labor room. She had no hospital dress. Instead she was wearing an OT gown, which covered her full height all right, but was open along the entire front. It was held in place by three strings, one at the upper end, one in the middle, and one a little lower down. The poor woman was clutching it around herself, trying to cover her modesty desperately despite labor pains. I called the ward and spoke to the nurse.
"Why did you send the patient without a hospital dress?" I asked her.
"I asked the doctor" she said "who said it was OK."
"The doctor says she asked you to give the patient hospital dress" I said. "The poor woman is almost naked., that too in front of all people in OT."
"I am new in this ward" she said.
"So what?" I was getting quite angry by then. "You must know hospital routine - giving a dress to a patient is the most basic of nursing care."
"OK. I am sorry" she said.
"But what about the patient on the OT table? She is still almost naked" I said.
"I said sorry, did I not?" she retorted.
I knew I could not improve things any way. After all, I was not involved in the selection process of the employees, nor were they answerable to me. I could just wonder at the coincidence, one patient being unduly clothed and the other hardly at all. Perhaps there was a cruel balance there, positive and negative nullifying errors due to extremes in each other.
